Self Funding Health Insurance Definition

The House of Representatives provides Members and employees health care through a self-funded insurance plan provided by BCBSM Community Blue.  A self-funded plan is the preferred term for a group health plan which the employer underwrites the cost of all covered health care services.

Self-funding health insurance is one method of containing benefit costs if you have a younger and healthy group.  In contrast, insurance plans that are premium based include risks provided in area pooling versus actual utilization.  Healthcare premiums have increased on average of 10% per year over the last 5 years due to rising health care costs and the aging population of employees. 

1997 – PENSIONS ELIMINATED

Newly elected House Members and newly hired House employees are no longer eligible for pensions. Both Members and employees are in a 401(k) system.

1997 – LEGISLATIVE RETIREE HEALTH CARE RESTRICTED

House Members must be age 55 before receiving health care upon retiring from the Legislature (if eligible after serving a full three terms).

2011 – LEGISLATIVE RETIREE HEALTH CARE ELIMINATED

Effective October 18, 2011, retiree health care benefits were eliminated for any Legislator who has not completed at least six years of service as a Legislator before January 1, 2013.

2012 – 2017 – 80/20 & HARD CAP COMPLIANCE MET

2018 – 80/20 & HARD CAP COMPLIANCE (PA 152 of 2011)

Coverage Number of Participants PA 152 House Allowable Amount 2018 House Average PA 152 Allowable Total 2018 House Total
Single 181 $6,561 $5,479 $1,187,541 $991,699
Two-Person 95 $13,720 $12,591 $1,303,400 $1,196,145
Family 150 $17,892 $16,103 $2,683,800 $2,415,450

2019 – 80/20 & HARD CAP COMPLIANCE (PA 152 of 2011)

Coverage Number of Participants PA 152 House Allowable Amount 2019 House Average PA 152 Allowable Total 2019 House Total
Single 215 $6,685 $5,736 $1,437,275 $1,233,240
Two-Person 87 $13,981 $13,187 $1,216,347 $1,147,269
Family 140 $18,232 $16,875 $2,552,480 $2,362,500

2020 – 80/20 & HARD CAP COMPLIANCE (PA 152 of 2011)

Coverage Number of Participants PA 152 House Allowable Amount 2020 House Average PA 152 Allowable Total 2020 House Total
Single 191 $7,044 $6,006 $1,345,404 $1,147,146
Two-Person 84 $14,731 $13,813 $1,237,404 $1,160,292
Family 134 $19,211 $17,686 $2,574,274 $2,369,924