EMPIRE PLAN
CHANGES
The Empire Plan is the medical coverage
provided by New York State to its employees and therefore our
unions and school districts are not allowed to enter into any
negotiations for its contract. The only item the
SFT negotiates about the Plan is the contribution of the
Sewanhaka District to the premiums the state charges.
The changes for 2009 are; in-network
co-payments increased from $18 to $20, out of pocket maximum
for non participating providers changed from $1650 for all of
the members of a family to $1000 for member, $1000 for the
spouse and $1000 for all of the covered children.
Another of the significant changes concerns mental health and
substance abuse services. Effective January 1,
2009, Optum Health will replace Value Options as vendor for
mental health and substance abuse services.
Enrollees in treatment before January 1st with a
network provider who is not in the Optum Health network may
continue to receive network benefits until March 31, 2009.
Enrollees are encouraged to contact Optum Health prior to
March 31st to access the transition of care
benefit. Enrollees may call Optum Health to ask to
have their providers recruited to be in the network.
The phone number is 1-877-769-7447.
Reminder that Medicare beneficiaries must
be accepted by the medical doctors prior to activating Empire
which is the secondary plan.
RETIREES
ALERT
Medicare Surcharge
Reimbursement
The following applies to Medicare
beneficiaries who are paying a surcharge because their income
is $80,000 plus. Thanks to the NYSUT lawsuit all
surcharges must be reimbursed.
-
Contact the Sewanhaka Central Office the
phone number is 516-488-9807 and speak to Mrs. Ann Mulligan
-
Must show proof of payment 1099 plus
letter from the Social Security/Medicare with amount of
surcharge
-
Reimbursement is retroactive to first
year of your payment
-
Surcharge reimburse is a separate check
from the basic premium reimbursement
Any questions please e-mail Anna Zurawinsky
at Zurawinsky@aol.com.
