Under a restructuring, DC 37 Med Team/Choice is no longer covering out-of-network benefits, except for emergency care, and it is increasing the copayment for in-network hospital stays.

The restructuring is occurring because Empire Blue Cross Blue Shield (MedTeam's insurer) said it couldn't offer the previous plan for what the city pays for health-care coverage.

"As we studied ways to deal with the rising cost of health care, it made sense for us to make this transition, because only a very small percentage of DC 37 Med Team participants actually go to out-of-network providers," said Willie Chang, director of the union-run health plan. "So, for most people, the change shouldn't be noticeable."

As the cost of health care continues to soar, the DC 37 Health and Security Plan is working to ensure that members and retirees keep the option of participating in the unique plan. Out of the 14 health plans that the city offers to DC 37 members and retirees, DC 37 Med Team/Choice is the only one that the union sponsors.

On July 1, DC37 Med Team/Choice became what's known in the health care industry as an "exclusive provider organization" (EPO). Under its old structure, the plan was a "preferred provider organization" (PPO). There are essentially two differences between the EPO and PPO programs.

Whereas PPO participants may get treatment out-of-network as long as they are willing to pay a higher co-payment, EPOs don't provide for out-of-network coverage, with the exception of emergency treatment.

With the restructuring, DC 37 Med Team/Choice's copayment for in-network, inpatient hospitalization will increase from $100 to $250 for individuals and from $250 to $625 for families.

Under the restructuring, participants will continue to enjoy the comprehensive benefits offered by Empire Blue Cross Blue Shield's EPO program, which has a network of 94,000 physicians and other health providers and 206 network hospitals in New York, New Jersey and Connecticut.

Empire will continue to provide participants with customer-centered health care including doctor's office visits, preventive care, including well-child and well-woman services, emergency care, maternity care and hospitalization coverage.

As long as they receive care from Empire's network of providers and hospitals, participants don't have to pay deductibles or file claim forms.

Except for the increased copay for in-network hospital stays, all other DC37 Med Team/Choice in-network benefits with the EPO program remain the same.

Before receiving care, DC37 Med Team/Choice participants should check with their providers to ensure that they are part of the Empire EPO program or the BlueCard program.

If you have any questions about the DC37 Med Team/Choice EPO program or want to verify a provider's participation, please feel free to contact Empire's member services representative at 1-800-342-9816. A list of participating providers is also on Empire's Web site. You may also contact the DC37 Med Team Unit at DC37 Headquarters at 212-815-1313.