Health Notes


Picking your health plan? It’s about more than just the premium


By LORRAINE SIMPKINS The end of the year is traditionally


the time to decide in which health benefit programs you want to enroll or change for the coming year. With health care costs rising, it’s


more important than ever to choose your benefits wisely. Follow these pointers to help you prepare for the annual Option Transfer Period. 1. Know what health benefit


programs are available to you – The annual Option Transfer Period is your opportunity to enroll in or change your enrollment in the following health benefit programs: • New York State Health Insurance


Program (NYSHIP) – You will need to decide which option you want: The Empire Plan or a NYSHIP-approved Health Maintenance Organization (HMO) serving the geographic area where you live or work; • Health Care Spending Account –


HCSA lets you set aside up to $2,500 ($100 minimum) in pre-tax salary to pay for health-related expenses not reimbursed by your health insurance or any other benefit plan (Open enrollment ends November 9); • Productivity Enhancement


Program – PEP lets eligible full- and part-time employees forfeit vacation and/or personal leave in exchange for a reduction in their biweekly insurance premium; • Pre-Tax Contribution Program –


PTCP lets you pay your health insurance premium on a pre-tax basis,


which may lower your taxes. Under IRS regulations, if you’re enrolled in this program, you can’t change your health insurance deduction until next year’s annual Option Transfer Period unless you experience a major life change such as getting married or divorced, or having a child; and • Opt-out Program – This lets


eligible employees opt-out of NYSHIP in exchange for an annual incentive payment of $1,000 for individual coverage and $3,000 for family coverage. You must already be in NYSHIP to opt out of it. 2. Get option transfer information


– The state was expected to mail the publication Planning for Option Transfer to you in late October. It provides information about the health benefit programs available to you and important dates. Ask your agency health benefits


administrator to give you Choices for 2013, your guide to NYSHIP health insurance options. When 2013 rates are approved,


information about the cost of each option will be mailed to your home. All option-transfer information will


be posted on the state Department of Civil Service website at www.cs.ny.gov. From the home page, choose Benefit Programs. Follow the prompts to access NYSHIP Online and then select Health Benefits & Option Transfer. 3. Set aside time – Take time to


read the option transfer materials. They Wondering what EmblemHealth is?


If you are among the PEF members who have been wondering why the name “EmblemHealth” has been coming up in relation to dental benefits, here’s your answer. The GHI Preferred Dental Plan is


now called the EmblemHealth Preferred Dental Plan. All benefits remain the same. The toll-free phone number (800-947-0101) is also the same. EmblemHealth is a for-profit


Page 14—The Communicator November 2012


health maintenance organization (HMO) and health insurance company based in New York City. It was formed in 2006 by the merger of Group Health Incorporated (GHI) and HIP Health Plan of New York. – Deborah Stayman


will give you the information you need to


decide which plan will best suit you and your family in 2013. Take time to understand how each plan works. Determine if the providers you and your family use are in the plan’s network. If you take prescription medication, find out if it’s covered and what your copay for it will be. 4. Look at


more than just the premium – Looking only at how much money would be deducted from your paycheck is not a good way to choose a health plan. For example, paying low monthly premiums could mean you’ll face higher copayments and/or higher deductibles. Look for access to the care you need and want for the least cost to you. Use the NYSHIP Plan Comparison


tool on the Civil Service website (see instructions above) to estimate what your out-of-pocket costs will be under each plan. Also look for any limitations on your benefits such as a maximum number of visits that are covered. 5. What’s Changing? – If you decide


to stick with the same health plan you have now, look for differences between this year’s costs and benefits and those for next year. In addition to premiums changing, out-of-pocket costs and prescription drug formularies often change from one year to the next. 6. Know your deadlines – If you


intend to enroll in a program or make any changes from last year, be sure to take action before the deadline. Missing a deadline could be a very costly mistake. 7. Do you need more information?


– Ask your agency health benefits administrator for help if you have any questions about your health plan, the options available to you, enrollment instructions or deadlines.


PEF Information Line: 1-800-553-2445


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  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32