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 – 2020 – 80/20 & HARD CAP COMPLIANCE MET
2021 – 80/20 & HARD CAP COMPLIANCE (PA 152 of 2011)
| Coverage | Number of Participants | PA 152 House Allowable Amount | 2021 House Average | PA 152 Allowable Total | 2021 House Total |
|---|---|---|---|---|---|
| Single | 185 | $7,304 | $6,573 | $1,351,240 | $1,216,005 |
| Two-Person | 98 | $15,276 | $15,128 | $1,497,048 | $1,482,544 |
| Family | 135 | $19,921 | $19,387 | $2,689,335 | $2,617,245 |
2022 – 80/20 & HARD CAP COMPLIANCE (PA 152 of 2011)
| Coverage | Number of Participants | PA 152 House Allowable Amount | 2022 House Average | PA 152 Allowable Total | 2022 House Total |
|---|---|---|---|---|---|
| Single | 187 | $7,399 | $6,573 | $1,383,613 | $1,229,151 |
| Two-Person | 105 | $15,474 | $15,128 | $1,624,770 | $1,588,440 |
| Family | 122 | $20,180 | $19,387 | $2,461,960 | $2,365,214 |
2023 – 80/20 & HARD CAP COMPLIANCE (PA 152 of 2011)
| Coverage | Number of Participants | PA 152 House Allowable Amount | 2023 House Average | PA 152 Allowable Total | 2023 House Total |
|---|---|---|---|---|---|
| Single | 204 | $7,703 | $6,573 | $1,571,412 | $1,340,892 |
| Two-Person | 114 | $16,109 | $15,128 | $1,836,426 | $1,724,592 |
| Family | 124 | $21,008 | $19,387 | $2,604,992 | $2,403,988 |