Carriers and Benefit Plans

State Health Plan PPO
Blue Cross Blue Shield
of Michigan (Blue Cross)
Customer Service: 800-843-4876
www.bcbsm.com/som

• CY26 Plan Summary
• CY25 Plan Summary
• Guide: Navigating the Blue Cross Find-a-Doctor Tool
• Find a Doctor

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

• CY26 Active Employee & Non-Medicare Retiree Formulary (1/1/26–6/30/26)
• CY25 Active Employee & Non-Medicare Retiree Formulary (7/1/25–12/31/25)
• CY25 Active Employee & Non-Medicare Retiree Formulary (1/1/25–6/30/25)

Medicare Eligible Retirees
866-635-5941

• CY25 Medicare-Eligible Retiree Formulary
• CY25 Medicare-Eligible Wrap Coverage Drug List
• CY24 Medicare-Eligible Retiree Formulary
• CY24 Medicare-Eligible Wrap Coverage Drug List

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

• CY26 C.O.P.S. Health Trust Plan Comparison Chart
• CY25 C.O.P.S. Health Trust Plan Comparison Chart

C.O.P.S. Health Trust Plan Summaries

• CY26 C.O.P.S. Health Trust Plan 1
• CY26 C.O.P.S. Health Trust Plan 2
• CY26 C.O.P.S. Health Trust Plan 3
• CY26 C.O.P.S. Health Trust Plan 4

• CY25 C.O.P.S. Health Trust Plan 1
• CY25 C.O.P.S. Health Trust Plan 2
• CY25 C.O.P.S. Health Trust Plan 3
• CY25 C.O.P.S. Health Trust Plan 4

• CY25 C.O.P.S. Health Trust Plans 1 - 4 Rx Copays
• CY24 C.O.P.S. Health Trust Plans 1 - 4 Rx Copays

• CY26 C.O.P.S. Health Trust Plan 1 - 4 Formulary
• CY25 C.O.P.S. Health Trust Plan 1 - 4 Formulary

• C.O.P.S. Health Trust Plan 2 Health Savings Account (HSA)

• CY26 Health Plan Comparison Chart
• CY25 Health Plan Comparison Chart

To determine individual eligibility for HMO health plans, use the HMO ZIP Code Tool.

CY26 HMO ZIP Code Coverage Maps:

• Blue Care Network (BCN)
• Health Alliance Plan (HAP)

CY25 HMO ZIP Code Coverage Maps:

• Blue Care Network (BCN)
• Health Alliance Plan (HAP)

Delta Dental of Michigan
800-524-0150
www.deltadentalmi.com/som

CY26 State Dental Plan
Active and MSPTA Plan Booklet
Dental Plan Comparison Chart

CY26 Preventive Dental Plan
Plan Booklet

CY25 State Dental Plan
Active and MSPTA Plan Booklet
Dental Plan Comparison Chart

CY25 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.

www.mi.gov/fsa

Eligible Expenses:

• General Purpose Health Care FSA
• Limited Purpose Health Care FSA
• Dependent Care FSA
   

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.