Timothy’s Law boosts mental health coverage
By now, you should have received any retroactive benefit adjustments as a
result of Timothy’s Law to your claims
for mental health services.
The state’s enactment of the law in 2006 changed coverage requirements for
mental health benefits in group health plans, including the Empire Plan and
NYSHIP HMOs, effective January 1 of this year.
Timothy’s Law requires that health plans provide for no less than 30 days of
inpatient care and 20 days of outpatient care for the diagnosis and treatment of
mental, nervous or emotional disorders. The law does not affect substance abuse
benefits.
For the most part, network-level benefits provided under the Empire Plan Managed
Mental Health and Substance Abuse Program already met or exceed those required
by Timothy’s Law. However, the law also requires that these benefits be covered
to the same extent for services from non-network providers.
Empire Plan changes to meet this requirement are retroactive to January 1.
If you have a question about your Empire Plan benefits and Timothy’s Law, call
1-877-7-NYSHIP (1-877-769-7447), and select Option 3.
HMO enrollees who have questions about the effect of Timothy’s Law on their
benefits should contact their HMOs directly.
— Deborah Stayman
Health refunds to be mailed in
July
Refunds will be paid in July to PS&T employees and retirees whose NYS health
insurance premiums were improperly inflated by the cost of a Medicare Part B
component from January 2006, through March 2007.
These refunds, which result from the settlement of a lawsuit brought by PEF and
other unions, will go to Empire Plan enrollees and to HMO enrollees whose
premiums did not exceed those of the Empire Plan during the affected period.
The amount of your refund will depend on which health plan you were in, whether
you had individual or family coverage, and whether you were paying premiums for
the entire period or just part of it. Since most employees’ premiums are paid
with pre-tax dollars, taxes will be withheld from their refunds.
The refunds for employees on the institution payroll will be added to paychecks
for July 19. Those on the administration payroll will receive their refunds in
the July 25 check. Refunds will be added to retirees’ pension checks for July
31. And teachers who do not receive paychecks in July or August will receive
their refunds in their first September paycheck.
— Sherry Halbrook
The Communicator
July/August 07
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