If you are a full-time or part-time employee budgeted to work 22.5 hours or more a week, you may participate in the health care plans. Coverage begins on the first day of the month following your start date.
You can also extend coverage to your family, generally defined as your spouse or domestic partner and your children. Eligible children are covered to the end of the month in which they turn 26.
You and the Hospital share the cost of the medical and dental coverage you elect. Your bi-weekly contributions are deducted from your paycheck on a before-tax basis.
Employees in Local 1199 are covered under a collective bargaining agreement and should refer to their respective contract for health care coverage information.
There are two choices for medical coverage: the Empire EPO plan and Empire PPO plan.
Important Note: All members will receive new ID cards for 2020, even if you make no changes to your medical plan election!
Empire EPO Plan - This is the most cost-effective option. When you use Tier I (White Plains Hospital and their physicians who participate with Empire/Montefiore Health System facilities and their employed physicians), you will have the lowest out-ofpocket costs. You may also utilize Tier II providers; however, office co-pays will be higher and hospital/facility based services will be subject to a deductible, co-insurance (and co-pay, in some cases). There is no out-of-network coverage (except for emergent care).
Empire PPO Plan -This option provides the same benefit as the EPO for Tiers I & II; however, the deductible and co-insurance for hospital and facility based services is less. Tier III provides coverage for eligible services from an out-of-network (nonEmpire) provider or facility. These services are subject to a higher deductible and co-insurance and may be subject to balance billing that may require the member to pay the difference between what the provider bills and what the plan pays.
- Click here for BCBS website
- Medical Plan Claim Form
Premier Plan Enhancement for TMJ
Your dental benefits for 2020 include the following changes and enhancements: White Plains Hospital will be offering on-site dental clinics in 2020 through Virtudent! In less than an hour, right here at the Hospital, a trained dental professional will provide a complete oral health exam and cleaning, including x-rays and intra-oral photographs. Within a week of your visit you’ll receive your dental records, including your complete oral health status and dentist recommendations. If additional care is need, the records of your visit will be shared with your local dentist or, if you don’t have one, they will help you find one. Please look for additional announcements and details on this great opportunity.
. Our Premier plan includes coverage for TMJ; we are expanding that to include coverage for the Occlusal Guards. The guards will be covered only as necessary to treat TMJ, and be subject to the same coinsurance and calendar year maximum as all other TMJ expenses. You should work with your dentist and CIGNA to confirm coverage for your specific needs. Our dental partner will change from Delta Dental to CIGNA dental. CIGNA’s dental network is as broad as the Delta network, but it offers more favorable negotiated rates on many services. This means you may spend less for services than before. If you elect dental coverage, you will receive dental ID cards from CIGNA before January 1. Please make certain to notify your dentist of the change to CIGNA on your first dental visit on or after January 1, 2020. Generally, our dental plans will remain the same. In-network benefits are outlined below. Coverage levels are the same for out of network however, your cost will be higher for out of network claims, as you will be responsible for all costs above reasonable & customary payment limits.
In-network benefits are outlined below. Coverage levels are the same for out of network however, your cost will be higher for out of network claims, as you will be responsible for all costs above reasonable & customary payment limits.
Core Plan - You pay Premier Plan - You pay:
Class I: Preventive/Diagnostic
$0, deductible waived $0, deductible waived
Class II: Basic/Restorative
20%, after deductible 15%, after deductible
Class III: Major/Restorative
50%, after deductible 50%, after deductible
50%, no deductible 50%, no deductible
$1,500 plan payment $2,000 plan payment
lifetime max lifetime max
Not covered 50%, after deductible
Calendar Year Maximum Plan Payment
1. Click here for Cigna Dental Program Information
2. Click here to have your questions answered about Cigna Dental PPO
Your Prescription benefits for 2020 include the following changes and enhancements
We are implementing a new Value Based Plan
. Your plan will now offer reduced copays for specific generic preventive medications prescribed to treat Asthma, Diabetes, Hypertension and Hyperlipidemia. The chart below provides details on the new program.
There are standard formulary changes
. As is the normal course of pharmacy program management, you will find that there are changes to the prescription drug formulary as we focus more on the clinical value of the medications. If your medication is impacted by any changes, you will receive a notification from our pharmacy benefit manager, RX Benefits, with information on alternatives for care.
A new Diabetic management program will be rolled out in 2020
. The current White Plains Diabetic Management program will be replaced by Living Connected, a new diabetes management program. Living Connected allows both you AND your impacted family members to participate in a comprehensive diabetes management program which offers free diabetic supplies, such as monitors and test strips, to participating and engaged members; members that continue to test regularly and transmit those results to the Living Connected Team. All eligible members will receive a letter with information about the program. The letter will provide complete details on how to participate and offer 10 days to opt out. If you do not opt out, you will automatically receive a welcome kit and an invitation to speak with your personal Living Connected Care Coordinator.
Your 2020 pharmacy benefits are as follows:
|| Mail Order
||30 Day Supply
|| 90 Day Supply
|Preventive Generic (1)
|Prescription Drug Maximum Out of Pocket
||$2,500 Single/$5,000 Family
(1) Applies to listed medications prescribed to treat Asthma, Diabetes, Hypertension and Hyperlipidemia only
1. Express Scripts Registration Information
2. Express Scripts Home Delivery Information
3. Prescription Drug Plan Benefits
4. Prescription Drug Mail Order Form
5. Click here for Express Scripts website
Securing Your Future
Who Is Eligible for Financial Security Benefits?
All full-time, part-time and per-diem employees are eligible to participate in WPH’s financial security programs as of your date of hire. Eligibility for the Hospital contribution under the White Plains Hospital 403(b) Defined Contribution Program is upon completion of one year of service.
* Per-diem employees and employees in the Local 1199 collective bargaining unit are not eligible for the Hospital contribution.
White Plains Hospital 403(b) Defined Contribution Program
The Program gives you the opportunity to accumulate retirement savings through two sources: a fixed, Bi-Weekly Hospital contribution and your voluntary pre-tax contributions. New employees are automatically enrolled for voluntary contributions starting at 3%. The contribution will increase by 1% each year, until you reach 10%. Employees may opt out if they wish. The Hospital contribution is a fixed percentage of your annual base salary, based on your years of service: 4% for the first four years, 5% for years 5-9 and 6% for years 10 and above. You do not have to enroll or contribute your own money to the Plan in order to receive the annual Hospital contribution. Your voluntary tax-deferred contribution allows you to add to your retirement savings. You may elect to contribute through payroll deduction on a tax-deferred basis, up to the annual IRS limit. Your voluntary contributions and any associated investment gains are tax-deferred until you take money from your account. You decide how to invest both the Hospital and your own contributions. The Plan offers a choice of mutual funds as well as the option to open a self-directed account. You are immediately vested in your own contributions and earnings (including rollovers and/or transfers from other qualified plans). You become vested in the Hospital contributions and any associated investment earnings after completing three years of vesting service (1,000 hours of pensionable hours per year). Under certain circumstance, you may withdraw or borrow against your voluntary contributions.
1. Click here for Mass Mutual website
There are no changes to your benefits in 2020. The plan pays both in and out of network benefits, including routine vision care, eye glasses, contact lenses and corrective surgery. You are responsible for the full cost of this plan, per pay period. Your 2020 cost for this plan will be the same as 2019. Please take the time to review the benefit summary and learn more about your vision plan.
- Click here for EyeMed website
- Employee Vision Plan Benefits
- EyeMed Vision Network near WPH