General Plan Information
[/vc_column_text][vc_toggle title=”What benefits do I receive through the Voluntary Hospitals House Staff Benefits Plan?” el_id=”1471476234466-66e2c7b9-bf39″]You are entitled to health insurance through Empire BlueCross/BlueShield, dental insurance through Guardian, and prescription coverage through Express Scripts. You will receive three separate insurance cards from each of these providers. Your optical benefit is provided through VHHSBP – click here for information on how to use your optical benefit.In addition, you are entitled to short and long-term disability, life insurance, hearing aid benefit, and legal services. You will be automatically enrolled in these benefits when you complete your enrollment form.[/vc_toggle][vc_toggle title=”I recently enrolled myself and/or dependents in the benefits plan – how long will it take to receive insurance cards?” el_id=”1471476234478-65f9a982-6f32″]I recently enrolled myself and/or dependents in the benefits plan – how long will it take to receive insurance cards?
If you enrolled during orientation (June), it can take several weeks before your information is registered due to the large volume of enrollments we receive during this time period. You can expect cards sometime toward the end of July or early August. However, all coverage will be effective from your start date. Enrollments during all other times of the year typically take 2-3 weeks to process. If you have an emergency and do not have an insurance card yet, you should contact the benefits office immediately.[/vc_toggle][vc_toggle title=”I lost my insurance cards, how can I request new cards?” el_id=”1471476354756-ce3bca57-e5b3″]To request a new dental card, contact Guardian at 1-888-600-1600. Be sure to provide our group number: G-417733.
To request a new health insurance card, contact Empire at 1-800-553-9603. Our group number is 720070.
For prescription cards, contact Express Scripts at 1-866-439-3658. Be sure to refer to our group number when you call: K4DA.
For optical, there are NO insurance cards – click here for more information on how to use your optical benefit.[/vc_toggle][vc_toggle title=”I contacted my insurance provider for information and they said I wasn’t enrolled yet, even though I completed my enrollment form. Why not?” el_id=”1471476354248-e1ae7ccb-7bcc”]It takes at least 2-3 weeks from the time you submit your enrollment form for your information to be processed by our office, and for our insurance providers to receive this information. If you enrolled more than 2-3 weeks ago, and are still not active, please contact the benefits office immediately. Missing social security numbers, date of birth, gender, or missing address can delay your enrollment and prevent your coverage from being active.[/vc_toggle][vc_toggle title=”What is open enrollment and when does it occur?” el_id=”1471476353709-89beceef-fe81″]Open enrollment is the period where you can change your dental plan, or add dependents to your plan if you did not enroll them previously. See adding dependents for more information. If you opted out of benefits previously, you may also opt back in during this time. Open enrollment occurs every January and July and forms must be received by January 31 or July 31 of the open enrollment period.[/vc_toggle][vc_toggle title=”I recently moved – how can I update my address?” el_id=”1471476351943-7b548473-af5c”]To notify the plan of an address change, contact the benefits office at 212-356-8180. You may also email, fax, or mail in your address change request. Once you provide us your address, we will send this information automatically to our insurance providers (Empire, Guardian, Express Scripts).[/vc_toggle][vc_toggle title=”When does the plan year begin and end?” el_id=”1471487481913-c7985055-6371″]The plan year begins July 1 and ends June 30 of the following year.[/vc_toggle][vc_toggle title=”How much do I pay for benefits for myself and dependents?” el_id=”1471487480500-a4c5c0a6-3442″]Benefits are provided at NO COST to you or your eligible dependents (spouse and children). However, for domestic partners, you will incur a tax liability on the value of the benefits at the end of the year. See domestic partners for more information.[/vc_toggle][vc_toggle title=”Union dues are taken out of my paycheck bi-weekly. Is this for my health insurance premium?” el_id=”1474307477388-ee565218-35cc”]No, members do not pay any premiums for benefits. The union has negotiated for your hospital to pay the full premium. Union dues go directly to the union to support the work involved in organizing, contract negotiations, and other organizational costs. For more information on dues, you should contact CIR directly at 212-356-8100.[/vc_toggle][vc_toggle title=”I already have insurance through my spouse. Can I opt-out of the benefits plan?” el_id=”1474307480545-aeeb866a-f018″]You may opt-out of the benefits plan at any time, provided you complete an opt-out form and provide proof of alternate insurance. However, keep in mind that you do not pay anything for your benefits, and by opting out, you and your dependents will be removed from all parts of the benefits plan, including health insurance, prescription, dental, optical, disability, life insurance, and legal services. If you would like to opt back in at a later date, you must wait until open enrollment to do so or loss of your alternate insurance.[/vc_toggle][/vc_column][vc_column width=”1/3″][vc_column_text css=”.vc_custom_1474311148893{background-color: #6796bf !important;}”]
