2011 Elfun Medical/Dental Benefits

The Elfun Medical Benefits Plan Committee has completed our annual review with United Health Care, the plan administrator.  The review included examination of current and projected premium income, claims payments, financial status, administration expenses, cost trends and other relevant data.  As most participants know, the plan is self-supporting -- monthly premiums paid by participants fund all benefit payments and plan expenses.

In 2010, participation increased slightly to 23,175 people from 22,975 last year.  We expect stable participation levels next year and for the foreseeable future.

The Committee has approved keeping the 2011 monthly premium rate at $135 per participant.  This decision reflects the generally favorable claims experience we have had this year, our projections for 2011, and the status of the plan’s financial reserves.

Rising medical costs significantly affect a plan like ours which typically pays 80% of covered after-deductible expenses that are not paid by Medicare and the basic GE plans.  Because we have had a better-than-expected year in 2010, we are able to hold the premium at the same level.  We believe the 2011 premium rate will allow us to continue the excellent level of protection for plan members, maintain the plan’s financial stability, and help to sustain the plan for the longer term.

The Elfun Medical Benefits Plan’s (EMBP) objective is to provide comprehensive coverage (after plan deductibles) for hospital, physician, and prescription drug charges not reimbursed through Medicare Parts A and B and the basic GE post-65 hospitalization and drug plans.   The plan’s $2,000 annual out-of-pocket maximum provides excellent protection against the high cost of care for more serious illnesses.  EMBP requires that participants have coverage under Medicare Parts A and B, the GE Medical Care Plan for Pensioners, and the GE Pensioner Prescription Drug Plan.  The plan also offers coverage for many services not provided under the basic GE plans, including prescription drug benefits, dental preventive care benefits and medical services received outside the United States.  These extra coverages, which exceed and add to those available in the basic GE plans, offer valuable benefits for our members.  Of course, the cost for these added protections is reflected in the plan premium.

Costs for the plan and related administrative expenses are paid through premiums charged to plan participants.  The monthly premium for 2011 will be maintained at $135 per covered person.  

If you have questions about the plan, please call the GE Pensioner Benefits Claims Center at 1-800-848-8406.

Click here for Elfun Medical Benefits Plan Highlights

Click here for Dental Claims Processing Guide

Click here for the 2011 Medical/Dental Claim Form