State Health Plan PPO
Blue Cross Blue Shield
of Michigan (Blue Cross)
Customer Service: 800-843-4876
www.bcbsm.com/som
Behavioral Health/Substance Use Disorder (BH/SUD) Administrator for the State Health Plan PPO
Blue Cross Blue Shield
of Michigan (Blue Cross)
866-503-3158
www.bcbsm.com/som
Optum Rx (SHP PPO)
www.optumrx.com/SOM
Specialty Pharmacy FAQs
Active Employee Copay Structure
Active Employees and Non-Medicare Retirees
866-633-6433
Medicare Eligible Retirees
866-635-5941
C.O.P.S. Health Trust
(MSPTA-represented only)
800-229-2210
248-524-0454
Fax: 248-524-2752
https://copstrust.com/mspta/
Find a Doctor
C.O.P.S. Health Trust Plan Comparison Chart
C.O.P.S. Health Trust Plan Summaries C.O.P.S. Health Trust Rx Copay Structures C.O.P.S. Health Trust Formularies C.O.P.S. Health Trust Plan 2 Health Saving Account
State HDHP with HSA
Blue Cross Blue Shield
of Michigan (Blue Cross)
Customer Service: 800-843-4876
www.bcbsm.com/som
CY25 State HDHP with HSA Benefit Booklet
CY25 State HDHP with HSA Benefits-at-a-Glance
CY24 State HDHP with HSA Benefit Booklet
CY24 State HDHP with HSA Benefits-at-a-Glance
Behavioral Health/Substance Use Disorder (BH/SUD) Administrator for the State HDHP
Blue Cross Blue Shield
of Michigan (Blue Cross)
866-503-3158
www.bcbsm.com/som
Optum Rx (State HDHP with HSA)
www.optumrx.com/SOM
Copay Structure
Active Employees
866-633-6433
HealthEquity Health Savings Account (HSA)
877-284-9840
Log in at www.bcbsm.com/som to manage your HSA from HealthEquity.
Blue Care Network
Customer Service: 800-662-6667
www.bcbsm.com/som
Health Alliance Plan (HAP)
800-422-4641
www.hap.org/som
To determine individual eligibility for HMO health plans, use the HMO ZIP Code Tool.
CY25 HMO ZIP Code Coverage Maps:
CY24 HMO ZIP Code Coverage Maps:
Delta Dental of Michigan
800-524-0150
www.deltadentalmi.com/som
CY25 State Dental Plan
Active and MSPTA Plan Booklet
Dental Plan Comparison Chart
CY25 Preventive Dental Plan
Plan Booklet
CY24 State Dental Plan
Active and MSPTA Plan Booklet
Dental Plan Comparison Chart
CY24 Preventive Dental Plan
Plan Booklet
Flexible Savings Account (FSA)
Health Care & Dependent Care
www.healthequity.com
877-924-3967
Select Login in the upper-right corner, then EZ Receipts, then Members|For Individuals from the drop-down menu.
Eligible Expenses:
Note: The HealthEquity|WageWorks platform has been rebranded to EZReceipts. You will be seeing co-branding across their web platforms and resources, including www.healthequity.com, the member portal, emails, and other materials.
Long Term Disability (LTD)
Sedgwick
800-324-9901
Employee & Dependent Life Insurance
Securian Financial Group, Inc.
Underwritten by Minnesota Life Insurance Company
877-867-5781
Note: These booklets are not a contract. Rather, they are intended to be a summary description of benefits. Every effort has been made to ensure the accuracy of this information. However, if statements in this description differ from the applicable coverage documents, then the terms and conditions of those documents will prevail.
