Frequently Asked Questions: Empire BlueCross BlueShield

Listed below are questions and answers you may have regarding our change in health plan administrators from UnitedHealthcare to Empire BlueCross BlueShield effective January 1, 2011. If you need additional assistance, please email openenrollment@hofstra.edu.

Q1.         Will my benefits change as a result of the change from UnitedHealthcare to Empire BlueCross BlueShield?

A1.         No. UnitedHealthcare was the administrator of the Hofstra plan. Their role was to process claims in accordance with the Hofstra benefit plan design. Empire BlueCross BlueShield will play that same role.

Q2.         How can I find out if my doctor (or neighborhood hospital) is a participant in the Empire BlueCross BlueShield network?

A2.         With a 96% overlap of doctors and hospitals between UHC and Empire BlueCross BlueShield , there is an excellent chance that your health care provider is a participant. You can ask him/her if they participate in the Empire BlueCross BlueShield EPO or POS plan, or you can see an up-to-date list of participating providers on the Empire BlueCross BlueShield at http://www.empireblue.com.

Q3.         My doctor is not an Empire BlueCross BlueShield participant but  would like to join. How does one become part of the network?

A3.         Some providers choose not to participate in every plan or are selective in the plans they do join. Empire BlueCross BlueShield has advised us that any physician who is properly credentialed would be invited to participate. This should be done through Human Resources.

Q4.         Why did the University change health plan administrators?

A4.         Periodically, the University will "shop the market" to determine the best plan administrator or insurance carrier for our benefit plans. Our independent benefits consultants assist us in evaluating potential service providers from the standpoint of cost, service level and value to the University and its employees.

Q5.         I'm currently enrolled in the EPO (or POS) plan. Will I be able to stay in that plan?

A5.         Yes, Empire BlueCross BlueShield will administer the EPO and POS plans. You will automatically be enrolled in the same plan you currently have unless you elect to make a change during the upcoming annual benefits open enrollment period.

Q6.         UnitedHealthcare had the Cancer Resource Center. Does Empire BlueCross BlueShield have a similar program?

A6.         Yes, the Empire BlueCross BlueShield program is called National Blue Distinction Centers for Specialty Care which includes Memorial Sloan-Kettering.

Q7.         Will I be getting a new ID card?

A7.         Yes, you should receive a new ID card in the mail before close for winter break.

Q8.         My dependent child is away at college. Will he/she  be issued his/her  own ID card?

A8.         Each family member will receive an ID card that lists all covered family members.

Q9.         I heard that my 24 year old son who does not have health coverage can now join my plan. How do I get him enrolled?

A9.         Recent health care reform legislation allows for dependent children up to the age of 26 to be covered under their parents' health plan. If you already have family coverage, there is no additional charge to add your dependent child. The open enrollment material that you will receive via email will contain a special enrollment form to add your dependent child. Keep in mind, that your dependent child will lose  coverage at the end of the month he/she turns  26 and will become eligible for COBRA coverage at that time.

Q10.       I have claims from an out of network provider that I did not mail in yet. Should I send them to Empire BlueCross BlueShield?

A10.       No. UnitedHealthcare will be responsible for processing all claims where the date of service was prior to January 1, 2011. Keep in mind that claims must be submitted within 12 months of the date of service to be considered for reimbursement.

Q11.       Will I still be able to use my flexible spending account to pay for copays and deductibles?

A11.       Yes.

Q12.       There are several “flavors” of plans listed on the Empire BlueCross BlueShield website when I tried to find a participating doctor. Which plans will Hofstra be using?

A12.       The Hofstra plans will be the “plain vanilla” EPO and the Direct POS.