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MI AUTO NO-FAULT CHANGES

RELATED TO YOUR HEALTH PLAN BENEFITS

As Michigan Auto No-Fault Insurance is changing in early July, the following is an excerpt from the 2020 Ave Maria Foundation Health Plan Summary/Wrap Document as it relates to health coverage and coordination with automobile insurance. Please refer to this document when when making your automobile insurance selections. Discussion with your insurance agent is advisable.

"Coordination with Automobile Insurance - If an individual owns and operates a motor vehicle on the public highways as defined in the law, the individual is required to carry no-fault insurance in states where no-fault laws apply. Basic no-fault insurance Personal Injury Protection ("PIP") covers all necessary medical and certain rehabilitation expenses the individual may incur in the event the individual is injured in an automobile accident. In the event you choose PIP coverage with a dollar limit (rather than "unlimited" PIP coverage), then PIP covers all necessary medical and certain rehabilitation expenses but only up to the chosen PIP limit.

If PIP coverage is coordinated with the group medical coverage then this Plan pays first, and then the PIP coverage applies up to the PIP limit, as discussed further below. When you purchase "coordinated" PIP coverage, meaning the coverage coordinates with other health or disability coverage you have, this may reduce your PIP premium. Note that Medicaid and Medicare, and some self-funded group health plans do not allow coordination with PIP coverage.

The BCBSM-insured coverage under the Plan coordinates its coverage with no­-fault automobile insurance.

The BCN-insured coverage under the Plan will coordinate its coverage with no­-fault automobile insurance if the Participant has a coordinated no-fault insurance policy. In this case, BCN will assume primary liability for Covered Services. The no-fault automobile insurance would be secondary. If the Participant has coverage through a non-coordinated no-fault automobile insurance policy, then the automobile insurance will be considered the primary plan. BCN would pay Coverage under the Plan secondary.

If a Participant is injured while riding a motorcycle due to an accident with an automobile, then the automobile insurance for the involved automobile is primary for the Participant's medical services. BCN would provide for Covered Services under the Plan secondary.

If a Participant is injured in a motorcycle accident that does not involve an automobile and if the motorcycle insurance plan provides medical coverage, then the motorcycle insurance plan is primary. BCN would pay for Covered Services under the Plan secondary.

If the motorcycle insurance does not provide medical coverage, or if that medical coverage is exhausted, then BCN will pay for Covered Services under the Plan as the primary. Participants who ride a motorcycle without a helmet are required by Michigan State law to purchase medical coverage through their motorcycle insurance plan, and BCN will pay secondary.

Services and treatment for any work-related injury that are paid, payable or required to be provided under any workers' compensation law or program will not be paid by BCN.

If any such services are paid or provided by BCN, BCN has the right to seek reimbursement from the other program, insurer or Participant who has received reimbursement.

Applicable BCN Preauthorization and Coverage requirements (i.e. seeking services from a Participating Provider except for Emergent situations) must always be followed for auto or work-related injuries. Failure to follow applicable Preauthorization and or Coverage requirements may leave you solely responsible for the cost of any services received.

If the individual does not have no-fault insurance on the individual's vehicle when no-fault insurance is required and the individual is injured while riding in or driving the vehicle, benefits under the Plan will be primary. In states that do not require no-fault insurance, if the individual does not have no-fault insurance on the individual's vehicle and the individual is injured while riding in or driving the vehicle, benefits under the Plan will be primary.

If an individual is involved in an accident as a non-owner operator or a passenger or a pedestrian, the Plan will provide coverage for the individual's medical expenses only to the extent any coverage provided under any available automobile insurance is insufficient to pay all of the individual's medical expenses and only up to the maximum benefits provided under the Plan."

If you would like to read the complete 2020 Ave Maria Foundation Health Plan Summary/Wrap Document please click on the following link:

• 2020 Health Plan Wrap Document, Ave Maria Health Plan

FYI: The 2020 Health Plan Wrap Document is always available online on the Medical Benefits tab, then located in "Information" at the bottom of the medical benefits page.