Page 15 - Work Force May 2016

2016 NYSHIP Dependent Eligibility Verification enters Phase 2
Previous Work Force articles have discussed NYSHIP’s dependent eligibility verification project for those enrollees with family health insurance.
This project impacts all NYSHIP enrollees with family health insurance (The Empire Plan and NYSHIP HMOs). The verification of dependents is being performed in three separate phases.
Phase 1 verification period ended on April 15, 2016. Please note: NYSHIP has allowed a brief grace period for enrollees to submit the required documentation to HMS Employer Solutions (until 5/04/16)
Phase 1 included the Verification Period for Local Government employees and retirees (counties, cities, towns, villages, school districts, libraries, etc.).
Due to time restraints, enrollees are encouraged to submit documentation by electronic web upload at VerifyOS.com or fax the documentation to 1-877-223-8478.
Documentation must be received by May 4, 2016.
Current Step:
Phase 2 Verification Period (5/02/16 – 6/17/16)
New York retirees and participating employers (authorities, etc.) employees/retirees must provide proof (verification) of ALL dependents.
Verification of Dependents
• Requires all enrollees with family coverage to provide proof that each spouse/dependent is eligible for coverage under NYSHIP.
• Failure to provide proof could result in losing dependent coverage effective Jan. 1, 2016 and being held responsible for repaying claims paid under NYSHIP for those dependents as early as the date the dependent was first added to coverage. Other penalties could also be imposed.
The verification process can be completed in these steps:
• Collect copies of all required
documents for each enrolled
dependent.
• Sign and date the Verification
Form.
• Submit the Verification Form with
copies of all required documents to HMS Employer Solutions no later than June 17, 2016. Please ensure a copy of the Verification Form is included with all documents submitted.
• For faster processing, please submit required documents by uploading them via the web portal, VerifyOS.com, or by faxing them
to 1-877-223-8478. Documents may also be mailed to HMS Employer Solutions, P.O. Box 165308, Irving, TX 75016-9923. Please do not mail original documents.
NEXT STEP:
Phase 3 Verification Period (7/5/16 – 8/19/16)
Active New York State employees must provide proof (verification) of ALL dependents
• July 5 – Aug. 19, 2016 (dates to
submit proof of eligibility).
Empire Plan’s Center of Excellence for Infertility Program changes as
oUf June 1
nited HealthCare (UHC)
administers the Center of Excellence (COE) for Infertility Program. Effective June 1, 2016, the Empire Plan will use the Optum Infertility COE Network.
This change is designed to take advantage of Optum’s focused evaluation process to identify
centers with proven experience and statistically successful track records while maintaining all of the elements of this very successful program.
The Empire Plan Centers of Excellence for Infertility Services Program itself is unchanged. There are no changes in the infertility benefits available under the Empire Plan.
However, a change in the center’s network COE status may impact your choice of provider. Enrollees who have been seeking care from a center that will no longer be part of the Empire Plan’s COE for Infertility as of June 1, 2016, were sent correspondence from United HealthCare about how this change will impact them. Empire Plan participating Infertility COEs as of June 1, 2016, include;
Empire Plan adds new vendors
The Empire Plan Home Care Advocacy Program (HCAP) provides home care services, durable medical equipment (DME) and supplies at no cost when preapproved and received through an HCAP vendor.
In 2016, The Empire Plan has new HCAP vendors for breast pumps, Transcutaneous Electrical Nerve Stimulation (TENS) units and Neuromuscular Stimulation (NMES) units.
Breast Pump Suppliers
Empire Plan enrollees are eligible for one pump after the birth of a child. To receive the maximum, paid-in-full benefit, the breast
pump must be purchased from a contracted supplier. The current Empire Plan network breast pump suppliers are:
• Byram Healthcare: 1-877-902- 9726 or byramhealthcare.com
• Edgepark: 1-888-394-5375 or edgepark.com
• McKesson: 1-844-727-6667 or mckesson.com
• Medline: 1-800-633-5463 or medline.com
TENS or NMES Unit Suppliers
Empire Plan Durable Medical Equipment vendor EMPI, Inc.,
has closed and will no longer
be supplying Transcutaneous Electrical Nerve Stimulation
(TENS) units and Neuromuscular Stimulation (NMES) units and related supplies. If Empire Plan enrollees need a new TENS or NMES unit, or compatible supplies, they can contact the following vendors: • Kinex: 1-800-845-6364
• Electrostim Medical Services, Inc. (EMSI): 1-800-588-8383
• Zynex: 1-800-495-6670
The Empire Plan Medical Program can be contacted toll-free at 1-877-7NYSHIP (1-877-769-7447).
May 2016
• Boston IVF, the Albany Center (Albany)
• Columbia University for Women’s Reproductive Care (New York)
• Cornell Center for Reproductive Medicine and Fertility (New York)
• Genesis Fertility and Reproductive Medicine (Brooklyn)
• Infertility and IVF Medical Associates of Western NY (Snyder)
• Long Island IVF (Lake Success, Melville, Port Jefferson)
• New York University Fertility Center (New York)
• Reproductive Medicine Associates of Connecticut (Norwalk, CT)
• Reproductive Medicine Associates of New York (New York)
• Strong Fertility Center (Rochester) Enrollees/dependents with specific
questions regarding this change or
its impact on any services already planned or in progress should call the Empire Plan Medical Program toll free at 1-877-7NYSHIP (1-877-769-7447), select Medical Program, and then Benefits Management Program.
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