Tuesday, November 18, 2014

Decreased Copay for In-System Urgent Care

Many minor injuries and illnesses may not warrant a trip to the local ER, yet may require some sort of clinical attention. No need to panic and spend the $150 copay for an ER visit in 2015, more and more in-system urgent care centers will be popping up within our communities at a reduced copay (in 2015) of just $30. In addition to our already established in-system centers in:

  • Bethpage: 4300 Hempstead Turnpike, 11714
  • Rego Park: 95-25 Queens Blvd., 11374

North Shore LIJ has partnered with Access Clinical Partners to create even more centers, saving you time and money on those many bumps and bruises, sneezes and belly aches.

North Shore-LIJ Partners to Create GoHealth -
In-System Urgent Care



These facilities will be open, M-F, 8 am to 8 pm and weekends, 9 am to 5 pm.
Many more in-system urgent care centers are due to open in 2015. Read more.

In-Network Urgent Care
If you are not close to any of the in-system centers that are currently open, check in with one of the many in-network/United Healthcare urgent care centers within our communities. The copay for these visits remain at $40 in 2015.

When to Seek Emergency Care
Not sure what you should do? Review United Healthcare's considerations on your level of emergency care.

Value and Buy-Up Medical Plans

What's the Difference Between the two Medical Plans??
First let's clarify that there are two plans - both administered through our carrier, United Healthcare: they are referred to as the Value and Buy-Up. The terms "In-System, In-Network and Out-of-Network" are not referring to the Medical Plans they are referring to the providers, facilities and services you use once you elect a plan. So when you are reviewing those medical plan grids in your 2015 Benefits Resource Guide (pages 4-9) understand - the Blue is Value and the Teal is Buy-Up They are two different plans with just a few basic differences. Now is when the terms  "In-System, In-Network and Out-of-Network" come into play.
  • In-System means you are using a North Shore-LIJ healthcare provider, facility or service. 
  • In-Network means you are using a United Healthcare provider, facility or service.
  • Out-of-Network means you are using a healthcare provider, facility or service outside of the health system and the United Healthcare network
No Differences Here!
There are no differences in the Value and Buy-Up Plans when you use in-system providers, and North Shore-LIJ facilities and services.
Value Plan
In-System has no annual deductible and no coinsurance 
In-System has a copay of $20 for primary care and $40 for specialty care
Buy-Up Plan
In-System has no annual deductible and no coinsurance 
In-System has a copay of $20 for primary care and $40 for specialty care

Differences Here
The differences in Value and Buy-Up Plans come up when you use in-network and/or out-of-network providers and facilities.
Value Plan
In-Network/United Healthcare has an annual deductible or $750 for an Individual and $1,500 for Family.
In-Network/United Healthcare has a coinsurance of 30%
Buy-Up Plan
In-Network/United Healthcare has an annual deductible or $500 for an Individual and $1,000 for Family
In-Network/United Healthcare has a coinsurance of 10%
Value Plan
Out-of-Network has an annual deductible or $2,500 for an Individual and $5,000 for Family
Out-of-Network has a coinsurance of 50%
Buy-Up Plan
Out-of-Network has an annual deductible or $1,000 for an Individual and $2,000 for Family
Out-of-Network has a coinsurance of 30%

To Sum it Up
If you want to have access to out-of -network providers, facilities and services you may want to consider paying a bit more per pay check for the Buy-Up Plan. 
Most employees chose the Value Plan - in fact, in 2014 the health system had 80% domestic utilization.
Visit HealthPort-HR-Benefits and print out a copy of the 2015 Medical Plan Options.


Friday, November 14, 2014

Compare Plans in Advance

With most organization's Open Enrollment occurring in November,  North Shore-LIJ recognizes that you may be considering enrolling in your spouse's plan in 2015 and may need to make an educated decision - now - and not wait until December 3 (which is when North Shore-LIJ's Open Enrollment begins). That is why we have made the necessary information available to non-union employees and Lenox Hill Hospital/MEETH Registered Nurses on HealthPort>HR>Benefits.

For the Non-Union Population
Benefit Groups
  • Benefit Group 1A generally refers to executives and physicians
  • Benefit Group 1 generally refers to directors and AVPs
  • Benefit Group 2 generally refers to managers and clinical mid-level providers
  • Benefit Group 3 generally refers to staff-level employees
Location Reference
Another thing to keep in mind as you read through your Open Enrollment materials, the term "non-365" refers to employees who do not work in a facility that operates 24/7, 365 days a year. Non-365 employees receive the same healthcare benefits as an employee working in a hospital (referred to as a 365 Employee) with slightly different plans for disability, life insurance, and Paid Time Off. There in no "Non-365" status for physicians and executives.

Tuesday, November 11, 2014

Your 2015 Benefits - Simplified

Thanks for checking in on nslijbenefits.blogspot.com, your go-to place for Open Enrollment information - simplified. Over the next couple of weeks the Benefits Blog will share topics of interest surrounding your "non-union" benefits package.

Follow the Blog for Easy-to-Follow Information
A great way to make this information come right to your inbox  is to "Follow the Blog". All you have to do is submit your email address directly to the right of this paragraph. Every time a new article is posted you will be alerted with an introduction to that post. You can choose to read further or pass. Just another way of simplifying your Benefits during Open Enrollment!

Time Frame
2015 Benefits Open Enrollment is Wednesday, December 3 through Wednesday, December 17. At this time you will have access - on Employee Self Service - to enroll, re-enroll or waive your benefits with North Shore-LIJ.

What to Consider NOW
In preparation for Open Enrollment, take the time to review the 2015 North Shore-LIJ Plan Options, found on Employee Intranet>HR>Benefits. This is the only time of year you are eligible to update or newly enroll in the health administered plans.

