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Employee Non-Med Retiree Retiree Summary of Plans

NYC Health Benefits Program

Introduction

Through collective bargaining agreements, the City of New York and the Municipal Unions have cooperated in choosing health plans and designing the benefits for the City’s Health Benefits Program. These benefits are intended to provide you and your eligible dependents with the fullest possible protection that can be purchased with the available funding.

Coverage for Employees 65+

If you're over 65, still working for the City and enrolled in the NYC Health Benefits Program, do not use your Medicare card when you visit your doctor's office. Instead, be sure to use the member ID card provided to you by your current HBP health plan.

The OLR website and the NYC Health Benefits Program Summary Program Description (SPD) provide you with information about your benefits under the New York City Health Benefits Program.

Health Benefits Program 2018 Annual Transfer Period - October 1st through October 31st

During the Annual Transfer Period, employees may transfer into any health plan for which they may be eligible, add or drop Optional Rider coverage, or add or drop dependents in their present plan.

Health Benefits Applications are available through NYCAPS Central (212-487-0500). DOE employees should contact DOE HR connect at 718-935-4000 and NYC H+H employees should contact H+H Shared Services at 646-458-5634. All other employees can obtain an application by contacting their agency personnel office.

All changes will take effect on the first day of the first full pay period in January 2019.

Opioid Treatment Drug Coverage

Effective July 1, 2017

Your base health plan will cover you and your dependents for medicines used to treat substance-use disorders. This includes medicines usually prescribed for opioid addiction and dependence. These medicines, along with counseling and behavioral therapies, can successfully treat these disorders and help with recovery. Visit your health plan for a list of covered opioid medicines and copays.

Health Plan Websites

Use the links below to visit your health plan where you will be able to find an in-network doctor, urgent care center, lab or pharmacy.

Learn more about MetroPlus Gold for City Employees. Now available in all 5 boroughs! Play the video


		Important Changes to HIP HMO Effective July 1, 2017. Learn More

		NOTE: Hospitalization coverage for GHI CBP is underwritten and administered by Empire BlueCross BlueShield (EBCBS). View the EBCBS Directory of participating NY, NJ, CT hospitals*

*Provider information contained in the Empire BlueCross BlueShield Directory is updated on a regular basis and may have changed. Therefore, please check with your provider before scheduling your appointment or receiving services to confirm participation.

Expert Medical Review for Those Diagnosed with Cancer with Best Doctors

(For Those Covered Under the EmblemHealth GHI-CBP Plan)

Best Doctors will provide a free expert medical review from an oncologist¹ as well as Oncology Insight With Watson, the world’s most advanced cognitive technology for Emblem GHI-CBP members. For more information call Best Doctors at 844.282.4994 or visit BestDoctors.com/NYC

1. Gallup® has audited and certified Best Doctors, Inc.’s database of physicians, and its companion Best Doctors in America® List, as using the highest industry standards survey methodology and processes.

Please be advised that you will not be a patient of Best Doctors or of any Best Doctor Expert that reviews your medical information, and that no doctor-patient relationship will be created between Best Doctors and you or between any Best Doctors Expert and you. Any treatment decisions will be made solely by your treating physician(s) and you.

24/7 Telemedicine Program with Teladoc

(For Those Covered Under the EmblemHealth GHI-CBP Plan)

With Teladoc, you can talk with a doctor within minutes rather than days or hours. Teladoc doctors can diagnose, treat and prescribe medication (when medically necessary) for non-emergency medications. This includes treatments for the flu, sore throat, allergies, stomach aches, eye infections, bronchitis, and much more. The copay is $10 per consultation. To set up your account now so you can talk with one of Teladoc’s board-certified doctors anytime when you don't feel well, call 1-800-Teladoc (1-800-835-2362) or visit Teladoc.com/emblemhealth

List of Health Plans

Listed are the non-Medicare Health Plans offered by the New York City Health Benefits Program to its employees and non-Medicare retirees. View the List of Health Plans

Aetna EPO Basic Plan
Aetna EPO Basic Plan with Prescription Drugs
Cigna HMO Basic Plan
Cigna HMO Basic Plan with Prescription Drugs
DC 37 Med-Team
Empire BlueCross BlueShield EPO Plan with Prescription Drugs
Empire BlueCross BlueShield EPO Plan without Prescription Dugs
Empire BlueCross BlueShield HMO with Prescription Drugs
Empire BlueCross BlueShield HMO without Prescription Drugs
Empire BlueCross BlueShield PPO with Prescription Drugs (Hawaii and Alaska Only)
Empire BlueCross BlueShield PPO without Prescription Drugs (Hawaii and Alaska Only)
Empire BlueCross BlueShield Hospital Plan Only (Companion to GHI CBP Medical Coverage)
GHI CBP Basic Plan
GHI CBP Basic Plan with Enhanced Schedule and Prescription Drugs (Optional Rider)
GHI HMO Basic Plan
GHI HMO Basic Plan with Prescription Drugs
HIP HMO Basic Plan
HIP HMO Basic Plan with DME and PDN
HIP HMO Basic Plan with Prescription Drugs
HIP POS Basic Plan
HIP POS Basic Plan with Prescription Drugs
MetroPlus Gold
Vytra Basic Plan
Vytra Basic Plan with Prescription Drugs

View the Summary of Benefits and Coverage (SBC) for each Plan.

Form 1095-C

Form 1095-C is a tax form under the Affordable Care Act ("ACA") which contains information about your health care insurance coverage. Form 1095-C is distributed to all full-time employees working an average of 30 hours or more per week, for all or part of the calendar year. For information about Form 1095-B, please contact your health care provider directly.

Learn more about Form 1095-C

2015 Cyber-Attack Impacting Empire Blue Cross Blue Shield

Anthem, Inc., the parent company of Empire Blue Cross and Blue Shield, one of the City’s health insurance providers, was the victim of a highly-sophisticated cyber-attack in 2015. Visit the Anthem website – www.anthemfacts.com, or call their hotline, 1-877-263-7995, for updated information.