Changing Health Plans
During the annual Benefit Choice period, the Benefit Choice Options booklet is available online for employees outlining any changes that will occur for the new plan year, July 1 through June 30. This may include changes to premiums, provisions, providers, participating plans, and level of benefits. Changes take effect the following July 1.
During this period, employees may change from one type of health insurance plan (QCHP, HMO, or OAP) to another. Changing plans may be done online through NESSIE, by selecting the link at the top of the Benefits Choice page.
You and your dependent(s) must be covered on the same health care plan. If both you and your spouse are insured employees, either or both of you may elect health coverage for dependents; however, the same dependent cannot be enrolled under both spouses for the same type of coverage (health, dental or life).
You may change from the current plan you are on to any other available health care plan; Quality Care Health Plan (QCHP) or one of the Managed Care Plans (MCP) - Health Maintenance Organization (HMO) or one of the Open Access Plans (OAP).
Enrolling in one of the health insurance plans automatically enrolls you in the Vision Plan, at no additional cost.
If you select a Managed Care HMO Plan, you must select a Primary Care Physician (PCP). When entering your information, you will be required to enter your PCP's National Provider Identification (NPI) number. This number can be found in your plan's Provider Directory. The plan websites have the NPI numbers listed. See the HMO providers links for informationon obtaining NPI numbers.
Keep in mind that in an HMO plan your PCP will direct all healthcare services and will make referrals for specialists and hospitalizations.
If you wish to change your PCP, this change can only be made by calling your insurance plan's Customer Service department directly. This phone number can be found in your HMO Provider Directory.
In most cases, Managed Care Plan benefits are not available for you or your dependents if you reside outside the service area. This may include children attending college away from home. Check with your health plan administrator for passport or reciprocity programs. See the Managed Care Plan map for plan availability. If you have concerns about specific benefit limitations or exclusions, contact your health plan administrator directly.
When enrolling in a Managed Care Plan, keep in mind that you may be required to pay co-pays at the time of visit.