Health Insurance Information

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.

 

There is much debate about the pros and cons of universal health care. I cannot speak with certainty to the financial aspects of this debate. In truth, I have little faith in any words spoken by either Republicans or Democrats regarding this topic. I will, however, offer a personal philosophy regarding health care: My father should not die in his retirement due to his inability to pay for diabetes medicine because his former employer did not offer a retirement health plan; my child should not die from cancer because I lost my job in this difficult economy and cannot afford to pay for her chemotherapy. This simple philosophy should guide our legislative health care decisions because my child and my dad are as valuable as the children and parents of our elected officials. TMB

Join us every year on opening day for Annual Member Benefits Display. Vendors generally include the Health Insurance Companies listed below, several Investment Companies chosen from the list that appears on our Investment Companies 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. Visit our Communities Serviced by VC page to link to each of our villages and towns to explore the benefits of living and shopping locally.

Pictured above are Richard Steger, Laurie Hey and John Bonagura working the VCTA table at our September 2006 Member Benefits Display.

Keep your Friends & Neighbors Working by Buying Local!

 

Health Insurance Plans, Sites & Forms Utilized By VCTA Members

  • Dental & Optical Claim Forms: Go to the SIDS website for claim forms, a review of your itemized claim history and a look at the benefits booklet to determine coverage eligibility.

  • AFLAC Claim Form: This link takes you to the AFLAC (IRS 125 Plan) website's PDF claim form that may be used to request reimbursement for dependent childcare and unreimbursed medical expenses. Enrollment in the IRS 125 must take place by October 1st of each year to be eligible for reimbursements.

  • Comparison Chart for 2015-2016 Health Insurance Rates: View this chart to compare premiums between OUSDHP (Indecs), NYSHIP and MVP. Rates are calculated by monthly premiums and per-paycheck deductions, accounting for necessary employee contributions per CBA.

  • New York State Health Insurance Plan (NYSHIP): Link to the NYSHIP website to explore the benefits offered by the state indemnity plan. If the above link takes you to the login page: Select "I am not sure." Type "Newburgh" and Submit. Select "Newburgh City School District" and Submit. Log on to NYSHIP. This is the same plan that Newburgh and Pine Bush are utilizing.

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

  • OUSDHP Insurance Plan: This link takes you to the Orange-Ulster School Districts Health Plan website. Many forms are not available on this site; however, the VCSD has made many of these forms available on their website:VCSD Health Insurance Forms.

  • 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.

  • VCSD Health Insurance Forms: The following health insurance forms can be accessed by visiting the Valley Central School District website:

    • Health Insurance Buy-Back Form

    • OUSDHP-INDECS Health Insurance Enrollment Form

    • INDECS (Orange Ulster School Districts Health Plan) Change Form

    • OUSDHP (Indecs) Young Adult Child Enrollment Form (under age 26)

    • Indecs Dependent Student Certification Form

    • NYSHIP Health Insurance Application 

  • NOTE: Members may choose any PPO/HMO they wish; however, the VCTA has helped to make the preceding PPOs/HMOs easily accessible to provide some alternatives to the District' Indemnity Plan (i.e., OUSDHP). In 2008 the VCTA negotiated to bring NYSHIP (New York State Health Insurance Plan) back to VC employees. Both NYSHIP and OUSDHP are combination Indemnity/PPO insurance plans. 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.

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)

Important Facts About Health Insurance

  • Active and retired members may select either of the current Indemnity Plans (i.e., OUSDHP or NYSHIP) or any alternative HMO/PPO of their choice. NOTE: OUSDHP will not permit retirees to reenter the plan if they leave the plan during retirement. NYSHIP does not have this restriction.

  • Active VCTA members must contribute toward their selected health plan's insurance coverage at the rate specified in Article XXV.

  • Active members selecting an alternative plan (i.e., a plan other than OUSDHP) with higher premium rates than the OUSDHP will also make a contribution based on the OUSDHP rates. In addition, members 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 (i.e., 50% of the difference between individual and family coverage).

  • 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 $2,000 at the end of the school year or will receive two semi-annual payments of $1,000 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.

  • 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.

Workers Compensation Board (NYS) Links: The VCTA does not provide specific information regarding potential Workers' Compensation Claims. Members should refer to the following links to seek information, advice and/or representation:

The VCTA consists of two bargaining units: Teachers and School Related Professionals

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