Page 5 - Gerald R Ford International Airport Authority 2022 Benefits Guide

Medical and pharmacy plan overview

We offer the choice of two medical plans through BlueCross BlueShield of Michigan (BCBSM). Both of the medical
options include coverage for prescription drugs. To select the plan that best suits your family, you should consider
the key differences between the plans, the cost of coverage (including payroll deductions), and how the plan covers
services throughout the year.

Understanding how your plan works

1. Your deductible 2. Your coverage 3. Your out-of-pocket maximum
You pay out-of-pocket for most Once your deductible is met, you and When you reach your out-of-pocket
medical and pharmacy expenses, the plan share the cost of covered maximum, the plan pays 100% of
except those with a copay, until you medical and pharmacy expenses covered medical and pharmacy
reach the deductible. with coinsurance. The plan will pay a expenses for the rest of the plan year.
You can pay for these expenses from percentage of each eligible expense, Your deductible and coinsurance apply
your Health Savings Account (HSA), and you will pay the rest after deductible toward the out-of-pocket maximum
or flexible spending account if you are is met. For the BCBSM HDHP w/HSA eligible health care expenses.
enrolled in the BCBSM PPO Plan. is paid at 100% with the exception of
prescription copays.

PPO embedded deductibles and HDHP aggregate deductibles and
out-of-pocket maximum. out-of-pocket maximum.
Example Employee Only: Example Employee Only:
● $250 deductible (employee responsibility) ● $1,400 deductible (employee responsibility)
● 80% coinsurance BCBSM / 20% coinsurance ● 100% coinsurance BCBSM / 0% coinsurance
(employee responsibility) (employee responsibility)
● $1,250 out-of-pocket maximum (employee ● $2,250 out-of-pocket maximum (employee
responsibility, and includes deductible, coinsurance, responsibility, and includes deductible, coinsurance,
and copays) and copays)

Example Family: Example Family:
● $500 deductible (employee responsibility) two or ● $2,800 deductible (family responsibility) one or
more members meeting $250 individual deductible more members can meet the full family deductible

● 80% coinsurance BCBSM / 20% coinsurance ● 100% coinsurance BCBSM / 0% coinsurance
(family responsibility) two or more members (family responsibility) one or more members meet
● $1,250 out-of-pocket maximum (family responsibility, full family coinsurance
and includes deductible, coinsurance, and copays) ● $4,500 out-of-pocket maximum (family responsibility,
two or more members meeting individual and includes deductible, coinsurance, and copays)
out-of-pocket maximum one or more members meet can meet the full family
out-of-pocket maximum

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