What is CareConnect?
North Shore-LIJ CareConnect Insurance Company, Inc. (or CareConnect for short) is your plan administrator. It is fully-owned by Northwell Health, and is the first provider-owned commercial health insurance company in New York State. It was launched to make it easier for people to get and stay healthy, so it does things a little differently than most insurance companies.
In Person Customer Service
CareConnect stresses customer service. It has a walk-in Customer Care Center at 2200 Northern Blvd. in East Hills, where you can drop by any time between 8am and 5pm, Monday through Friday, to talk to a Customer Service Connector. A Service Connector can answer questions about your coverage, explain potential costs, even make your doctor, lab and x-ray appointments. Bring your kids along -- they will enjoy the crayons, games and books in the play area, while you get your tasks done.
On the Phone Customer Service
Don't feel like making the trip? Just pick up the phone - a Connector will be able to answer your questions or resolve your issue. Or try the CareConnect website, CareConnect.com, to take care of simple things like printing a temporary ID card, or checking the status of a claim.
CareConnect Providers
CareConnect can also simplify your life when it's time to see the doctor, thanks to its close relationship with the providers in the network -- which includes not just Northwell Health, but many other New York health systems: Maimonides Medical Center in Brooklyn, Montefiore Health System in the Bronx and Westchester, Northern Westchester Hospital and Mount Kisco Medical Group also in Westchester are just to name a few. Keep in mind, although the network is large, the plan does not cover out-of-network care.
In addition to making appointments that fit your schedule, CareConnect will work closely with Northwell Health's Care Solutions to make sure you have all the support you need.
All of this and lower rates too! In fact, for many employees, CareConnect Northwell Health Employee Plan rates are lower than the Value Plan. To find out more, visit CareConnect.com, email questions@nslijcc.com or read about CareConnect in your 2016 Benefits Resource Guide.
Showing posts with label medical plan. Show all posts
Showing posts with label medical plan. Show all posts
Friday, December 4, 2015
Tuesday, November 18, 2014
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.
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.
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
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.
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%
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%
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%
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.
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.
Tuesday, May 6, 2014
Visit UnitedHealthcare Online at myuhc.com
If you have medical benefits through North Shore-LIJ's Value or Buy-Up Plan then you have access to valuable health information housed on UnitedHealthcare's confidential myuhc.com website.
Get Started
Once registered and logged in, you can view your benefits and coverage, medical and reimbursement policies, all while utilizing interactive tools, such as myHealthcare Cost Estimator, a tool designed to estimate your healthcare costs, leading you to better decision making.
Great Resource for Health Information
In addition to being a great resource when managing your services and claims, myuhc.com shares valuable health information that is constantly updated and refreshed.
- View May's Wellness Online featuring Blood Pressure Awareness.
- Visit the LiveWell, BeWell, WorkWell section - covering sensitive topics such as grief and loss, domestic violence, alcohol and drug abuse, anger management and so much more*.
- And don't forget to check in and utilize the I Do section. Here you can research weight management, stress relievers, exercise, nutrition and general preventive care.
Download the Health4Me App
Now you can get all this information - and more - right in the palm of your hand. Download the free Health4Me app to your Smartphone and get myuhc.com on the go. Take a moment and view this brief video to see how it works.
*If you find yourself dealing with difficult topics or feelings, be sure to reach out to the North Shore-LIJ behavioral health experts at the Employee Assistance Program: 1-877-327-4968 or eap2@nshs.edu. EAP is a professional, confidential counseling service designed to help you resolve problems that have an impact on your life at home, school or work.
*If you find yourself dealing with difficult topics or feelings, be sure to reach out to the North Shore-LIJ behavioral health experts at the Employee Assistance Program: 1-877-327-4968 or eap2@nshs.edu. EAP is a professional, confidential counseling service designed to help you resolve problems that have an impact on your life at home, school or work.
Wednesday, March 19, 2014
Dependent Audit for Benefits
Have you received a letter in the mail asking for proof of your dependents? If so, it is important that you reply with the correct documentation, such as a birth certificate or marriage license. North Shore-LIJ is verifying that all dependents currently covered by the health system-sponsored medical plans are actually eligible for this coverage. If it turns out your loved one is not eligible for our health plans you will not be penalized but you will have to find alternative coverage. If you need assistance providing the documentation requested contact the third party vendor, ACS, HR Solutions at 1-888-218-1475.
Some of the relationships that are not legitimate for dependent coverage include:
In order to be eligible for medical coverage your dependent must be:
Some of the relationships that are not legitimate for dependent coverage include:
- Ex-spouses
- Live-in partners or roommates
- Girlfriends/boyfriends or same-sex domestic partners
- Cousins, nieces, nephews, sisters, brothers, parents
- Neighbors and/or friends
- Children over 26
In order to be eligible for medical coverage your dependent must be:
- A legally married spouse
- Children under the age of 26 - natural, step and adopted
- Unmarried children who are incapable of self-support due to physical or mental disability
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