Schedule B - Pricing.xlsx
XLSX spreadsheet 19 KB Posted
- Attached to
- HMO Services for MPSERS
- Solicitation number
- RFP-171-190000002803-2
- Issued by
- Michigan
About this file
Schedule B - Pricing.xlsx is a rate document for the Michigan Public School Employees Retirement System (MPSERS) HMO health insurance program covering the calendar year 2020. The document presents premium rates for self, spouse, and child coverage, distinguishing between scenarios with and without the Affordable Care Act (ACA) health insurer fee.
The pricing schedule provides two sets of monthly premium rates: one assuming a waiver of the ACA health insurer fee and another incorporating the fee. For individuals without Medicare, self coverage ranges from $682.32 to $686.00, spouse coverage from $566.04 to $569.10, and per child coverage from $171.04 to $171.97. For Medicare participants, rates are significantly lower, with self coverage ranging from $131.21 to $143.94. The document specifies that the Plan Sponsor will pay rates in the "With ACA Health Insurer Fee" column if the fee is in place, and switch to the "Assuming Waiver of ACA Health Insurer Fee" column if the fee is waived, with provisions for correcting past and future rate payments.
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Text version
2020 HMO Rates
MPSERS HMO Premium Rates Effective: 1/1/2020 - 12/31/2020
| Without Medicare | ||
| Assuming Waiver of ACA Health Insurer Fee | With ACA health insurer fee | |
| Self | $ 682.32 | $ 686.00 |
| Spouse | $ 566.04 | $ 569.10 |
| Per Child | $ 171.04 | $ 171.97 |
| With Medicare | ||
| Assuming Waiver of ACA Health Insurer Fee | With ACA health insurer fee | |
| Self | $ 131.21 | $ 143.94 |
| Spouse | $ 113.68 | $ 126.22 |
| Per Child | $ 128.04 | $ 140.59 |
Note: Two sets of rates have been developed which takes into consideration whether the HMO will be subject to a fee pursuant to Section 9010 of the Patient Protection and Affordable Care Act (ACA). If the fee is in place, Plan Sponsor will pay the rates in the “With ACA Health Insurer Fee” column in order to cover the cost of the fee. If at any point the fee is waived, Plan Sponsor will pay the rates in the “Assuming Waiver of ACA Health Insurer Fee” column. This includes correcting rate payments going forward as well as recovering from Contractor overpayments made in order to cover the expected fee.
File details come from the government source that posted it. Updated .