Non-par
providers will cost moreIf you’re in the Empire Plan, you know that, with a few exceptions, you must first satisfy an annual deductible before you receive reimbursement for services performed by a non-participating (non-par) provider.
You are also responsible for paying 20 percent of covered charges until you reach the annual coinsurance maximum.
The amount of the deductible and coinsurance maximum are adjusted January 1 of each year to reflect changes in health care costs as measured by the medical component of the national Consumer Price Index for Workers (CPI-W) for the 12-month period ending the previous June 30.
This time, that component increased 4.1 percent.
Beginning January 1, 2008, the following Empire Plan changes are anticipated:
• Basic Medical Deductible: The Empire Plan Basic Medical Program annual deductible for medical services performed and supplies dispensed by non-par providers increases from $335 to $349.
• Basic Medical Coinsurance Maximum: The annual coinsurance maximum under the Empire Plan Basic Medical Program increases from $1,610 to $1,676. Once you reach the maximum, the plan will pay 100 percent of the total charge or the “reasonable and customary” charge, whichever is less.
— Lorraine Simpkins
Deadlines ahead for ’08 benefit choices
- November 16 is the last day to enroll in the Health Care Spending Account (HCSAccount) for 2008. The HCSAccount allows you to set aside $100 to $4,000 in pre-tax salary to reimburse yourself for health care expenses that are not paid or reimbursed by health insurance or other benefit plans. Apply for enrollment at www.flexspend.state.ny.us or call 1-800-358-7202.
- November 30 is the deadline for changing your Pre-Tax Contribution Program (PTCP) status for 2008. The PTCP allows you to have your health insurance premiums deducted from your pay before taxes are withheld. This lowers your taxable income. After November 30, you may not cancel your participation while still eligible, or switch between family and individual coverage while your covered dependents are still eligible unless you experience a “qualifying event” such as marriage, divorce or death of a spouse, or the birth or adoption of a child.
- The deadline to switch to a different health plan for 2008 will be 30 days after the health insurance premium rates for 2008 are set by the state Department of Civil Service and delivered to other state agencies. These rates are usually set in late November or early December. If you don’t change health plans by the deadline, you will be automatically re-enrolled in the same one.
— Lorraine Simpkins