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HEALTH BENEFITS DEPARTMENT



News From the Health Benefits Department


Important Information for all MVP PPO Enrollees: - Updated: Nov. 12, 2014
Effective January 1st, 2015 CVS/Caremark will be the new pharmacy administrator for the MVP PPO Plan. You will receive new ID cards with an anticipated ship date of December 15, 2014. You can download the 2015 MVP PPO Formulary list here. You can also continue to search for pharmacies on the mvphealthcare.com website. Members will receive letters if their medication or pharmacy is impacted.

Please see below for highlights about the changes:

Prior Authorizations:
  • Prior authorizations that extend beyond 1/1/15 will be transitioned to CVS/Caremark automatically. (No action is required).
  • Prior authorizations that end before 1/1/15 must be re-initiated by the prescriber.

Formularies:
  • No changes as a result of the transition to CVS/Caremark. Members are normally notified by mail during the year whenever a formulary change affects them.

Pharmacy Network:
  • The 2015 network of participating pharmacies will be very much the same as the current pharmacy network. Members are not limited to using CVS Pharmacies. There will be a mail alert sent out in December to any member using a pharmacy that will not be in the network as of 1/1/15 and it will include two alternative pharmacies to utilize.

Online Formulary Network Access:
  • The 2015 formulary list is available on mvphealthcare.com

Mail Order & Specialty Drug Change:
  • All non-controlled and non-compound Rx’s with refills will be sent to CVS/Caremark by 1/1/15
  • Member letters will be sent to those with active Rx’s in mid- November.
  • CVS/Caremark forms will be included for members to use with their first order.



Important information for NYSHIP Enrollees: - Updated: Oct. 10, 2014
Beginning October 1st, 2014, eligible non-Medicare primary enrollees and their dependents may receive the following preventative vaccines without a copayment when administered by a licensed pharmacist at a pharmacy that participates in CVS Caremark’s national vaccine network. NYSHIP enrollees will receive a Preventative Vaccine Postcard from NYSHIP in the mail shortly.
  • Influenza- flu
  • Herpes Zoster-shingles
  • Pneumococcal- pneumonia
  • Meningococcal- meningitis

**You must be at least 18 years of age and Non- Medicare primary to receive the preventative vaccinations listed at a participating pharmacy.**

*** Shingles immunizations provided for individuals ages 55-60 may be subject to a $5.00 co- payment.***

Please visit www.empireplanrxprogram.com and select CVS/Caremark to find participating pharmacies in your area.


2014 Retirement System Consultation Site Schedule: - Updated: Oct. 10, 2014
The 2014 Retirement System Consultation Site Schedule is available: Download Now


Pension & Retirement Education Program Fall 2014: - Updated: Oct. 9, 2014
The Fall 2014 Schedule of PREP Seminars is available: Download Now


2014- 2015 Health Insurance Open Enrollment: - Updated: Oct. 3, 2014
2014-2015 Health Insurance Open Enrollment is currently underway. During the months of October and November you can make changes to your current health insurance plan or switch health insurance plans. Please be sure to review the Summary of Benefits Comparisons section on the Health Benefits page. You will be able to compare our different health insurance options and elect the one that is right for you. Please note if switching plans, you will need to complete both an enrollment form for the new plan and a cancellation form to terminate the old plan. All forms must be submitted to the Health Benefits Department by November 30, 2014. All changes will become effective on January 1st, 2015.


