HCTC PLANS AND RATES

GREAT NEWS!  The Health Coverage Tax Credit (HCTC) program has been reauthorized for 2021 and the HCTC AMP program will begin providing the MONTHLY 72.5% subsidy to eligible participants that have returned the NEWLY RELEASED and UPDATED 13441A form to Benistar either by fax (860)409.9010 or by email memelig@benistar.com.  The monthly program begins again on February 1, 2021, following a brief termination.  The recent reauthorization of the program by Congress is for 1 year and now set to expire December 31, 2021.  As the AMP program begins, the IRS/HCTC has informed us they will be requiring ALL HCTC AMP participants to complete a NEW 13441A form.  This is a mandatory action each individual and each family must take, in order to participate in the AMP program for 2021.

If you fail to complete and return a new 13441A form to Benistar, you will not be eligible to a=participate in the AMP program.

The Special Open Enrollment Period will run 01/06/21- 01/22/21.  If you intend on making a change, during this Special Open Enrollment period, to your 2021 BCBSM plan level or if you terminated your BCBSM insurance at the end of 2020 and would like to re-enroll, please complete the Pre-65 BCBSM Enrollment form and check "HCTC Enrollment or Change" box.  If you do not wish to make any plan changes for 2021 during this Special Open Enrollment Period, you do not need to complete the Pre-65 BCBSM Enrollment form buy you do need to complete the newly issued 13441A Form.

The IRS/HCTC will not accept 13441A forms directly from members, you must send the completed newly released 13441A form to Benistar.  Benistar will review the forms for errors and will work with you to correct any information if necessary.  Benistar will forward your form to the IRS/HCTC on your behalf along with your updated insurance information.

Once the IRS/HCTC AMP program receives and approves your enrollment/re-enrollment into the AMP program, they will send you a re-enrollment letter, welcoming you back into the program.  You will then be able to make your 27.5% monthly premium payment directly to the IRS.  You must include the voucher with your check when sending in your premium payment.  IRS/HCTC PIN numbers will remain the same for participants enrolled in previous years.

To ensure you receive the HCTC AMP for February, Benistar should receive your 13441A form by January 20.  After January 20, the IRS may not have time to process your form in time for a February AMP start which means you will begin making 27.5% payments in March.  You can also elect for a March 1st AMP start date if you wish.  It is recommended that you fax or email your forms to Benistar.  The undated 13441A sample forms are available under the forms tab.  If you need assistance in completing these forms or need anything else, please contact Benistar.  

Benistar Phone Number:  1(800) 236.4782

Benistar Fax Number:  1(860) 409.9010

Email:  memelig@benistar.com

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1(800)236-4782

 Dental and Vision Benefit information for Gold, Silver, Bronze and Copper Plans 

Dental Plan
Network  Access Information
 
With Blue Dental PPO Plus, members can choose any licensed dentist anywhere . However, they'll save the most money when they choose a dentist who is a member of the Blue Dental PPO network.
Blue Dental PPO Network
Blue Dental members have unmatched access to PPO dentists through the Blue Dental PPO network, which offers more than 260,000 dentist locations nationwide.  PPO dentists agree to accept our approved  amount as full payment for covered services - members pay only their applicable coinsurance and deductible amounts.  Members also receive discounts on noncovered services when they use PPO dentists  (in states where permitted by law). To find a PPO dentist  near you, please visit mibluedentist.com  or call 1-888-826-8152.
1 Blue Dental uses the Dental Network of America (DNoA) Preferred Network for its dental plans.
2 A dentist location is any place a member can see a dentist to receive high-quality dental care. For example, one dentist practicing in two offices would be two dentist  locations.
Blue Par SelectSM Arrangement 
Most non-PPO dentists accept our Blue Par Select arrangement, which means they participate with the Blues on a "per claim" basis. Members should ask their dentists if they participate with BCBSM before every treatment.  Blue Par Select dentists accept our approved amount as full payment for covered services - members pay only applicable coinsurance and deductibles . To find a dentist who may participate with BCBSM, please visit mibluedentist.com.
 Note: Members who go to nonparticipating dentists are responsible for any difference between our approved amount and the dentist's charge.
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Like most group benefit programs, benefit programs offered by Blue Cross Blue Shield, and its affiliates contain certain exclusions, exceptions, reductions, limitations, waiting periods, and terms for keeping them in force. Please contact Blue Cross Blue Shield or the Benistar Retiree Service Center for costs and complete details. 1-800-236-4782

Vision Plan

Vision Benefit Information

Blue Vision benefits are provided by Vision Service Plan (VSP), the largest provider of vision care in the nation. VSP is an independent company providing vision benefit services for Blues members. To find a VSP doctor, call 1-800-877-7195 or log on to the VSP Web site at vsp.com. 

Note: Members may choose between prescription glasses  (lenses and frame) or contact lenses, but not both.

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PRE 65 DENTAL AND VISION RATES
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