Empire Plan offers new non-par provider discounts
If you are enrolled in the Empire Plan, you get the best health care discounts and benefits when you use the plan’s participating (par) providers.
However, if you can’t or don’t use an Empire Plan par provider, you may want to take advantage of a new program that became available October 1, called the Empire Plan Basic Medical Provider Discount Program.
This program offers discounts from select providers who don’t participate in the Empire Plan, but who are part of the MultiPlan network — a nationwide provider organization contracted with United HealthCare
(UHC).
The more than 200,000 providers who participate in the Basic Medical Provider Discount Program network nationwide have agreed to accept a discounted fee for covered services. Empire Plan enrollees will not be billed for charges over that discounted fee.
When you use a multi-plan provider, you must first meet the annual Basic Medical deductible. Once that deductible is met, you will pay 20 percent of the discounted fee and the Empire Plan will pay the remaining 80 percent of it, rather than 80 percent of the “reasonable and customary” charge that is otherwise used to reimburse services performed by non-par providers.
Another advantage is you don’t have to submit a claim to UHC. The provider will submit the claim and UHC will pay the provider directly for covered services. According to UHC, most MultiPlan providers will not require the 20 percent payment from you at the time of service. They will wait until they receive UHC’s payment determination and then bill you for any amounts applied to the deductible and/or the 20 percent of the discounted fee.
To find a provider in the Empire Plan Basic Medical Provider Discount Program, ask if the provider is an Empire Plan MultiPlan provider or call 1-877-7-NYSHIP (1-877-769-7447) toll free, choose UHC and ask a representative for help.
Or go online to the UHC Web site at www.myuhc.com or the state Department of Civil Service site at
www.cs.state.ny.us. Click on employee benefits, then on Empire Plan providers and pharmacies.
— Lorraine Simpkins |
Tuition money flowing once again
If you are a state or Roswell Park Cancer Institute PS&T employee, you can, once again, get tuition assistance through Article 15 of the PS&T contract.
According to PEF Education Director Cliff Merchant, the traditional college tuition voucher program is expected to begin April 1, 2005.
However, to provide tuition support for the remainder of this fiscal year, the joint Professional Development Committee has established an interim
college-tuition-
reimbursement program. Courses underway at accredited colleges or universities on September 14, 2004, and those beginning September 15, 2004, through March 31, 2005, qualify for reimbursement under this interim program.
In addition, a program is now available for non-college courses underway on September 14, 2004, and for those beginning September 15 through March 31, 2005. This program reimburses registration fees for educational opportunities other than college course work, such as professional development workshops, seminars, continuing education programs and computer application software training for users.
Applications and guidelines for these programs, including the maximum amount of reimbursement available per college course, are expected to be available and posted on the PEF and the Governor’s Office of Employee Relations (GOER) Web sites by November. Copies of these materials also are available through PEF, as well as through state agency human resources and training offices.
For more information about these programs, call the PEF Education Department at 1-800 342-4306, ext. 328 or e-mail the department at
cmerchant@pef.org.
— Sherry Halbrook |