2 0 2 3 Benefits Resource G u id e for Full - Tim e , Non - Union S ta f f Table of C o n t e n t s I nt r o d u c ti o n ............................................................. 1 B e n e f it s - a t - a - G l a n c e ............................................... 2 Eligibilit y & E n r o llm e n t ...................................... .... 3 - 5 Medical Plan O p ti on s ............................................. 6 - 7 Medical Plan Resources.......................................... 8 - 9 Healthcare Assistance ................................................ 10 2023 Medical C o n t r i b u tio n s ................................... 11 Prescription Dru g C o v e ra g e ................................... 12 Dental B e n e f its ....................................................... 13 - 14 Vision B e n e f its ....................................................... 15 Flexible Spending A cc ou n ts ................................... 16 - 17 Commuter B e n e f its ................................................. 18 L ife & Accident I n s u r a nce ...................................... 19 - 21 I ncome Protection B e n e f its..................................... 22 Retirement B e n e f its ............................................... 2 3 - 26 • New York State and L ocal Retirement S y stem (NYS L RS) • New York State Voluntar y Defined Contribution (VDC) P l a n • D e f in e d B e n e f it o r D e f ine d C o n t r ib u ti o n ? Comparison of Plan Choices Voluntar y Retirement Savings Pl a n s ................ 27 • Tax Deferred 403(b) Annuit y P l a n • Flexible Premium A nn u it y Other Savin g s P r o g r a ms ....................................... 28 • NYSaves 529 Colle g e Savings P r o g r a m • Municipal Credit U n i o n Emplo y ee Assistance P r o g r a m........................ 2 9 Bri g ht Horizons Care A d v a n ta g e .......................... 30 Paid Leave............................................... 31 I mportant Contact I n f o r m a ti o n........................32 This brochure sum m arizes the Non - Union Bene f its P r ogra m . The descriptions o f each pl a n do not p r ovide all plan details. You can r e quest e ach Sum m ar y Plan Description through the Bene f its Of f ice. Of f icial plan do c u m e nt s w il l t a k e p r e ce d e nc e i f th e r e a r e dis c r e p a n c i e s in in f ormation presented in this guide. This guide is int e nded to p r ovide in f ormation on curr e nt bene f it plans o ff ered and is not to be const r ued as a pro m ise o f e m ploy m ent or f uture bene f its. The Ne w York Public Librar y reserves the right, i n its sole and a bsolute discretion, t o a m end, m odif y or discontinue, i n w hole or in part, an y o f the provisions o f the bene f its described h e r e in, in c ludin g a n y h ea lth b e ne f it s th a t m a y b e e x t e nd e d to e m plo y ees, retirees and their dep e ndents. Further, the Librar y reserves the exclusive right, po w er and authorit y , i n it s s ol e a n d a b s olut e di s c r e tion, t o a d m ini s t e r , a ppl y a nd interpret the bene f it plans describ e d herein and t o decide all matters arising in connection w ith the operation o r ad m inistration o f such plan. I n tr o d u c tio n Welco m e to The New York Public Library’s Ben e f i t s P r og r a m fo r F u l l - T i m e , N on - U n i on S t a ff! Our e m plo y ees are o u r g reatest asset. That’s wh y we offer a c o m p r e h e n s i v e a nd c o m p e titi v e b e n e f it s p r og r a m , w h i c h pro v ides v aluable health and fi n ancial pr o tection to y ou and y our fa m il y I t also enco u ra g es and supports health y beha v iors and li v ing well! Our benefits pro g ra m g i v es y ou the choice and flexi b ilit y to elect the plans that will b est m eet y our needs. T h is guide pro v ides a sum m ar y of the Li b rar y ’s benefits. We enco u rage you to review this guide carefull y alon g wit h other benefits inf o r m ation available to y ou and share it with y our fa m il y