2010 Empire Plan claims due April 30


By LORRAINE SIMPKINS Empire Plan enrollees take note: Time


is running out for filing claims for covered medical services received in 2010. This year, for the first time, you get an


extra 30 days to file. April 30, instead of March 31, is the last day to submit your 2010 claims to:


• United HealthCare for the Empire


Plan Basic Medical Program, the Home Care Advocacy Program (HCAP), and for non-network physical medicine services;


• OptumHealth Behavioral Solutions


for non-network mental health and substance abuse services; and


• Medco for prescriptions filled in


2010 at non-participating pharmacies or without using your Empire Plan Benefit Card. If the Empire Plan is your secondary


insurer, you must submit claims by April 30, or within 120 days after your primary health insurance plan processes your claim, whichever is later. If you are covered under the Empire


Plan as both an enrollee and as a dependent, you may submit secondary claims to the Empire Plan for expenses not reimbursed under your primary coverage – such as copayments (including prescription drug


copayments), deductibles and coinsurance amounts. Claims submitted after the deadline


will be rejected. The carriers will only reconsider their denial of these claims if you provide documentation indicating it was not reasonably possible for you to meet the deadline (for example, due to illness). Ask your agency Health Benefits


Administrator for claim forms, or call the Empire Plan toll-free telephone number 1-877-7NYSHIP (1-877-769-7447). Or just download the forms from the state Department of Civil Service website, www.cs.state.ny.us/ebd/. Select “Using Your Benefits” and then “Forms.” Mail completed claim forms with


supporting bills, receipts and, if applicable, a Medicare Summary Notice or statement from your other primary insurer to:


• United HealthCare P.O. Box 1600 Kingston, NY 12402-1600;


• OptumHealth Behavioral


Solutions P.O. Box 5190 Kingston, NY 12402-5190; or


• Medco Health Solutions P.O. Box 14711 Lexington, KY 40512.


New labor-backed grants assist Union Plus participants


If you are a Union Plus credit card holder and


facing a tough time, you may be entitled to some unique benefits such as layoff assistance, a job loss grant, a furlough grant or mortgage assistance. Members of Union Plus, which is a part of Union Privilege and established by the AFL-CIO, provides


consumer benefits to members and retirees of participating labor unions such as PEF. A financial hardship support and philanthropy program was developed to


provide labor-backed grants, money that does not need to be repaid. For example, if you had a job loss within the last 12 months that has lasted


at least 90 days, and have a Union Plus credit card, you may be eligible for a $250 grant. Or if you are furloughed for at least 15 days, you also may be eligible for a


$250 grant. PEF President Ken Brynien said Union Plus tailors its programs to the needs


and interests of working families. “Union Plus has always supported the labor movement. For families facing


special circumstances, the Union Plus programs may help provide relief.” For more information about the grants, plus free financial counseling services, visit unionplus.org and click on assistance.


— Deborah A. Miles Page 14—The Communicator March 2011 PEF Information Line: 1-800-553-2445 BANKS


Regional post, 5 board seats filled


PEF Region 4 has a new


coordinator and the union also has five new Executive Board members elected in January to fill mid-term vacancies. In April, nominees will be sought to


fill three new vacancies on the board. Meanwhile, Peter


Banks, a nurse 2 at SUNY Upstate Hospital in Syracuse is the new Region 4 coordinator. The new Executive Board members are Dr. Andy Coates, Elizabeth Cheese, Bill Cruz, Barbara Ulmer, and Joe Donahue. Petitioning can


begin April 6 to


nominate candidates to fill the three newest board vacancies. They are: • Seat 95, representing certain


members at University Hospital in Syracuse, including all teaching and research center nurses in the following categories: nurse1; specialty nurses with last names beginning with M-Z; nurse 2 with last names beginning with A-C and T-Z; nurse 3; all remaining titles; and all PS&T titles at SUNY Alfred, Oswego and Cortland. • Seat 155, representing certain


members at the Adirondack Park Agency; and • Seat 275, representing certain


OMH members at Hutchings and Hutchings Children’s and Central NY PCs, and Region 4 members only at Central NY DDSO. Nominating petitions are available


after April 6 at the PEF regional offices. Petitioning will end April 27. If


more than one candidate is certified for a seat, ballots will be mailed May 18 to members of that constituency. The ballots must be returned to the American Arbitration Association by June 9, for counting June 10. Members elected to fill mid-term


vacancies will serve until the regular three-year terms expire July 31, 2012.


—Sherry Halbrook


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24