Health Insurance Information

Valley Central Teachers Association 

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Pictured above are Richard Steger, Laurie Hey and John Bonagura working the VCTA table at our September 2006 Member Benefits Display. Join us every year on opening day for this annual event. Vendors include the Health Insurance Companies listed below, several Investment Companies chosen from the list that appears on our Investment Page, a NYS Deferred Compensation Plan Representative and an IRS125 Plan Representative. In addition to these Health and Investment Companies, local vendors representing small "mom and pop" businesses within our community will be present to present/display their services. For a listing of some of these businesses visit our Member Discounts & Savings Page. Please visit our Local Communities Page as well to link to each of our villages and towns to explore the benefits of living and shopping locally.

  1. Health Insurance Plans Currently Utilized By VCTA Members

  2. Miscellaneous Health Information & Forms

  3. Dates & Deadlines For Health Insurance

  4. Important Facts About Health Insurance

Health Insurance Plans Currently Utilized By VCTA Members

 

  • Empire Insurance:  This link takes you to the Empire website where you can download useful medical forms, including their Medical Reimbursement/Claim Form.

  • GHI Insurance:  This link takes you to the GHI website where you can download useful medical forms, including their Medical Reimbursement/Claim Form.

  • MVP Insurance:  This link takes you to the MVP website where you can download useful medical forms, including their Medical Reimbursement/Claim Form.

  • OUSDHP Insurance: This link takes you to the Orange Ulster School Districts Health Plan website. Many forms are not available on this site; therefore, we have attempt to add necessary OUSDHP forms to this page as well as the Forms, Form Letters & FAQ page in PDF format.

  • NOTE:  Members may choose any PPO/HMO they wish; however, the VCTA has helped to make the three preceding PPO/HMOs easily accessible to provide some alternatives to the District' Indemnity Plan (i.e., OUSDHP). The VCTA does not endorse any plan. The choice is the member's to make. It is recommend that members consult physicians, family friends, colleagues, or the Internet to assist in the decision making process. Also ask "What if...?" questions to be sure that specific doctors and hospitals will be available through the plan or plans that are being considered.

  • New York State Health Accountability Foundation:  This site offers HMO Information and Data and provides a NYS Health Care Report Card that reports on all hospitals and commercial HMOs in NYS and includes quality measurements and other indicators of performance and cost grouped by topic. Where comparable, icons and colors are used to indicate whether a particular measure is significantly above, at, or below average.

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Miscellaneous Health Information & Forms

 

  • Glossary of Health Benefit Terminology:  Health Benefit Plans; Prescription Drug; Consumerism and Quality Measures; Financial and Cost Reporting; Laws, Regulations, New York State and Federal Programs―Prepared by NYSUT.

  • Health Insurance Open Enrollment Package:  Dates, changes and contribution information for 2009. A side-by-side comparison for 2009 regarding OUSDHP, MVP, GHI/HMO and Empire/HMO is included. Rates for OUSDHP change July 1st and rates for the other plans change January 1st of every year.

  • Health Insurance Buyback Form:  This form must be completed each year. If you chose to keep comparable health insurance coverage through your spouse this form will notify the District of your intention to receive the buyback compensation covered in Article XXV, Section C of the CBA.

  • Health Insurance Comparability Checklist/Form:  ALWAYS CONSULT A UNION OFFICER BEFORE SUBMITTING THIS FORM!! This is a District form that provides a format to compare the OUSDHP to the health plan provided to your spouse for the purpose of determining buyout options.

  • OUSDHP Claim Form: This interactive claim form is required for each patient for whom a claim is made. Participants should NOT pay PPO Network Providers.

  • OUSDHP Dependent Student Certification Form: Information is to be completed by the Registrar's Office of the college your dependent is attending. Failure to have this form will result in a delay of coverage for your dependent.

  • OUSDHP Appeals Form: Use this form to appeal a denied claim with the OUSDHP. It is suggested that you contact the Superintendent for Business at Central Office for assistance. S/he is the OUSDHP representative for Valley Central employees.