before decidin g which benefits are ri g ht f o r y ou and y our fa m il y I f y ou have an y questions about t h e Librar y ’s benefits and/ or enrollin g for coverage, contact the HR S e r v ice Center at 212 621.0 5 00 Option 4 Detailed benefits i n for m ation including sum m ar y plan d escri p tions can be found o n L a ir Things to Consider Before You E n r o l l Do y ou need medical, dental and / or vision care coverage through the L ibrar y ? Or does y our spouse have coverage through h i s/ her emplo y er? You ma y want to compare health care offerings and c ost to determine which plan will m ee t y ou r n ee ds. Y ou m a y want to consider the Bu y Out Waiver if enrolled in c overage elsewhere. Consider a flexible spending account if y ou anticipate out - of - pocket health care and/or dependent care expenses for the plan y ear. Do y ou have m onthl y commuting e x pen s e s ? If so, y ou ma y w ant to consider participating in the commuter benefits plan to help offset the co s t Be sure to revie w your retire m ent plan options carefully to ensure y ou choose the plan(s) that w ill help y ou m eet y our retire m ent savings goals. I t ’ s i m po r t a n t t h a t you und e r s t a nd t h e b e n e f it s a v a il a b l e a nd ho w t h e y w o r k s o you ca n m a k e i n f o r m e d d ec i s i on s 1 B e n e f i ts - a t - a - G l a n c e Below is a quick glance at t h e benefits a v ailable to y ou at the L i b r a r y Health Care B e n e f it s Medical P l a n s ( I ncludes Prescription Co v erage through O p t u m R x ) Unite d Healthcare Choice — I n - Network Onl y Plan Unite d Healthcare Choice Pl u s Pl a n — I n - & Out - of - Network Pla n Dental P l a n U n it e d H ea lt h ca r e Vision P l a n U n it e d H ea lt h ca r e Retirement B e n e f it s New Yor k Public L ibrar y Retire m ent P l a n s The New York State and L ocal Retire m ent S y ste m SUNY Voluntar y Defined Contribution Plan Employer - Paid B e n e f i t s Life & Accid e nt; L ong Ter m D i s a b il it y Lincoln F inancial G r oup Short Ter m Disabilit y / Paid L e a v e * Lincoln F inancial G r oup Business Tra v el Accident I n s u r a n c e C hub b E m plo y ee Assistance Progr a m ; Health Care H e l p Corporate Counselin g A ss o c i a t e s Pai d Ti m e O f f New York Public L i b r a r y Voluntary B e n e f it s F lexible Spending A cc o u n t s Benefit Resourc e , I n c Co mm uter B e n e f i t s Benefit Resourc e , I n c Voluntar y L ife & A cc i d e n t Lincoln F inancial G r oup 403(b) Ta x Deferred Annui t y P l a n s T I AA Vo y a F i n a n c i al College Sa v ings P l a n NY State’s 5 2 9 College Sa v ings P r og r a m Back - Up Da y care / Elder C a r e Bright Horizon s Care A d v a n t a g e * P a i d L e a ve i s no t an e m p l o ye r - pa i d b e n e fit 2 Eligibility & E n r o l l m e nt E l i g i b i li t y F or Yourself. You ar e eligible to participate in the benefits progra m if y ou are a full - ti m e, non - union New York Public L ibrar y e m plo y ee consistentl y scheduled to work 30 or m ore hours per we e k F or Your Dep e ndents. Y o ur depend e nts are eligible for co v erage if the y are y our: • L egal spouse/do m estic partner (with do c u m e n t a ti on ) • Children up to age 26, incl ud ing stepchildren, foster children and a dopted c hildren (to the end of the m onth in which the y turn age 26 ) • Disabled child of a n y age (with docu m entation) who is depen d ent on y ou for support due to a m ental or ph y sical handicap that occurs befo r e reaching ag e 2 6 Domestic Partner Eligibility Requirements You m a y enroll y our do m estic partner for gro u p h ealth a n d supple m ental benefits. * Be n efits a v ailable will be the same as benefits offered to m arried spouses (a n d d e pend e nts) of New York Public L ibrar y e m plo y ees but contributions for do m estic partner benefits are m ade on an after - tax basis, and there are ta x cons e que nc es for do m estic partner b e n e f it s T a x I m p l i ca t i on s D e f i n e d U