Page 18 - Work Force December 2020

NYSHIP health plan choices for 2021
Now is the time for New York State employees to compare NYSHIP health plans if you are considering changing your health insurance option for the 2021 plan year. Consider your choices carefully as you typically are unable to change your option after the annual Option Transfer Period.
Selecting a health
insurance plan for you
and your family is
an important and
personal decision.
Only you know your
family’s lifestyle,
health, budget and
benefit preferences.
An important step
toward making the
best choice for you and
your family is to understand
the NYSHIP options and how they may differ.
The 2021 Health Insurance Choices guide has been sent to state agencies. The health insurance choices includes a summary of The Empire Plan and each of the NYSHIP health maintenance organizations (HMOs). NYSHIP enrollees
are encouraged to familiarize themselves with the health plans available in their area.
New York State also offers a
plan comparison tool to assist by creating a side-by-side comparison of the benefits provided by each of the NYSHIP plans in your area. To perform a comparison, go to www. cs.ny.gov/employee-benefits and choose your group and plan, if prompted. From the NYSHIP online homepage, select Health Benefits
& Option Transfer. Click on Rates and Health Plan Choices and then NYSHIP Plan Comparison. You can select the counties in which you live or work. A listing of health plans available will be listed and you can check the box next to the plans you want included in the comparison.
At press time, the 2021 NYSHIP premium rates were not yet approved. Once approved, the 2021 NYSHIP health plan rates will be mailed to your home and posted
on NYSHIP Online. The rate flyer will also include the option-change deadline and dates that changes in health insurance payroll deductions will occur.
Pre-Tax Contribution Program
The Pre-Tax Contribution Program (PTCP) Election Period
for Executive Branch state employees runs concurrent
with the annual Option Transfer Period. The
(PTCP) is a voluntary program that allows
employees to have their share of health
insurance premium deducted from their wages before taxes are
withheld, which in turn may lower tax liability. Pre-tax status is initially
chosen when first enrolled in health insurance. Per Internal Revenue Service (IRS) rules, the PTCP Election Period is the only opportunity for employees to change their PTCP status (without a qualifying event). If you wish to verify your PTCP status, please review your paycheck.
• If you are enrolled in PTCP, your paycheck stub shows “Regular Before-Tax Health”. Your health insurance premium is deducted from your wages before taxes are withheld.
• If you are not enrolled in PTCP, or part of your deduction
is taken after tax (e.g. you
have a non-federally qualified dependent), your paycheck stub shows “Regular After-Tax Health”. Your health insurance premium (or a portion of) is deducted from your wages after taxes are withheld.
Next steps
Once the Option Transfer Period is announced, the following actions can be made by timely completing the necessary paperwork with your agency health benefits administrator:
• Change your NYSHIP option for the next plan year to one of the following:
• The Empire Plan
• A NYSHIP health maintenance organization (HMO) offered where you live or work
• The Opt-Out Program (if eligible and meet criteria)
No action is required if you wish to keep your current option and you are still eligible for it.
Additional changes permitted during the Option Transfer Period:
• Change from Family to Individual (regardless of whether a qualifying event has affected your dependents’ eligibility)
• Change from Individual
to Family (late enrollment provisions will apply)
• Voluntarily cancel your coverage (regardless of a qualifying event has affected your eligibility)
• Enroll in NYSHIP coverage (late enrollment provisions will apply)
Updates for Empire Plan enrollees:
The following enhancements were made:
• Effective January 1, 2021, Empire Plan enrollees and their covered dependents will have nationwide access to UnitedHealthcare’s network of medical providers. The Participating Provider Program network will consist
of over1.2 million physicians, laboratories, physical therapists, occupational therapists and chiropractors throughout the United States. You can find a participating provider online
at www.cs.ny.gov/employee- benefits. Choose your group and plan, if prompted, and from the NYSHIP Online homepage, select Find a Provider. Scroll to the Medical/Surgical Program and select the link to the online directory. You may also call the Empire Plan toll free at
•
1-877-7-NYSHIP and press or
say 1 for the Medical Surgical Program.
Earlier this year, The Empire Plan began offering a new telemedicine benefit to help you and your covered dependents access health care services remotely. Through Empire BlueCross’s partnership with LiveHealthOnline, you can stay home and have a telephone
or video visit with a board- certified doctor or licensed therapist on your smartphone, tablet or personal computer. To begin the registration process for remote care, go to www. empireblue.com/nys and select the link to LiveHealth Online. It is important to enter your name and Empire Plan ID number exactly as it appears on your card, otherwise the claim may not process correctly.
18 The Work Force
December 2020
•
Change your Pre-Tax Contribution Program election
Updates for NYSHIP HMO enrollees for 2021:
• HMOs are community rated
and determine copayments and other out of pocket expenses. HMOs send enrollees a side-by- side comparison showing any changes made from plan year 2020 to plan year 2021.
• A new HMO option, BlueShield of Northeastern New York (option #069), will be available to NYSHIP enrollees who live or work in Albany, Columbia, Fulton, Greene, Montgomery, Rensselaer, Saratoga, Schenectady, Warren and Washington Counties.
• CDPHP Central HMO (option #300), will expand its NYSHIP service area to include Clinton and Franklin Counties.
• MVP Health Care Rochester HMO (option #058) will expand its NYSHIP service area to include Chemung and Schuyler Counties.
Additional information regarding these plans can be found in the Choices Guide or by performing
a plan comparison on NYSHIP Online.