Home Sweet Home

Isn't nice to live in an area where you have access to quality healthcare? As the health system grows so does the number of in-system providers/services.
In Area Designation 
With a Clinical Integration Independent Practice Association (IPA for short) of over 9,000 + doctors/healthcare providers (up a few thousand since 2012) the health system is truly spreading its wings. In-system providers are now present on eastern Long Island. Coram, Port Jefferson, Selden and even Wading River are just a few of the newly designated "in area" residences for 2014. These areas were declared within the primary service area due to the amount of providers within a 2 to 10 mile radius of that zip code. In-system providers include primary care physicians, obstetrician/gynecologists, pediatricians, and specialists. Need a doctor? Now you can find a North Shore-LIJ In-System Provider within 10 miles of your home sweet home.

Out-of-Pocket Maximum for 2014

Did you do a double take on page 4 of the Benefits Guide? 
Third column down on both Value and Buy-Up Plans reads Annual Out-of-Pocket $6,350 for an Individual and $12,700 for a Family. Gee didn't that say "none" in 2013? Don't be alarmed by the number ... It's not that there were no out-of-pocket expenses for in-system copays in 2013 it's just that there was no requirement for specified maximums. Due to Healthcare Reform in 2014, maximum out-of-pocket expenses now must now be specified. $6,350  is the maximum out-of-pocket you can spend on your in-system copays for yourself and $12,700 is the maximum you can spend on your in-system copays for your family.

Who Figures This Stuff Out?
Rest assured these figures were derived by Actuaries, not the Benefits Team. Actuaries analyze the financial cost of risk and uncertainty. They use mathematics, statistics and financial theory to assess the risk that an event will occur and help businesses develop policies that minimize the cost of that risk.
There! Don't you feel better knowing that?

Wellness Pledge Advantage

Your health and wellness is an important piece of the North Shore-LIJ strategy to be a leader in preventive care for our communities and all employees. The newest Wellness Pledge for 2014, a video which was designed to engage you and your family in the health system's proactive thinking on health awareness, is a direct link to another Pledge, the Health Assessment Pledge. The creation of both Pledges stems from the true passion of our own wellness experts, Dr. Jennifer Mieres, SVP of Community and Public Health and Dr. Jacqueline Moline, VP of Population Health.

1. If you have not gotten the opportunity to watch the Wellness Video, visit HealthPort>Quick Links>iLearn. The health system's Learning Management System will guide you through the Wellness Module and Video. 
2. If you have not gotten the opportunity to fill out your Health Assessment, visit myuhc.com, register and login, click on Health Assessment on the far right side. The HA is housed in a secure portal through UnitedHealthcare and keeps your health information 100% confidential. 

Both Pledge actions will credit your 2014 paycheck $260 each, as long as you comply before December 2. Yes, that's right ... it pays to be healthy!

Better Late Than Never

It is a well known fact that a good percentage of employees do not chose to participate in Flexible Spending Accounts because they are afraid they may lose the pre-tax dollars they put aside come the end of the year. Well rest easy -  each year the health system gives its FSA participants a three month grace period for their healthcare account. This gives you the opportunity to spend what's leftover in 2013 rather than losing it in 2014.

Use It or Lose It Rule
For those organizations that do not offer such a generous grace period - the U.S. Treasury recently announced a modification to its "Use It or Lose It" ruling. This modification now allows participants to rollover $500 of unused dollars into 2014. Keep in mind, This rollover does not pertain to North Shore-LIJ Flex Spending participants due to the grace period already in place.

North Shore-LIJ Grace Period
The health system's generous 3 month grace period allows you to deplete your account in its entirety and does not limit you to only $500. This extension gives you the opportunity to purchase most eye-related products, orthopedic and surgical supports, blood pressure monitors, dentures and so much more.
So go ahead and be consumer savvy - put aside those pre-tax dollars during 2014's Open Enrollment, you've got nothing to lose!

Healthcare FSAs allow you to set aside a minimum of $150 and a maximum of $2,500 per year to pay for expenses not covered in your medical plan, such as co-pays and other out-of-pocket costs. This account will come to you in the form of a Debit card giving you convenient access to your funds.
Dependent Care FSAs allow you to set aside a minimum of $150 and maximum of $5,000 per year to pay for dependent care expenses for children under the age of 13, disabled adults or elder care.