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Dates & Deadlines For Health Insurance

 

  • December 1:  Health Insurance Buyback―Deadline to Waive District Sponsored Health Insurance and Receive the Buyback Provision Effective January 1 (Article XXV, Section C)

  • January 1:  Health Insurance Change Date―This is the date that your new insurance plan will take effect if you select a different option during open enrollment.

  • June 1:  Health Insurance Buyback―Deadline to Waive District Sponsored Health Insurance and Receive the Buyback Provision Effective July 1 (Article XXV, Section C): Make sure this options is included in your retirement letter. If receiving the buy-out provision you must be reentered into a health insurance plan 30 days before your effective retirement date. Be sure to fill out the form for the company you wish to utilize.

  • June 15:  1st Payment Due For Insurance Dependent Coverage:  This is the first date that you must pay the district if you are keeping dependents on insurance coverage if your retirement effective date is June 30. You will pay ½ the difference between single and family coverage; however, you will no longer make the percentage contribution to your health insurance premium. 

  • 10 Years:   Retirement Health Benefits―Number of Years a Member Must Work in the District to be Eligible (Article XXV, Section B) 

  • 30 Days: Open Enrollment―Members have 30 days from the date that the District and VCTA receive final rates from the alternative health plans to change their health insurance carrier if they so desire.

  • 30 Days:  Health Coverage―Activate Before Retirement If Currently Receiving the Buyout:  Employees denied the benefit of District sponsored Health Insurance by operation of the buyout provision shall have the right to institute the coverage provided for in the CBA not more than thirty (30) days prior to retirement. (Article XXV, Section D)

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Important Facts About Health Insurance

 

  • Active and retired members may select the current Indemnity Plan (OUSDHP) or any alternative HMO/PPO of their choice.

  • Active VCTA members must make a 5% contribution toward their selected plan's insurance coverage.

  • Active members selecting an alternative plan (i.e., a plan other than OUSDHP) with higher premium rates than the OUSDHP will make a 5% contribution based on the OUSDHP rates. In addition, members must bear the cost of any additional premiums exceeding the rate established by the OUSDHP.

  • Retired members selecting an alternative plan (i.e., a plan other than OUSDHP) with higher premium rates than the OUSDHP must bear the cost of any additional premiums exceeding the rate established by the OUSDHP.

  • Retiree members must bear 50% of the cost of dependent coverage. This year's 50% contribution based on OUSDHP rates is $4,236 for the fiscal year.

  • Retiree members must submit payment for dependents by the 15th of the month preceding the month of coverage.

  • Retiree members must inform the District when they turn 65 years of age in order to receive Medicare reimbursement.

  • Active members who decide not to participate for an entire fiscal year or are not eligible to receive health benefits because their spouse provides comparable coverage will receive a single buyout payment of $1,800 at the end of the school year or will receive two semi-annual payments of $900 each.

  • Members with dependents in college must generally submit verification of their child's (full-time) registration for classes to their health insurance plan each semester for continued dependent coverage. Additionally, make sure you are aware of the minimum number of classes your child must be registered for to be eligible for continued coverage. BEWARE: Rules vary from plan to plan. For example, OUSDHP will accept a paid tuition bill or a copy of the student's college schedule in lieu of the INDECS form.

  • To read more information regarding Health Insurance Benefits and Procedures read the September 2006 Echoes articles: The Questions about "Comparable" Health Coverage―Or Do I Have To Take The Buyout (page 3) and FAQs Concerning Health Insurance Choices (page 4).

  • New York State Health Accountability Foundation:  This site offers HMO Information and Data and provides a NYS Health Care Report Card that reports on all hospitals and commercial HMOs in NYS and includes quality measurements and other indicators of performance and cost grouped by topic. Where comparable, icons and colors are used to indicate whether a particular measure is significantly above, at, or below average.

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