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 – 2019 – 80/20 & HARD CAP COMPLIANCE MET

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

2021 – 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 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