Page 12 - Work Force January 2016

Dependent Eligibility Verification Project
For enrollees with family coverage under NYSHIP
What to do now
As previously noted, the Dependent Eligibility Verification Project administrator, HMS Employer Solutions, sent NYSHIP enrollees
an information packet in early December describing the Special Amnesty Period.
If you currently have a dependent covered under your policy that does not meet the NYSHIP eligibility criteria, make sure that you request to remove the ineligible dependent during the Special Amnesty Period, which will end on Jan. 29, 2016.
If you remove an ineligible dependent during the Amnesty Period, the dependent will be removed from coverage effective Feb. 1, 2016 and no repercussions will
be applicable beyond that action. Please submit the form included in
the Special Amnesty Period information packet
directly to HMS.
What happens next?
New York
state will hold
three separate
Dependent
Eligibility
Verification
phases. Eligibility
verification packets
will be mailed to enrollees
after the plan-wide Special Amnesty Period ends. The packets will include a list of the enrollee’s dependents,
an eligibility worksheet to help determine whether dependents meet NYSHIP’s eligibility requirements,
a list of eligible proofs and
instructions/deadlines to submit the required documentation.
When will the verification packet arrive?
After the amnesty phase is completed,
you will receive a letter from HMS that will detail the next steps in the
process, the verification phase. Phase and date of your verification letter are
as follows:
• Enrollees of NYSHIP
participating agencies will receive letters dated Feb. 29, 2016;
• Enrollees who are New York state retired employees will receive letters dated May 2, 2016;
• Enrollees of NYSHIP participating employers will receive letters dated May 2, 2016 and
• Enrollees who are New York state active employees will receive letters dated July 5, 2016.
HMS has a secure online web portal at www.VerifyOS.com that contains information about the project and real-time information on verification of dependent eligibility and status updates.
Call HMS Employer Solutions
at 1-855-884-9475 from 8 a.m. to 11 p.m. ET, Monday through Friday, if you have questions. Look for more information in future editions of The Work Force.
Empire Plan claims deadlines for calendar year 2015
Empire Plan enrollees have until April 30, 2016, 120 days after the end of the calendar year, to submit medical expenses incurred during the 2015 plan year to:
United Health Care Service Corp. P.O. Box 1600
Kingston, N.Y. 12402-1600
For the Empire Plan Basic Medical Program, the Home Care Advocacy Program (HCAP) and for non-network physical therapy or chiropractic services.
Empire Blue Cross and Blue Shield NYS Service Center (Code YLS) P.O. Box 1407 – Church Street Station
New York, N.Y. 10008-1407
For Empire Plan and non-network Inpatient or Outpatient hospital services.
Value Options
P.O. Box 1800
Latham, N.Y. 12110
For non-network mental health and substance abuse services.
The Empire Plan Prescription Drug Program c/o CVS Caremark
P.O. Box 52136
Phoenix, A.Z. 85072-2136
For prescriptions filled at non-participating pharmacies or at participating pharmacies without using your New York Government Employee Benefit Card.
Enrollees can call the Empire Plan at 1-877-7NYSHIP (1-877-769-7447) with questions or to get claim forms. As a reminder, when using the Empire Plan’s toll-free telephone number, pay extra attention to the choices offered by the automated system.
Network providers/pharmacies will submit claims directly to the appropriate insurance carrier on your behalf when provided with all necessary information.
If you have a non-network claim submission, make sure you complete the requested subscriber information on the claim form, include the original billing or receipt (if requested), and sign the claim form.
May 15 is deadline for submitting proposed Resolutions, changes to CSEA’s Constitution & Bylaws
Proposed Resolutions and proposed amendments to the CSEA Constitution & ByLaws for consideration by CSEA delegates to the union’s 2016 Annual Delegates Meeting must be submitted by May 15, 2016.
Proposed Resolutions may be submitted only by a delegate and must be submitted on the proper forms. Forms for submitting Resolutions are available from CSEA headquarters and region offices.
Proposed Resolutions and proposed amendments to the Constitution and Bylaws must be submitted no later than May 15 to the Statewide Secretary, CSEA Headquarters, 143 Washington Ave., Albany, N.Y. 12210-2303.
The 2016 Annual Delegates Meeting will be held Oct. 17 to 21 in Washington, D.C.
12 The Work Force
January 2016