Published by CSEA 143 Washington Ave., Albany, N.Y. 12210 (518) 257-1000 (800) 342-4146 www.cseany.org Danny Donohue, President CSEA Local 1000 AFSCME AFL-CIO is published to share information and generate ideas on subjects important to retirees. Health insurance lawsuit Continued from page 2 Empire Plan enrollees: procurement updates for 2014 Empire Plan Prescription Drug In 2013, the Empire Plan Prescription Drug Program was insured and administered by United HealthCare/Express Scripts (Medco). A request for proposals (RFP) process was performed to determine the Empire Plan Prescription Drug Program administrator beginning in 2014. CVS/Caremark was awarded a five-year contract as administrator for the Empire Plan Prescription Drug Program with an effective date of Jan. 1, 2014. Under the new contract, the program will be administered on a self-insured basis. Empire Plan Medicare Rx (for Medicare primary enrollees) will be administered by SilverScripts, a Caremark company. Please note that CVS Caremark replaced the current plan administrator (United HealthCare/ Express Scripts (Medco)) beginning Jan. 1, 2014. As in the past, an annual prescription drug formulary review is performed by New York state and the Empire Plan Prescription Drug Plan administrator. Covered drugs may be assigned a different co-payment tier or be excluded from coverage as a result of the annual formulary review. In December 2013, enrollees were sent a copy of the Empire Plan’s Flexible Formulary for 2014 (or the Empire Plan Medicare Rx formulary for Medicare primary enrollees) that reflects the annual formulary changes. Enrollees should be aware that as a result of the transition to CVS/Caremark, some pharmacies that were considered part of the network with Express Scripts/ Medco will now be considered out-of-network pharmacies with CVS/Caremark. Please be assured that major retail chain pharmacies (Rite Aid, Walgreens, CVS, Duane Reade, Walmart, etc.) continue to participate under The Empire Plan with CVS/Caremark. Please contact the Empire Plan Prescription Drug Program with any questions toll-free at 1-877-7-NYSHIP (1-877-769-7447) and select option 4. Empire Plan Mental Health/ Substance Abuse Following an RFP process in 2013, Value Options was initially awarded a five-year contract as administrator for the Empire Plan Mental Health and Substance Abuse (MH/SA) Program. However, in November 2013, New York state notified that it would be reissuing the MH/SA RFP in 2014 and a one-year emergency procurement contract would be obtained with the current vendor, Optum Behavioral Health. In a last-minute turn of events, on Dec. 24, 2013, New York state advised that after much evaluation and numerous discussions, the Department of Civil Service recommended, and the Office of the State Comptroller approved, the one-year emergency procurement contract be awarded to Value Options. Value Options began administering the Empire Plan’s MH/SA Program as of Jan. 1, 2014. Empire Plan enrollees who received care in the last six months of 2013 from a participating provider who does not participate in the Value Options network will receive a letter from Value Options regarding their transition of care benefit. This benefit allows such enrollees to continue to receive care at the network level of benefits for up to 90 days with their current provider, even if their provider has not joined the Value Options network as of Jan. 1, 2014. CSEA is concerned about the bidding process and the resulting short time frame allowed for transition to the new vendor. “There is something not right here,” said CSEA President Danny Donohue. “There’s either some serious incompetence or political interference going on.” Enrollees seeking mental health and/or substance abuse services should contact the Empire Plan toll free at 1-877-7-NYSHIP (1-877- 769-7447), press 3 for the MH/SA Program and select the option for 2014 benefits. their 2 percent property tax cap and meet some vague standard about consolidating services and merging with other localities — regardless of how unpopular that might be. How is this “relief” even remotely possible without cutting more services and putting more people out of work? CSEA retirees, like everyone else, want lower taxes but we sure don’t want more bad policy and political doubletalk that fails to truly solve problems, eliminates more jobs and increases people’s misery. Donohue Continued from page 2 Constitution, when the state and UCS raised retiree contributions from 10 percent to 12 percent for individual coverage and from 25 percent to 27 percent for family coverage effective Oct. 1, 2011. Retirees have long contributed 10 percent of individual coverage and 25 percent of family coverage for their health insurance coverage in retirement based on the percentages included in the state contracts when they retired. The unions asserted that it is illegal for the state to increase costs for already retired members, and the unions did not negotiate such increases.
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