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Updated April 25, 2008 - Health Benefits Homepage
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Now that we're well into 2008, here are some tips to help you make the most of the pre-tax dollars in your Health Care Spending Account (HCSA) or Dependent Care Advantage Account (DCAA). The following apply to both HCSA and DCAA: 1) New employees can submit a change in status application within 60 days of their start date. This change will benefit employees who don't receive their new employee orientation in a timely fashion. 2) Employees can now submit change in status applications on-line instead of via paper. The application is at http://flexspend.state.ny.us/. Health Care Spending Account 1) Orthodontia costs that are paid on a monthly payment plan are reimbursed after each monthly payment is due. However, if you pre-pay the entire cost of orthodontia treatment up front, you will only be reimbursed in a particular plan year for the value of the services that will be provided during that plan year. 2) The mileage allowance for transportation to obtain medically necessary health care was reduced from $0.20 to $0.19 by the IRS effective 1/1/08. 3) A list of over-the-counter drugs and supplies eligible for reimbursement under the HCSA is available here. 4) Remember that the total amount you set aside for the year is available at any time, you don't have to wait for the cash to accumulate in your account before you can use it. Dependent Care Advantage Account 1) Employees who leave state service can continue submitting receipts for reimbursement of eligible expenses to their Dependent Care Advantage Accounts until their funds are exhausted. 2) If you submit a receipt for more money than you have in your DCAAccount, the balance will be paid automatically when the funds are deposited from your next payroll deduction.
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 Generic
Albuterol Inhalers No Longer AvailableAlbuterol inhalers are used for asthma and related conditions. The U.S. Food and Drug Administration (FDA) has mandated that albuterol inhalers containing the propellant chlorofluorocarbon (CFC) be discontinued from the market by December 31, 2008. They are being replaced by albuterol inhalers containing a more environmentally friendly propellant known as hydrofluoroalkane (HFA). Several HFA inhalers are available as alternatives to albuterol CFC inhalers; however, they are available only as brand name medications. As a result of this FDA mandate, several prescription drug manufacturers have discontinued producing generic albuterol CFC inhalers, resulting in intermittent supply shortages in retail pharmacies, as well as the inability for large mail order facilities to receive timely shipments. Due to the shortages, the mail service pharmacy, Medco By Mail, will not be able to dispense generic albuterol CFC inhalers. Any prescription written for an albuterol inhaler or albuterol metered dose inhaler received at Medco By Mail will be filled with a Proventil HFA inhaler. Proventil HFA is a preferred brand name drug on the Empire Plan Preferred Drug List. The preferred brand name drug copay will apply. Generic albuterol CFC inhalers may continue to be available at your local retail pharmacy throughout 2008. If you would like to continue receiving generic albuterol inhalers and your local pharmacy has adequate supplies, your local pharmacist may be able to assist you in transferring the albuterol prescription from Medco By Mail. The pharmacist may contact Medco By Mail by calling The Empire Plan's Prescription Drug Program, followed by prompt #1 for 2008 prescription drug benefits. When the generic albuterol CFC inhalers are no longer available from your local retail pharmacy, you and your physician will want to consider transitioning to an HFA inhaler. For your reference, this table provides a list of albuterol HFA brand name inhalers, their placement on the 2008 Empire Plan Preferred Drug List, and the Empire Plan copayment at a retail pharmacy or through Medco By Mail. Please discuss with your physician which albuterol HFA product is right for you. If you have any questions, please contact the Empire Plan Prescription Drug Program at 1-877-7-NYSHIP (1-877-769-7447) and choose prompt #4 for the Prescription Drug Program, then select the option for 2008 prescription drug benefits.
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May and June are traditionally the months in which most full-time students complete their studies. If you have a child who is age 19 or older and enrolled in the NYS Health Insurance Program (NYSHIP), it is important to determine if he or she remains eligible for coverage. Your unmarried dependent children who are age 19 or over but under age 25 are eligible if they are full-time students at an accredited educational institution, and are otherwise not eligible for employer group or military health care coverage (e.g., cadets at U.S. military academies). They continue to be eligible until the earlier of the following dates:
Students who want to continue health insurance coverage during the summer must have been enrolled in the previous spring semester and must be enrolled as full-time students for the fall semester. If a dependent child who was a full-time student in the spring semester does not enroll as a full-time student for the fall semester, coverage under the parent's policy will end on the last day of the month in which the student was a full-time student attending classes.
If you want your child to continue to be covered without interruption, you must act quickly in one of two ways:
Under provisions of COBRA (the federal Consolidated Omnibus Budget Reconciliation Act), the employee or a family member is responsible for informing the Employee Benefits Division (EBD) of the NYS Department of Civil Service of a child's losing NYSHIP eligibility within 60 days from the date coverage ends. To obtain a COBRA election form, send a written request to: New York State Department of Civil Service Employee Benefits Division Attn: COBRA Unit Alfred E. Smith State Office Building 80 South Swan Street Albany, NY 12239 Please include your name, address, and social security number, your dependent's name and address (if different), the reason for the request, the date coverage ended, and a telephone number where you can be reached during the workday. If you do not notify EBD within the required 60-day period, regardless of the reason, the dependent will not be entitled to COBRA continuation coverage. The health care benefits your child may continue under COBRA are the same benefits you receive as an active employee enrolled in NYSHIP. COBRA requires that your child have the opportunity to continue coverage for up to 36 months. The cost of COBRA coverage is the full premium (both the employer and employee share) plus a two percent administrative fee. If your child is seeking admission to a school over the summer, but has not yet been accepted, coverage should be continued through COBRA. Once your child's enrolled for the fall semester, his or her dependent student status will be reinstated back to the date he or she lost eligibility and the COBRA premium paid during the interim will be refunded. In addition to continuation through COBRA, children losing eligibility are entitled to convert to direct-pay contracts after their NYSHIP coverage ends. Notification procedures and deadlines for applying for conversion coverage vary among the NYSHIP health care plans. The benefit package for direct-pay conversion contracts may differ from what your child had under NYSHIP. To obtain premium information, contact the carrier or HMO directly. Additional information concerning COBRA and Direct-Pay Conversion Contracts can be found in the January 1, 1996 NYSHIP General Information Book and the documents communicating changes made since then. You may also contact your agency health benefits administrator, who is usually located in your Personnel Office, for assistance.
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