Termination of Employment & COBRA
[/vc_column_text][vc_toggle title=”I am graduating/terminating from my residency program soon – when will my benefits end?” el_id=”1471476234506-28bca631-8ae0″]If your termination date is the final day of the month (i.e. June 30) your benefits will end on that day. If you terminate any other day during the month (i.e. July 10), your benefits will continue through to the end of the month (July 31). Once we receive a termination date from your hospital, we will automatically mail you a COBRA letter, which will provide information on how to continue your health coverage. See What is COBRA? for more information.[/vc_toggle][vc_toggle title=”What is COBRA?” el_id=”1471476234516-87e0cb9b-9c70″]COBRA is a Federal Act that allows employees and their eligible dependents to temporarily continue their health coverage due to reduction of work hours or loss of employment. You may extend your coverage for a maximum of 18 months and you must pay the monthly premium in order to remain active.[/vc_toggle][vc_toggle title=”What benefits are covered under COBRA?” el_id=”1474307964500-ab4f437e-8065″]Your health insurance, prescription coverage, dental insurance, and optical benefits will all continue under COBRA. Legal services, disability, and life insurance will terminate at the end of employment. However, you will have the right to convert your life insurance and disability coverage to an individual policy, and will receive information about your conversion rights in your COBRA letter.[/vc_toggle][vc_toggle title=”How long will my COBRA coverage last?” el_id=”1474307963878-14c7db4b-c0e7″]You may extend your coverage for a maximum of 18 months. If an additional qualifying event occurs while on COBRA (death of employee, divorce, or child ages out of plan), the spouse and/or children may extend their COBRA coverage for an additional 18 months, for a total of 36 months.[/vc_toggle][vc_toggle title=” Why haven’t I received my COBRA letter yet when I terminated residency already?” el_id=”1474307962327-8ba9837a-4551″]Contact the benefits office at 212-356-8180 and make sure we have your termination date on file. We rely on your employer to notify us of your residency termination date, and occasionally, there are delays in receiving this information. In addition, make sure we have your most current address on file. Once we have this information, we can generate a COBRA letter for you.[/vc_toggle][vc_toggle title=”How much is the COBRA premium?” el_id=”1474308065895-347c932f-c7da”]Premiums range from $300-400 per month for an individual plan, and $700-800 per month for a family plan. However, rates fluctuate each year, and you should contact the benefits office for the most current rates.[/vc_toggle][vc_toggle title=”How long do I have to elect COBRA?” el_id=”1474308064763-6a1ee22e-8c93″]You must send in your COBRA election form within 60 days from the date you terminated employment, or the day you receive your COBRA letter, whichever is later. Failure to elect COBRA within 60 days will result in the denial of continuation coverage.[/vc_toggle][vc_toggle title=”Once I elect COBRA, when will my benefits be reinstated?” el_id=”1474308064070-c960e116-4c68″]Your benefits will be reinstated the day immediately following your termination date, regardless of when you turn in your election form. For example, if you terminated on June 30, and send your election form on August 15, your COBRA benefits will become effective from July 1. In addition, you will be required to pay the July premium, regardless of whether you used your benefits in July.[/vc_toggle][vc_toggle title=”I elected COBRA, but haven’t received new insurance cards yet. Why not?” el_id=”1474308062692-7f2043e8-c706″]COBRA is a continuation of the same benefits you had while you were employed, and you may continue to use the same insurance cards. Your cards will only change if you changed your dental plan when you converted to COBRA, or if you moved out-of-state, and now require an Empire PPO plan. If you need new cards, you should contact the numbers listed below:To request a new dental card, contact Guardian at 1-888-600-1600. Be sure to provide our group number: G-417733.
