DC 37 Med Team switched its health insurance carrier in an effort to control escalating costs and still offer participants a quality medical plan. On June 9, 2003, the Board of Trustees of the DC 37 Health and Security Plan accepted a proposal from GHI, which will provide both medical and hospital services.

GHI was chosen over the Health Insurance Plan and Empire Blue Cross and Blue Shield, the previous carrier, whose renewal price exceeded the city’s basic health insurance obligation.

Beginning July 1, 2003, Med Team participants were enrolled automatically in GHI’s Preferred Provider Organization. In a PPO, participants have a financial incentive to use a network of physicians who accept the insurance carrier’s rates. Members of the plan may also receive care from an out-of-network provider. But those services are subject to a higher deductible, greater co-payments for office visits and lower reimbursements.

The Empire Blue Cross and Blue Shield “exclusive provider organization” used until now by DC 37 Med Team did not cover out-of-network care, but it offered a large, nationwide network of physicians. “This is a good program as long as you stay in the network,” said Rosaria R. Esperon, administrator of the DC 37 Health and Security Plan.

For people who stay in-network, “The GHI PPO offers very reasonable out-of-pocket expenses,” said Willie Chang, Med Team administrator. “The trade-off we made for being able to offer an affordable in-network program was, quite frankly, to accept a costly out-of-network program.”

In GHI, participants are responsible for a $10 co-pay for in-network services. The out-of-network annual deductible is $2,500 for individuals and $5,000 for families. The switch in carriers will be a burden to the 150 Med Team participants who don’t live in New York or New Jersey, which will be the GHI Med Team service area.

Participants from outside New York and New Jersey who wish to explore other healthcare options should contact the DC 37 Med Team Unit at DC 37 headquarters (212) 815-1313. DC 37 Med Team and GHI sent participants a packet with information about the new plan in June.

For more information
Participants may inquire about the changes by calling the DC 37 Med Team Unit at (212) 815-1313 or GHI at (212) 501-4444 weekdays from 9 a.m. to 5 p.m. Information, including a list of providers, is also available on the GHI Web site at www.ghi.com. Soon, GHI will send participants a membership card to use for office and hospital visits.

—Public Employee Press
July-August 2003 issue