HEALTH NOTES Negotiated Changes to Health Benefits As soon as the 2011-2015 PS&T contract was ratified, the state began implementing a number of changes to the health benefits provided to PEF-represented employees enrolled in the state Health Insurance Program (NYSHIP). These changes, along with their effective dates, are indicated below:   Changes affecting members enrolled in The Empire Plan or an HMO Benefit 2007- 2011 PS&T Contract 2011- 2015 PS&T Contract Employee Premium Contribution Employee’s share of the premium is 10%/25% (individual/family coverage) Effective 10/1/11, employee’s share of the premium is as follows: SG 10 & above:16%/31% SG 9 & below: 12%/27% Retiree Sick Leave Credit See NYSHIP General Information Book for life expectancy table currently used to calculate credit Effective 12/1/11, NYSERS 1999 Unisex life expectancy table will be used to calculate credit Enrollment Opt-Out Not Available Effective 1/1/12, eligible employees who opt out of NYSHIP will receive annual payment as follows: Individual: $1,000 Family: $3,000 Changes only affecting members enrolled in The Empire Plan Effective October 1, 2011 Benefit 2007- 2011 PS&T Contract 2011- 2015 PS&T Contract Preventive Care Services covered under federal health care reform law Covered preventive services subject to applicable copay Covered preventive services paid in full Non-par physician services provided in hospital ER Benefits subject to deductible and paid at 80% up to R&C charge Benefits subject to deductible and paid at 100% up to R&C charge Prescription Drug Program Flexible Formulary (“Brand for Generic” Program) Brand name drug with generic equivalent placed on Level 3 and generic placed on Level 1 Bran name drug with generic equivalent may be placed on Level 1 with generic excluded or placed on Level 3 Effective December 1, 2011 Benefit 2007- 2011 PS&T Contract 2011- 2015 PS&T Contract Rx Drug Program Copays   30-day supply at retail, mail or Specialty Pharmacy Level 1-$5 Level 2-$15 Level 3-$40 Level 1-$5 Level 2-$25 Level 3-$45 31-90 day supply at Mail Service or Specialty Pharmacy Level 1-$5 Level 2-$20 Level 3-$65 Level 1-$10 Level 2-$50 Level 3-$90 31-90 day supply at Network Retail Pharmacy Level 1-$10 Level 2-$30 Level 3-$70 Level 1-$10 Level 2-$50 Level 3-$90 Effective January 1, 2012 Benefit 2007- 2011 PS&T Contract 2011- 2015 PS&T Contract Par Provider Network Nurse Practitioners and “Minute Clinics” not included in the network Network will include Nurse Practitioners and “Minute Clinics.” No non-network coverage. Guaranteed Access Program Not Available If no access to par PCP or “core” specialist in NYS, then enrollee receives in-network benefit Basic Medical Deductible $388 enrollee, $388 spouse/partner, and $388 all dependent children combined Shared non-network deductible: $1,000 enrollee, $1,000 spouse/partner, and $1,000 all dependent children combined Mental Health Deductible $388 enrollee, $388 spouse/ partner, and $388 all dependent children combined No separate deductible. Subject to shared non-network deductible Substance Abuse Deductible $388 enrollee, $388 spouse/ partner, and $388 all dependent children combined No separate deductible. Subject to shared non-network deductible. Basic Medical Coinsurance Maximum $1,069 enrollee, $1,069 spouse/partner, and $1,069 all dependent children combined Shared coinsurance max: $3,000 enrollee, $3,000 spouse/partner, and $3,000 all dependent children combined Mental Health Coinsurance Maximum $1,069 enrollee, $1,069 spouse/partner, and $1,069 all dependent children combined No separate coinsurance maximum. Subject to shared coinsurance maximum Substance Abuse Coinsurance Maximum $1,069 enrollee, $1,069 spouse/partner, and $1,069 all dependent children combined No separate coinsurance maximum. Subject to shared coinsurance maximum Non-Network Hospital Coinsurance Maximum $1,500 enrollee, $1,500 spouse/partner, and $1,500 all dependent children combined No separate coinsurance maximum. Subject to shared coinsurance maximum  Note:Under the terms of the 2011-2015 PS&T contract, there will no longer be an annual CPI-W adjustment to the shared annual non-network deductible and coinsurance maximum. They will remain $1,000 and $3,000, respectively, for the term of the contract. MORE HEALTH NOTES STORIES State going back to Davis Vision Federal health reform brings co-pay relief Dispute arises over new Opt-out Program It’s the law: Parity for mental health, substance abuse benefits Negotiated Changes to Health Benefits

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