To request a new health insurance card, contact Empire at 1-800-553-9603. Our group number is 720070.
For prescription cards, contact Express Scripts at 1-866-439-3658. Be sure to refer to our group number when you call: K4DA.[/vc_toggle][vc_toggle title=”How can I pay for COBRA?” el_id=”1474308866128-9280e9d7-5be5″]The plan currently accepts check or money order payment, or credit card payments using Visa or MasterCard only. To elect credit card, you must fill out the electronic credit card authorization form.[/vc_toggle][vc_toggle title=”When is my COBRA premium due?” el_id=”1474308865450-6524b4d3-cfe9″]Premiums are due on the first of every month if you pay by check or money order. If you fail to submit your premium by the first, you have 30 days to remit payment before your coverage is terminated. If you are paying by credit card, we will automatically charge your premium on the 28th of the month for the upcoming month.[/vc_toggle][vc_toggle title=”Why haven’t I received a statement or bill for my COBRA?” el_id=”1474308864457-518c0db3-70c7″]The benefits office will not send you a monthly statement for your COBRA premiums. You are responsible for making your payment on time each month if you are paying by check or money order. If you elected credit card payment, the plan will automatically charge your premium on the 28th of the month for the upcoming month that a premium is due.[/vc_toggle][vc_toggle title=”I have a new insurance plan. How can I terminate my COBRA benefits?” el_id=”1474308967020-f7206767-d8dd”]You should contact the plan in writing to notify us you would like to cease your COBRA benefits. If you are paying by credit card, we must receive your letter at least 10 days prior to the end of the month, so we may terminate the automatic billing on your card.[/vc_toggle][/vc_column][vc_column width=”1/3″][vc_column_text css=”.vc_custom_1474311158898{background-color: #6796bf !important;}”]
Dependent Enrollment and Eligibility
[/vc_column_text][vc_toggle title=”I just had a newborn and/or got married – how can I add my dependent to the benefits plan?” el_id=”1471476234534-977aa971-d930″]To add a dependent to the benefits plan, contact the benefits office at (212) 356-8180 and request a benefits change form, or download one on our website. If you are adding a newborn, you must provide a copy of the hospital discharge papers OR birth certificate. If you are adding a spouse, attach a copy of your marriage certificate. Mail or fax all enrollment materials to the benefits office within 30 days from qualifying event (marriage or birth).[/vc_toggle][vc_toggle title=”How much time do I have to add my spouse/child to the benefits plan?” el_id=”1471476234542-7aa0c0d7-c5f4″]All additions to the plan must be made within 30 days of the qualifying event (birth or marriage). If you fail to notify the Plan within 30 days, you will need to wait until the next open enrollment period (January and July) to add your dependent.[/vc_toggle][vc_toggle title=”My spouse lost his/her insurance from their previous employer. How can I add them to my benefits plan?” el_id=”1474309130641-de22c056-f28d”]Contact the benefits office at (212) 356-8180 to request a benefits change form, or download one on our website. You must notify the plan within 30 days of the loss of coverage, and provide a certificate of coverage from their previous employer showing when their coverage ended. In addition, you must also provide a copy of your marriage certificate. If you fail to notify the plan within 30 days, you will need to wait until the next open enrollment period (January and July) to add your dependent.[/vc_toggle][vc_toggle title=”I just added my newborn to the benefits plan today, and we have a doctor’s appointment tomorrow. Can I still go?” el_id=”1474309132020-786739f1-45e9″]Yes. Newborns are covered as a temporary member under the plan for the first 30 days. Simply provide the mother’s insurance card, and your provider will send the information to Empire to be processed when the child’s enrollment is complete. Allow at least 2-3 weeks for the receipt of your newborn’s insurance card.