All over the country, health plans like ours face the same question every year, “How can we avoid cost increases for our members, when the cost of care continues to rise?”
We are thrilled that, again, our members will pay no monthly premiums, despite the rise in the cost of care. Meanwhile, the average worker pays hundreds of dollars in monthly premiums. To maintain these zero monthly costs to members, we instead agreed to change our plan to incentivize members to use lower-cost, high-quality in-network providers. These updates to our health plan went into effect on October 1st and an explanation was sent to members via email on July 31. There are two key changes:
- Lower the total amount you could pay for in-network care, by creating an out-of-pocket maximum for in-network care
- Increase the amount you will pay for using out-of-network providers
We understand there may be some confusion about benefit changes. This is due in part to an error made by Empire Blue Cross Blue Shield. If Empire’s error has caused you to be overcharged, you will be reimbursed for the amount you overpaid.
Please read more about the reimbursement process in the Frequently Asked Questions (linked below).
Going forward, the best way to avoid increased or unexpected costs is by using any of the 40,000 high-quality in-network providers who are included in our Empire Blue Cross plan. But also, for a limited time, the Benefits Office will ease the transition to higher-cost out-of-network care by partly subsidizing these increased costs.
Specific information can be found in the FAQ. Our job is to take care of you so that you can take care of your patients. That means alleviating worries over what your health care will cost and how to minimize it. Please take a look at the enclosed examples that outline how the health plan changes may affect you. Also, please carefully review the FAQ. Feel free to contact us with your questions or concerns at the Benefits Office: 212-356-8180, Monday – Friday, 9:00 am – 5:00 pm EST or via email at firstname.lastname@example.org