Be Money Smart

Did you know the health system automatically contributes 3% of your eligible compensation for your 403(b) plan account beginning on the the one year anniversary of your date of hire? Be smart and contribute at least 6% of your annual salary, and you will receive an additional 2% from the health system.
Here's how it works. After one year of service with the health system eligible employees may receive:

• 3% of  pay-based credits to your Cash Balance account
• 3% contribution of your eligible earnings to your 403(b) account (Benefit Group 1A receives 6% contribution)
• 2% employer matching contribution to your 403(b) account (that's if you contribute at least 6%)

That comes to 8% in employer contributions for Benefit Groups 1, 2 and 3 - and 11% for Group 1A! So what are you waiting for? Contact MetLife now and get money smart.

Attention: Married Couples at North Shore-LIJ

Being that North Shore-LIJ is the largest employer in the region, it's no wonder there are a number of married couples in the health system. If  and your spouse both work within the health system and are also non-union and benefits-eligible you need to be aware of the new requirement for benefits enrollment in 2014.

New for 2014 Open Enrollment: The spouse who is categorized in the higher benefit group (Group 1A being the highest) will now be responsible for electing coverage for themselves, or for themselves and their dependents.

For example: Mary works as an administrative assistant in IT (putting her in Benefit Group 3) and her husband, Larry is a physician on staff at North Shore University Hospital (putting him in Benefit Group 1A). Mary has always been responsible for electing benefits for herself, her husband and their two children. With this change in the enrollment process, Larry will now be responsible for electing coverage due to his higher benefit group.
For consideration in this case: Mary can continue to claim herself and two children. Since she chooses the Value Plan and completes all four Wellness Pledges her cost for benefits will remain at $0. Larry can cover himself as single, under Benefit Group 1A.

Benefit Group 3 generally refers to staff-level employees
Benefit Group 2 generally refers to manager-level employees
Benefit Group 1 generally refers to directors and assistant vice presidents
Benefit Group 1A generally refers to executives (above the AVP level) and physicians
Benefit Group 1A is considered the highest level of the Groups 

North Shore-LIJ feels this change in enrollment is in alignment with the compensation or its employees.

Employers Evaluate Spousal Coverage

You may be wondering "why this new spousal charge of $1040 for 2014". After all you have been claiming your spouse as a dependent for years. The reason behind the surcharge is based on the health system's goal to align with the initiative of Healthcare Reform. Many other organizations are either implementing or have implemented a spousal surcharge. According to Towers Watson up to 60% of hospital employees will have a spousal surcharge by 2015.

In comparison, there are a few large companies that skipped the surcharge and simply excluded a spouse's coverage when they have access to a medical plan through their own employer, referred to as Spousal Exclusion. According to benefits consulting firm Mercer, 6 percent of companies now exclude spouses who can get healthcare through their own employers, up 3 percent since 2008. That number is likely to grow.

Keep in mind, North Shore-LIJ will continue to cover your spouse if he or she is not eligible for health insurance through their own employer. In 2014 no one's spouse will be forced to purchase their own coverage on the State Exchange.

Here are some examples.

Benefits Eligible Employee at North Shore-LIJ	Spouse’s Status	Surcharge Status
Mary is married to Rob.	Rob is currently unemployed.	No surcharge - If Rob finds employment in 2014 and chooses to stay on Mary’s plan no surcharge will be incurred due to the fact that his employment status will not be considered a Qualifying Life Event (QLE).
Alex is married to Susan.	Susan is on Medicare.	No surcharge – Alex can enroll Susan in the medical plan with no surcharge because she is on Medicare.
Joe is married to Robert.	Robert is eligible for a medical plan through his own employer, but chooses to stay on Joe’s plan because his employer’s plan is much more expensive than the North Shore-LIJ plan.	Surcharge - If Joe continues to claim Robert as a dependent on his North Shore-LIJ medical plan he will see a surcharge of $1,040 in 2014.
Carol is married to Steven.	Steven, who is self-employed, wants to continue on Carol’s plan at North Shore-LIJ and not seek insurance on the State Exchange.	No surcharge – Carol can continue to cover Steven. He will not have to seek health insurance on the State Exchange because an employer is not offering him a medical plan.
Bob is married to Alice.	Alice, who just needs dental coverage, is eligible for a medical plan through her own employer and plans to enroll.	No surcharge - If Bob is electing just the dental plan for Alice he will not see a surcharge in 2014, but he will have to adjust his elections on Employee Self Service.

Read recent article from Newsday, The New Insurance Landscape for Spouses.