[/vc_toggle][vc_toggle title=”Is it possible to add my mother or father to the benefits plan?” el_id=”1474309133154-2bd47f67-39b1″]No. Eligible dependents include your legal spouse, dependent children/step-children, or your registered domestic partner. Parents, grandparents, or other relatives are not eligible for benefits.[/vc_toggle][vc_toggle title=”How can I enroll my domestic partner in the benefits plan?” el_id=”1474309134111-bc50fbdc-6ae0″]To enroll a domestic partner, download an application here. You must provide at least two documents as proof of partnership and have your form notarized. Refer to the application for a list of acceptable documents. In addition, you will be taxed on the value of the benefits at the end of the year, which will be added to your W-2 as income. Refer to the application for more details or contact the benefits office.[/vc_toggle][vc_toggle title=”How long will my child be covered on the benefits plan?” el_id=”1474309224815-f08f283d-b2bd”]Children are eligible for health insurance until the age of 26 (end of calendar year). For dental and optical benefits, children are covered until the age of 19, or until the age of 23, provided they are a full-time student at a post-secondary institution. You must provide proof of full-time student enrollment each semester they are enrolled.[/vc_toggle][vc_toggle title=”What benefits are my dependents eligible for?” el_id=”1474309225950-1be0280f-587d”]Spouse and children are eligible for all the benefits including health insurance, prescription, dental, optical, hearing aid, and legal services. The only benefits that are MEMBER ONLY are disability. Life insurance is for member and spouse only.[/vc_toggle][vc_toggle title=”How can I remove my spouse or child from my insurance policy?” el_id=”1474309227015-1de58441-007d”]To remove any dependent, you must complete an opt-out form. In addition, you must provide a copy of their alternate insurance by submitting a certificate of coverage or copy of their ID card from their health provider. When you opt-out a dependent, you will remove them from ALL parts of the benefits plan, including health insurance, dental, optical, and legal services.[/vc_toggle][/vc_column][/vc_row][vc_row][vc_column width=”1/3″][vc_column_text css=”.vc_custom_1474311169660{background-color: #6796bf !important;}”]Health Insurance Information
[/vc_column_text][vc_toggle title=”What kind of health insurance plan do I have?” el_id=”1474309554747-c2fa9986-6b9c”]The health insurance is provided through Empire BlueCross/BlueShield, and is a DirectShare POS (Point-of-Service) plan. With your DirectShare POS plan, you have the option to go in-network or out-of-network, although costs will be always be lower when you use in-network providers. If you reside outside of the tri-state area (NY, NJ, CT) you will be transferred to the Empire PPO plan. Coverage is similar to that of the POS plan, and you will have a greater network of providers to choose from.[/vc_toggle][vc_toggle title=”What is the difference between using an in-network or out-of-network provider?” el_id=”1474309554926-a9e3f84f-cc62″]When you choose an in-network provider, your health care costs will be lower, and you will only be responsible for your co-pay. If you go out-of-network, you will be responsible for meeting your yearly deductible, in addition to paying 20% of reasonable charges (50% for behavioral health). Also, when you go out-of-network, you are responsible for precertifying certain services, whereas, when you go in-network, the provider will precertify these services for you.[/vc_toggle][vc_toggle title=”How can I locate an in-network provider?” el_id=”1474309555100-28bcc25a-d0bb”]Visit www.empireblue.com and click on “Find a Doctor”. Be sure to select the Empire DirectShare POS plan from the drop-down menu.[/vc_toggle][vc_toggle title=”What is a co-payment?” el_id=”1474309555270-6084f3bb-e2ed”]A co-payment is the amount that a patient is responsible for at the time they visit a physician or hospital, or have a prescription filled. The patient is responsible for this fee up-front, while the insurance provider covers the remaining cost of the medical service or prescription. Under Empire, you co-payment is $20 for office visits and $25 for behavioral health visits. For emergency room visits, your co-pay is $35, but is waived if you are admitted.