 Out-of-pocket costs going up
for Empire Plan enrollees Jan. 1
If you’re in the state’s Empire Plan, look for
these changes in enrollees’ expenses starting
January 1 that were authorized in the 1999-2003 PS&T
contract:
• $12 copayment — The copayment increases from
$10 to $12 for services by Empire Plan participating
providers, Managed Physical Network (MPN) providers and
ValueOptions network providers for outpatient
substance-abuse treatment and for physical therapy in a
hospital outpatient department;
• Basic Medical deductible — The annual
deductible increases from $271 to $283 under the Empire
Plan’s Basic Medical Program for medical services
performed and supplies prescribed by non-participating
providers; and
• Basic Medical coinsurance maximum — The
annual coinsurance maximum for out-of-pocket expenses
under the Empire Plan’s Basic Medical Program
increases from $1,303 to $1,362.
The changes to the deductible and coinsurance maximum are
the result of a 4.5 percent increase in the medical
component of the Consumer Price Index for Workers (CPI-W)
for the period of July 1, 2001, through June 30, 2002.
— Lorraine Simpkins
Aetna HMO of
Connecticut unavailable
Some HMO options changing
PS&T employees enrolled in the Aetna HMO plan of
Connecticut will have to choose another option for the
year 2003.
If you live in Connecticut and wish to remain in
Aetna’s HMO plan, you will have to enroll in the
Aetna HMO plan of New York, select a primary care
physician located in New York and receive all medical
services in New York.
The Joint Labor/Management Committees on Health Benefits
(JLMC) have reviewed proposals submitted by HMOs for
inclusion or continued participation in the New York
State Health Insurance Program (NYSHIP). The JLMC limited
new HMO requests for inclusion in NYSHIP, as well as
expansion requests from those already participating, to
five counties deemed underserved — Franklin,
Schuyler, St. Lawrence and Tompkins.
However, the JLMC did not receive any proposals from HMOs
requesting inclusion in NYSHIP or expansion into one of
these underserved counties. With the exception of Aetna
HMO plan of Connecticut, all of the HMOs currently
participating in NYSHIP will continue to be offered in
2003.
HMO-CNY (Central New York) and Univera Healthcare-CNY
have combined with Excellus Health Plan, resulting in a
change in names. These options will now be called
“HMOBlue.”
If you are enrolled in an HMO making a benefit change for
2003, you will be sent a side-by-side benefit comparison
by November 1.
Premium rate information for 2003 is not yet available.
Please be sure to review the rate flyer carefully, HMO
premium contributions may increase significantly from
year to year. — Lorraine Simpkins
Enroll by Nov.
15 in HCSA, DCAA
Time is running out to enroll in the Health Care Spending
Account (HCSAccount) for 2003. The deadline for
enrollment is November 15.
If you had more than $150 in out-of-pocket medical,
dental and vision costs last year, you could probably
save money by enrolling in HCSAccount for 2003 and paying
for next year’s expenses with pre-tax dollars.
To enroll by phone, call 1-800-358-7202 and a customer
service representative will take your information.
Or enroll on-line at www.flexspend.state.ny.us. This site also has information
about Dependent Care Advantage Accounts, another great
way to save money. — Deborah Stayman
 GO TO HEALTH BENEFITS WEBSITE
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