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PEP June 2016
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Public Employee Press

Health benefit changes set for July 1


A series of modifications to the city's health-care plans will go into effect on July 1.

The changes affect members and retirees who are not yet enrolled in Medicare.

The Municipal Labor Committee (MLC), which is comprised of public sector unions in the city and negotiates on health-care matters on their behalf, approved the benefit modification package on Feb. 22.

The February agreement will maintain the quality of the health-care plans, and it avoids premium contributions. New York City remains the only major municipality in the country with free health-care coverage.

The July benefit changes are being carried out as part of a $3.4 billion savings plan that the city and unions agreed to in 2015. The agreement opened the door for contract negotiations, which were stalled during the Bloomberg
administration.

The MLC and the city are discussing ways to hold down health-care costs by identifying waste and finding more efficient and creative ways to provide coverage.

For instance, the city is encouraging municipal employees to enroll in the Advantage Care Physician (ACP) network, which provides services more efficiently by offering comprehensive care under one roof.

The 2015 agreement with the MLC calls for $400 million in savings in fiscal year 2015, $700 million in fiscal year 2016, $1 billion in fiscal year 2017 and $1.3 billion in fiscal year 2018. The agreement aims to guarantee $1.3 billion in health care savings annually after 2018.

Under the February plan, the copay for visits to primary care physicians will remain the same ($15 for GHI-CBP and $0 for HIP/HMO).

Other changes in the Emblem Health GHI plan include a copay increase from $25 to $30 for visits to non-surgical specialists, a copay increase from $20 to $30 for surgical specialists, a copay increase for physical therapy from $15 to $20, a copay increase for diagnostic lab work from $15 to $20, and an increase of the MRI/CT copay from $15 to $50.

To encourage workers to enroll in the Advantage Care Physicians network, the agreement eliminates the $15 copay for primary care physicians and the $20 co-pay for specialists in the plans.

To discourage members from going to the emergency room when their medical condition can be treated for less at a doctor's office, the agreement raises the copay for hospital emergency visits from $50 to $150.

 
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