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

• Opening November 21 GoHealth: 102-29 Queens Blvd, Forest Hills 
• Opening later in December, GoHealth: 5165 Merrick Road, Massapequa

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.

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.

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.