UFT Health Care Chapter Benefits

The No Surprises Act protects you from balance billing if you get treated by an out-of-network provider from an in-network hospital or emergency room. Balance billing happens when an out-of-network provider charges you the difference between the total cost of your care and what your health plan agreed to pay.

The No Surprises Act is designed to ensure that you aren’t balance billed if you receive care under these circumstances. It protects you from paying extra when the circumstances are beyond your control.

You should still use network providers whenever possible. Visit your insurance carrier’s website to find a list of network providers near you (see below).

If you believe that you’ve been wrongly billed, contact the Employee Benefits Security Administration (EBSA) at 866-444-3272 or through their website.

The above summary is not a complete description of your rights under the No Surprises Act. For more detailed information about the No Surprises Act, read this notice.

Empire BlueCross BlueShield Benefits

POS and PPO Out-of-Area (OOA) Benefits for Full-Time Members Only (and Other Eligible Members Who Buy-Up Coverage)

Hospital-Only Benefits for Part-Time Nurses Employed by NYU Langone at Hospital and Family Health Care Facilities in Brooklyn, NY

You can find more information about the No Surprises Act on the Empire BlueCross BlueShield website.

The federal regulations require health plans and insurance carriers to disclose pricing information for certain items and services. The required information includes negotiated rates with in-network providers, as well as provider charges and amounts previously paid to out-of-network providers. The regulations require the information to be updated monthly. The information is contained in machine-readable files. These files can be opened in a spreadsheet program like Excel. They are huge files and not easy to use for the average person. HMSA is responsible for the information in the files and for keeping them up to date. To access the files, you can visit the Empire BlueCross BlueShield website. Please note that you will need the Fund’s Employer Identification Number (13 6783346) to find the files.

For more information or to find a provider, visit the Empire BlueCross BlueShield website or call 844-995-1736.

Prescription Drug Benefits

For more information or to find a network pharmacy, visit the Express Scripts (ESI) website or call 800-467-2006.

HIP Prime HMO Benefits

Full-Time Members Only (and Other Eligible Employees Who Buy-Up Coverage)

Please note that the HIP Prime HMO plan is only available to participants who are currently enrolled in this plan. New participants cannot elect HIP Prime HMO coverage, and current participants cannot switch their enrollment into the HIP plan.

The federal regulations require health plans and insurance carriers to disclose pricing information for certain items and services. The required information includes negotiated rates with in-network providers, as well as provider charges and amounts previously paid to out-of-network providers. The regulations require the information to be updated monthly. The information is contained in machine-readable files. These files can be opened in a spreadsheet program like Excel. They are huge files and not easy to use for the average person. HMSA is responsible for the information in the files and for keeping them up to date. To access the files and to find more information about the No Surprises Act, you can visit the HIP Prime HMO website.

For more information or to find a provider, visit the HIP Prime HMO website call 800-839-7375.

Disclaimer

The above information highlights certain features of the UFT Health Care Chapter Benefit Fund. Full details are contained in the Summary Plan Description and other documents that establish the Plan provisions. If there is a discrepancy between the wording here and the documents that establish the Plan, the document language will govern. The Trustees reserve the right to amend, modify, or terminate the Plan at any time.

While this website contains links to outside websites, this the Fund is not responsible for the accuracy or content of information contained on those sites. Those websites and services may have their own privacy policies and customer service policies, or no policy (policies) at all. We encourage you to review the privacy policies of any third-party websites or services. These links are offered for your convenience and do not constitute an endorsement of those websites. The inclusion of any such link does not imply a recommendation or endorsement by the Fund of the content and information on those websites.