[/vc_toggle][vc_toggle title=”What is a deductible?” el_id=”1474309555434-c541aa3b-e37a”]A deductible is the out-of-pocket amount a plan participant must pay before the health insurance covers any medical expenses. Under Empire, you will only pay a deductible if you go out-of-network, and deductible amounts are $100/ individual or $200/family. In addition, after you meet your yearly deductible, you are also responsible for paying 20% of reasonable service charges, while Empire will pay 80% of reasonable charges.[/vc_toggle][vc_toggle title=”What services need to be precertified and how?” el_id=”1474309555599-0be3182b-fc1b”]Click here for the list of services that need to be precertified. When you go in-network, your provider will contact Empire to precertify these services for you. When you go out-of-network, it is YOUR responsibility to precertify these services. Precertification is necessary to ensure you receive the best quality care for the maximum length of time with the maximum coverage. To precertify services, you should contact Empire’s Medical Management Program at 1-800-845-4742.[/vc_toggle][vc_toggle title=”I have a question about a specific health service or claim – who should I contact?” el_id=”1474309555789-63ab7104-39fd”]Questions regarding specific services or health claims should be made directly to Empire. You can contact a customer service representative at 1-800-553-9603.[/vc_toggle][vc_toggle title=”Is my prescription benefit covered under my Empire plan?” el_id=”1474309555960-3db0d1b1-f8cb”]No, your prescription coverage is provided through Express Scripts, and you will receive a separate card.[/vc_toggle][vc_toggle title=”I have a doctor’s appointment today but don’t have my insurance card yet. Is there a temporary card I can download?” el_id=”1474309556143-2f4ebe4d-7fab”]Yes. Visit www.empireblue.com and select Register Now. You will be prompted to enter the member’s name, date of birth, and member ID. The member ID is the member’s social security number. Once you enter this information, you will need to create a username and password. After you log-in, you will be able to print a temporary ID card that you can use at the provider’s office.[/vc_toggle][/vc_column][vc_column width=”1/3″][vc_column_text css=”.vc_custom_1474311176518{background-color: #6796bf !important;}”]Termination of Employment & COBRA
[/vc_column_text][vc_toggle title=”I am graduating/terminating from my residency program soon – when will my benefits end?” el_id=”1474309556836-86c51e7b-91c2″]If your termination date is the final day of the month (i.e. June 30) your benefits will end on that day. If you terminate any other day during the month (i.e. July 10), your benefits will continue through to the end of the month (July 31). Once we receive a termination date from your hospital, we will automatically mail you a COBRA letter, which will provide information on how to continue your health coverage. See What is COBRA? for more information.[/vc_toggle][vc_toggle title=”What is COBRA?” el_id=”1474309557014-bd39dbb8-6d19″]COBRA is a Federal Act that allows employees and their eligible dependents to temporarily continue their health coverage due to reduction of work hours or loss of employment. You may extend your coverage for a maximum of 18 months and you must pay the monthly premium in order to remain active.[/vc_toggle][vc_toggle title=”What benefits are covered under COBRA?” el_id=”1474309557187-8ab4e236-637b”]Your health insurance, prescription coverage, dental insurance, and optical benefits will all continue under COBRA. Legal services, disability, and life insurance will terminate at the end of employment. However, you will have the right to convert your life insurance and disability coverage to an individual policy, and will receive information about your conversion rights in your COBRA letter.[/vc_toggle][vc_toggle title=”How long will my COBRA coverage last?” el_id=”1474309557375-b56d110a-24c1″]You may extend your coverage for a maximum of 18 months. If an additional qualifying event occurs while on COBRA (death of employee, divorce, or child ages out of plan), the spouse and/or children may extend their COBRA coverage for an additional 18 months, for a total of 36 months.