2007 HMO Changes

The NYS Jo int Labor-Management Committees on Health Benefits (JLMC) has completed reviewing proposals submitted by HMOs for inclusion or continued participation in the New York State Health Insurance Program (NYSHIP) in the year 2007. The JLMC has announced the following changes:

• Aetna will not be permitted to enroll state employees or retirees as new members or transfers in 2007.  The “freeze” on enrollment only affects new (or newly eligible) employees, or those who wish to transfer from another plan.  Current Aetna members who want to stay in Aetna may stay in Aetna.  They will not have to change plans.  For the second consecutive year, Aetna failed to submit a proposal that satisfied the requirements of the Specifications for HMOs Participating in NYSHIP.

• In addition, the NYSHIP-approved service area for Aetna will no longer include any counties in the State of Pennsylvania.  Previously, the state allowed retirees residing in these Pennsylvania counties to enroll in Aetna.  Now, the Empire Plan will be the only option available to these retirees.

• The merger of Vytra with HIP means that Vytra members will have to choose another option for 2007.  The NYS Department of Civil Service will notify current Vytra members of the need to choose a different health plan option during the annual option transfer period.  If another plan is not selected, the member will automatically be enrolled in the Empire Plan.

If you are enrolled in an HMO that will be making a benefit change for the year 2007, you will be sent a side-by-side benefit comparison.  HMOs making benefit changes are:  Aetna, Blue Choice, CDPHP, HMO Blue, Preferred Care and Univera. Premium rate information for the year 2007 is not yet available. Please be sure to review the rate flyer carefully. HMO premium contributions may increase significantly from one year to the next.