Important MVP PPO Plan Information: Run out period on claims incurred prior to 8/1/14 ends 10/31/14 - Updated: Oct. 3, 2014
MVP PPO enrollees: If you have any unpaid insurance claims that were incurred prior to 8/1/14 and a remaining deductible balance from last claim year, please submit the attached MSAS paper claim form along with your bill, EOB or proof of payment to Marshall & Sterling by October 31, 2014. October 31st, 2014 will be the last date to submit these claims. Marshall & Sterling will remit payment directly to you to pay the provider or if you have already paid the provider the check will reimburse you for your payment.
Download Claim Form


Important MVP PPO Plan Information: Run out period on claims incurred prior to 8/1/14 ends 10/31/14 - Updated: Oct. 3, 2014
MVP PPO enrollees: If you have any unpaid insurance claims that were incurred prior to 8/1/14 and a remaining deductible balance from last claim year, please submit the attached MSAS paper claim form along with your bill, EOB or proof of payment to Marshall & Sterling by October 31, 2014. October 31st, 2014 will be the last date to submit these claims. Marshall & Sterling will remit payment directly to you to pay the provider or if you have already paid the provider the check will reimburse you for your payment.


MVP PPO, SETTING UP ACCOUNT ONLINE AND HRA MANAGEMENT (REVISED) - Updated: Sept. 17, 2014
   The following PDF will walk you through setting up your MVP Account as well as managing your HRA account. Download Account Setup and HRA Management PDF


FLEX Plan Reps Building Schedule - Posted: September 5, 2014
   Use the following link to download a schedule of when the Flex plan/ supplemental insurance reps will be at each building/school for next week. Download Schedule


Wage Works Flex Plan - Posted: August 27, 2014
   Open enrollment for the Wage Works Flex Plan will begin on September 1, 2014. SRA forms and Flex Plan information are available on the Health Benefits Page. There have not been any changes from last year. All SRA forms must be submitted to the Payroll Department by Tuesday, September 16, 2014.


MVP PPO Health Care Form Update - July 28, 2014
The following forms have been updated/added:
   MVP PPO Claim Reimbursement Form
   Enrollment Change Form
   Medco Pharmacy, Mail-Order Form
They can also be found under the MVP Forms section to the right.


Important Information For All Mvp Ppo Enrollees - July 15, 2014
Important Information for all MVP PPO enrollees: Marshall & Sterling’s Call Center will be available during the week of Monday, July 21, 2014- Friday, July 25, 2014 from 9:30am – 11:30am and from 2:30-4:30pm to answer questions you may have concerning the MVP PPO plan renewal
To access the Call Center please use the following:
Dial in Number: (800) 501-8979
Use Access Code: 0092480


New Information Posted For The 2014 MVP PPO Plan Renewal - July 9, 2014
New information has been posted for the 2014 MVP PPO Plan. This includes the Health Risk Screen Form, information about the Wellstyle Rewards Program, and the 2014-15 Employee Benefit Guide


Lifestyle Tips - July Issue - July 3, 2014
The July 2014 issue of Lifestyle Tips is available for download. Click on the link below to access the document.
Lifestyle Tips - July Issue


MVP PPO Summary Of Benefits Posted - July 1, 2014
The MVP PPO Summary of Benefits (SBC) has been posted. In addition, the CHIRPA Notice and Medical Terms Glossary are also both available.


Pension And Retirement Education Program (PREP) - May 21, 2014
Click on the link below for the Summer 2014 Schedule of the NYS State PREP Program. The PREP Program seminars offer retirement planning advice.
Pension And Retirement Education Program (PREP) Document


Health Insurance Buyout - May 21, 2014
Click on the link below for the Health Insurance Buy-Out form for the 2014-2015 school year in addition to instructions for filling out the form. ANYONE WISHING TO PARTICIPATE MUST COMPLETE THE FORM. ALL FORMS MUST BE SUBMITTED BY JUNE 20TH, 2014
Download Health Insurance Buyout Form


CONTACT HEALTH BENEFITS



Keisha Martinez, Health Benefits Specialist
Newburgh Library/BOE Complex
124 Grand Street
Newburgh, NY 12550

Phone: (845) 563-3467



IMPORTANT PHONE NUMBERS



Empire1-877-769-7447
MVP1-888-687-6277
CDPHP1-800-777-2273
GHI1-877-244-4466
CSEA Dental/Vision1-800-323-2732