[/vc_toggle][vc_toggle title=” Why haven’t I received my COBRA letter yet when I terminated residency already?” el_id=”1474309557560-1b528e7c-cbac”]Contact the benefits office at 212-356-8180 and make sure we have your termination date on file. We rely on your employer to notify us of your residency termination date, and occasionally, there are delays in receiving this information. In addition, make sure we have your most current address on file. Once we have this information, we can generate a COBRA letter for you.[/vc_toggle][vc_toggle title=”How much is the COBRA premium?” el_id=”1474309557738-96263e05-0da1″]Premiums range from $300-400 per month for an individual plan, and $700-800 per month for a family plan. However, rates fluctuate each year, and you should contact the benefits office for the most current rates.[/vc_toggle][vc_toggle title=”How long do I have to elect COBRA?” el_id=”1474309557909-0cab8808-a585″]You must send in your COBRA election form within 60 days from the date you terminated employment, or the day you receive your COBRA letter, whichever is later. Failure to elect COBRA within 60 days will result in the denial of continuation coverage.[/vc_toggle][vc_toggle title=”Once I elect COBRA, when will my benefits be reinstated?” el_id=”1474309558095-f0039305-740a”]Your benefits will be reinstated the day immediately following your termination date, regardless of when you turn in your election form. For example, if you terminated on June 30, and send your election form on August 15, your COBRA benefits will become effective from July 1. In addition, you will be required to pay the July premium, regardless of whether you used your benefits in July.[/vc_toggle][vc_toggle title=”I elected COBRA, but haven’t received new insurance cards yet. Why not?” el_id=”1474309558273-47db541e-f898″]COBRA is a continuation of the same benefits you had while you were employed, and you may continue to use the same insurance cards. Your cards will only change if you changed your dental plan when you converted to COBRA, or if you moved out-of-state, and now require an Empire PPO plan. If you need new cards, you should contact the numbers listed below:To request a new dental card, contact Guardian at 1-888-600-1600. Be sure to provide our group number: G-417733.
To request a new health insurance card, contact Empire at 1-800-553-9603. Our group number is 720070.
For prescription cards, contact Express Scripts at 1-866-439-3658. Be sure to refer to our group number when you call: K4DA.[/vc_toggle][vc_toggle title=”How can I pay for COBRA?” el_id=”1474309558447-ae06680c-6212″]The plan currently accepts check or money order payment, or credit card payments using Visa or MasterCard only. To elect credit card, you must fill out the electronic credit card authorization form.[/vc_toggle][vc_toggle title=”When is my COBRA premium due?” el_id=”1474309558628-f1bb1f8f-1054″]Premiums are due on the first of every month if you pay by check or money order. If you fail to submit your premium by the first, you have 30 days to remit payment before your coverage is terminated. If you are paying by credit card, we will automatically charge your premium on the 28th of the month for the upcoming month.[/vc_toggle][vc_toggle title=”Why haven’t I received a statement or bill for my COBRA?” el_id=”1474309558819-3868f779-9c0f”]The benefits office will not send you a monthly statement for your COBRA premiums. You are responsible for making your payment on time each month if you are paying by check or money order. If you elected credit card payment, the plan will automatically charge your premium on the 28th of the month for the upcoming month that a premium is due.[/vc_toggle][vc_toggle title=”I have a new insurance plan. How can I terminate my COBRA benefits?” el_id=”1474309559020-49324e9e-67f1″]You should contact the plan in writing to notify us you would like to cease your COBRA benefits. If you are paying by credit card, we must receive your letter at least 10 days prior to the end of the month, so we may terminate the automatic billing on your card.[/vc_toggle][/vc_column][vc_column width=”1/3″][vc_column_text css=”.vc_custom_1474311183946{background-color: #6796bf !important;}”]
