Loaded with information this booklet has general information about your various health plan options, a comparison of your health plan options, enrollment forms, important documents like the Creditable Coverage and Privacy Practices Notices and much more.
The University offers a number of medical coverage options: one traditional fee-for-service plan (BCBS), two health maintenance organizations (BCN and HAP), one preferred provider plan (DMC Care) and two Medicare Advantage plans (Aetna Medicare Plan (PPO) and HAP Senior Plus – an HMO). The options differ in the benefit levels they provide, the doctors and hospitals you can use, and the cost.
If You are Retiring
To retire from WSU, you must have attained age 55 and have 10 years of service with the university or 5 years of university contribution in the retirement program. If you are retiring, you may choose to continue coverage with your current medical insurance plan by completing the Retiree Benefit Continuation Form found at on the TCW Forms page under the heading “Retiring from University Service”. This form should be returned to Total Compensation & Wellness via mail or faxed to 313-577-0637 at least two weeks prior to your retirement date.
Retiree medical insurance rates apply beginning the first of the month following your date of retirement. (Please note, if you are 9-month faculty retiring at the end of the Winter Semester in May, the retiree rate will apply beginning September 1.) You will be billed monthly for your premium by our billing agent, Automated Benefit Services (ABS).
If you are age 65 or over, please apply for Medicare Part B (Medical Insurance) at your nearest Social Security Office two to three months before your date of retirement. The Social Security Office may give you a form to be completed by your employer to verify your retirement and your medical insurance status. Please mail or fax this form to Total Compensation & Wellness. If we have a copy of your letter of retirement at the time we receive your form, we will be happy to complete the form for you and return it to you for delivery to your nearest Social Security Office. Please remember to send or fax us a copy of your Medicare card showing Hospital Insurance and Medical Insurance when you receive it. We need a copy of your Medicare card to properly invoice you.
Once you have Medicare, please remember that Medicare will be your primary insurance and your coverage through Wayne State University will be secondary. For services the first month after your date of retirement, you will want to show both your Medicare and your medical insurance card to your health care providers. It will make a difference in how they submit your claims.
If You are Already Retired
If you are already retired and turning age 65, we provide you with an opportunity to re-evaluate your university medical insurance coverage. You may change to any of the other university medical insurance plans. If you choose to enroll in Blue Cross Blue Shield, Blue Care Network, Health Alliance Plan or DMC Care, please complete the enrollment form found in the Retiree/LTD/Surviving Spouse Benefits Handbook. If you choose to enroll in HAP Senior Plus, please complete the HAP Senior Plus enrollment form on page 45 of the handbook. Once completed, your enrollment form must be returned to our office. Your new coverage will become effective on the first of the month of your 65th birthday. Please be sure to also provide us with a copy of your Medicare card.
If you wish to enroll in Aetna Medicare Plan (PPO), please complete the enrollment form in the Retiree/LTD/Surviving Spouse Benefits Handbook and send the form directly to Aetna at P.O. Box 14088 Lexington, KY 40512-4088.
If you and your spouse are enrolling in either HAP Senior Plus or Aetna Medicare Plan (PPO), you must both be Medicare eligible and each person must complete a separate enrollment form. TheRetiree/LTD/Surviving Spouse Benefits Handbook provides two enrollment forms for these plans. Please remember if you cover your spouse on your university medical insurance plan and he/she is under age 65, neither HAP Senior Plus nor Aetna Medicare Plan (PPO) will be available to you until you are both Medicare eligible.
If you are enrolling in Aetna Medicare Plan (PPO), you will receive your monthly invoice directly from Aetna.
If you decide to terminate your BCBS, BCN, HAP, HAP Senior Plus or DMC Care medical insurance coverage through Wayne State University, you must send a letter to Total Compensation & Wellness, Wayne State University, 5700 Cass Avenue, Suite 3638, Detroit, MI 48202 or complete the Medical Plan Termination Form in the Retiree/LTD/Surviving Spouse Benefits Handbook. Your insurance will be canceled at the end of the month in which we receive your note. To terminate Aetna Medicare Plan (PPO) coverage, you must communicate your intentions directly to Aetna.
If you no longer have medical insurance coverage through Wayne State University and you are a retiree, you can re-enroll in any of the plans following normal enrollment rules.
If you have any questions, or we can provide any assistance, please contact our office at 313-577-3717.