Note: Qualifying Life Event, which is a change in martial or dependent status, allows you to make changes in your benefits at certain milestones in your life. If you have additional questions regarding Qualifying Life Events, contact your Site HR Office.

Enrollment Options with Carrier Links
Medical (with Express-Scripts): Value or Buy-Up with United Healthcare with Prescription
Dental: DPPO or DHMO with Cigna
Vision: One plan option with Davis Vision
Flexible Spending Accounts: Healthcare and Dependent Care FSAs with Wage Works
Disability: Automatic Short-Term 50% with The Hartford, options to "buy-up" with evidence of good health
Life Insurance: Automatic basic term life with Accidental Death and Dismemberment with Aetna, options to "buy-up" with evidence of good health

Compare the Cost
Compare these plans with those offered by your spouse's employer (if applicable) by viewing the 2015 Plan Rates and Costs, found on HealthPort-HR-Benefits.



Thursday, October 23, 2014

The Gateway to Your Wellness Pledge Credits

If you are planning to enroll or re-enroll in the North Shore-LIJ Value or Buy-Up medical plan you are eligible to receive 2015 paycheck credits in exchange for completing an online Health Assessment and 3 additional health-related actions.

Health Assessment is the Gateway Pledge
It's not too late to complete the Health Assessment Pledge, which is the most important pledge. Without this pledge you are not eligible to receive paycheck credits for the others.
Example: Susan had a dental cleaning in March, an annual physical in June and a mammogram in August - if Susan completes the Gateway Pledge by October 31 she will receive the maximum amount of paycheck credits ($1,040) beginning with her first pay cycle in 2015. If Susan waits and does not complete her final Pledge until November or December - her paycheck credits will be delayed 4-8 weeks. If Susan ignores the Health Assessment altogether she will not receive paycheck credits for any pledges in 2015.

What are you waiting for? Complete your online HA now:
  1. Visit myuhc.com
  2. Register and log in with a username and password
  3. Click on the Health Assessment tab on the right side of page
  4. Register and login using the same username and password you used for myuhc.com
  5. Answer security questions
  6. Fill in the health information
  7. Hit submit
The Health Assessment is 100% confidential. Your health information is housed by a third party provider, Optum Health and not shared with North Shore-LIJ Health System. The only information the health system receives is the date you submitted it.

Wellness Summary
The Health Assessment will appear on your Wellness Summary, the third Monday of the following month in which the HA was completed and submitted.

The Program's Goal
The Wellness Pledge Program's goal is to educate and engage participating employees about the importance of their preventive healthcare routine. The Program runs on an annual basis and requires health-related actions the year prior to the receipt of paycheck credits. New Hires and those new to the medical plan have six months to comply. Scroll down and read more about the Wellness Pledge Program, or visit HealthPort-HR-Benefits-2015 Wellness Pledge Program.

Now you are on your way to a healthier and wealthier new year!

Thursday, October 2, 2014

October is Here!

Since the deadline for the Wellness Pledges have been extended that mammogram you scheduled for during Breast Cancer Awareness Month will be in accordance with the 2015 Wellness Pledge Program.
Let's review the Pledge deadlines:

  • Complete the online Health Assessment on myuhc.com and 3 additional pledges by October 31 and you will receive your maximum paycheck credits beginning with the first pay cycle in 2015
  • Complete the online Health Assessment on myuhc.com and 3 additional pledges after October 31 (in November/December) and your paycheck credits will still appear in 2015 but they will be delayed 4-8 weeks - keep in mind, they will not be retroactive!

What you can do NOW - if eligible for the Pledge Program*
Step One: 
Complete your online Health Assessment on myuhc.com - it's the gateway pledge and is required in order to receive any paycheck credits in 2015
Step Two: 
Watch the Wellness Video - it was posted on your iLearn Module for viewing and submission
Step Three: 
Schedule 2 appointments (pledges) before Oct 31 and you will receive full credits:
--Annual Exam or Physical
--Dental Exam and/or Cleaning
--Vision Exam
--Breast Cancer Screening/Mammography
--Skin Cancer Screening/Check with a Dermatologist
--Colorectal Cancer Screening
In Addition: 
If you currently have your spouse covered under our medical plan you are also eligible to receive credit if he/she completes the online Health Assessment on myuhc.com.

Read more by searching 2015 Wellness Pledge Program in the search box (upper right corner of this Blog) or click here.

*You must be a non-union benefits-eligible employee or a Lenox Hill Hospital RN who is planning to enroll of re-enroll in North Shore-LIJ's Value or Buy-Up medical plan with United Healthcare to be eligible for the paycheck credits. New hires and those new to the medical plan in 2015 will have 6 months from their benefit's eligibility date to comply with the Program. 


Friday, September 19, 2014

Wellness Pledge Program Extended

If you still have not completed your pledges and are having difficulty scheduling appointments or screenings in September, now you have a bit more time!
  • Complete the four wellness pledges/actions by October 31 and your paycheck credits will begin with the first pay cycle in 2015. 
  • Complete the pledges in November/December and you will receive your 2015 paycheck credits, but they will be delayed 4-8 weeks (or the first few pay cycles in January). These credits will not be retroactive, so do your best to complete all four pledges by 10/31!
Wellness All Year Long
The pledge extension has been opened up through December because the health system wants you to consider your preventive care routine all year long.

Give it Time!
If you are constantly checking your Wellness Summary to review the status of your pledges, remember it takes time for the providers to send in the claims, and it takes time for the claims to feed into the Wellness Summaries.

United Healthcare sends the claims to us the third Monday of every month so if you choose to do the Physician Wellness Visit in early August your date of service should be marked on your Summary after September 22 (remember September 1 was  legal holiday and did not count as the first Monday of the month).

If you took the time to take care of yourself, we'll take the time to take care of you!