Page 8 - 2013-14 MFCU benefits & Notices

Members First CU 2013-14

Medical Coverage

Members First Credit Union offers an HRA PPO medical plan to its eligible employees.

PPO Option

 The PPO plan is offered through Blue Cross Blue
Shield of Michigan (BCBSM). “PPO” stands for
Preferred Provider Organization.

 Approximately 95% of the US population is within
reach of a BCBS PPO provider.

 You do not need to choose a Primary Care
Physician (PCP) with a PPO – you may see any
provider you want to see, even a specialist.

 You receive the most benefits when you receive care from participating BCBS PPO providers.
You may see a non-BCBS PPO provider, but your benefits will be reduced and you’ll pay more
out of pocket.

 For a list of BCBSM PPO providers visit www.bcbsm.com or call 800.637.2227

 For a list of BCBS PPO providers outside of the MI visit www.bcbs.com & click Find a Doctor or
Hospital

Additional Plan Information

The medical plan does not have a pre-existing condition limitation.

The plan has a deductible, which is the amount you must pay before the plan begins paying for most
routine or emergency medical care. Click here for HRA reimbursement rules.

Preventive services are covered at 100% in network with no deductible on both plans. The benefit
summaries on the following pages show an abbreviated list of preventive benefits we cover.

Both plans have an out-of-pocket maximum. Once you have spent this out-of-pocket amount on
coinsurance following your deductible, the plan will pay 100% of any medical charge which would
otherwise have a coinsurance for the remainder of the plan year. The plan Summary of Benefits
Coverage (SBC) explains these out of pocket maximum and can be found in this booklet.

Waiver of Medical Coverage – Opt Out Option

You may elect to waive medical coverage from Members First Credit Union if you have and can provide
proof of existing coverage from another source (spouse, parent, etc). When proof of coverage is
provided to Human Resources and validated, you will be eligible to enroll in the dental plan at your cost.
The Opt Out Option provides a monetary subsidy to the eligible employee. Check with Human
Resources for the current amount of the benefit.

Should you suffer a HIPAA status change event, you may be added to Members First Credit Union’s
medical plan mid-year only if notification is given to Human Resources no later than 31 days of the event.
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