nd e r f e d e r a l l a w , un l e s s y ou r do m estic partner (or do m estic partner’s depe n dent child), is considered to b e y our “depe n dent” within the m eaning of the I nternal Re v enue Code, y ou will be taxed on t h e v alue of the e m plo y er - financed portion of do m estic partner health care and/or supple m ental benefits co v erage. I n addition to the i m puted inco m e to y ou, this a m ount will be treated as wages subject to withholding for inco m e tax and F I CA purposes an d will be reported o n y our W - 2. Example: I f the v alue of the plan equals $600/ m onth, y ou will be taxed on this a m ount. Assu m ing a 40% tax bracke t , this would m ean $240/ m onth in additional cost. You m a y want to consult with y our CPA, attorne y or tax ad v isor with regard to tax implications on benefits for y our do m estic partner. Note: F lexible Spending Ac c ount ( F SA) dollars cannot be used to rei m burse out - of - pocket health care costs y our do m estic partner incurs due to the tax sa v ings on y our contributions to an F SA. F or m ore infor m ation about adding a d o m estic partner to y our benefits, please v isit L air or contact the HR S er v ice Center for the d o m estic partner guide a nd for m s. * P r oo f o f d e p e nd e n cy i s r e qu i r e d ( e g ., D o m e s ti c P a r t n e rs h i p C e r tifi c a t e o f R e g i s t r a ti on ) t o e n r o ll a do m e s ti c pa r t n e r i n h e a lt h and s upp l e m e n t a l b e n e fit s C on t a c t t h e H R S e r v i ce C e n t e r f o r d e t a il s 3 Dependent Verifica t ion When you enroll your d epe n dents, you will n eed to provide supporting doc u mentation as proof of eligibility (e.g., birth c ertifica t e, m a rria g e certificate, do m estic partn e r registration certificate, adoption paper w ork, etc.). To provi d e de p enden t verifi c ation documentation, you must f a x it to the HR S ervice Center at 6 4 6 9 18 1 9 6 2 Eligibility & E n r o l l m e nt E n r o llme n t As a new hire, y ou ha v e 31 d a y s fro m y our date of hire to m ake y our health benefit elections. If y ou do not enroll when first eligible, y ou will ha v e to wait until the next enroll m ent period to m ake an y changes, u nless y ou experience a qualif y ing life e v ent. See M a ki n g Changes During the Year b elow. How to Enroll You m ust co m plete your new hire benefits election in Workday within 31 da y s of y our date of hire. Making Changes During the Y ea r The I RS re q uires that elections for benefits paid o n a pre - tax basis re m ain in effect for the full plan y ear. Howe v er, the I RS per m its mid - y ear changes within 31 da y s of a qu a li f y i n g e v e n t E x a m p l e s o f qu a li f y i n g l i f e e v e n t s i n c l ud e : Your m arriage, di v orce, leg a l separation or a nnu l m e n t , The birth of y our bab y , or adoption or place m ent of a child with y ou for adoption, or anothe r ch a nge in th e nu m ber of y our dependents , The deat h of a d e pe n d e n t, D e p e nd e n ts e li g i b i l it y o r i n e l i g i b i l i t y f o r c o v e r a g e ( e .g., the y reach the plan’s eligibilit y age li m it), A chan g e in work location or ho m e address for y ou, y our spouse or y our depend e nts, A ch a ng e in co v erage o f y our spouse or y our dependent under a n other plan , Your qualification for a spe c ial enroll m ent under the Health I nsurance Portabilit y and Account a bilit y Act of 1996 ( H I PAA) , A c o urt order recei v ed b y the plan, such as a Qualified Medical Child S upport Ord e r (QM CS O), o r Y ou , y ou r s pou se o r y ou r d e p e nd e n t ’ s qu a li f i ca t i o n f o r Medicare or M e dicaid I f y ou need to m ake an election cha n ge durin g the y ear or ha v e questions about what c o nstitutes a life status change, contact the HR Ser v ice Cen t er at 212.6 2 1.0 5 00 Option 4 4 Waiving Cove r age You may d ecide t o waive h e a lth insurance coverage through NYPL. I f during th e yea r you n eed to enroll in health insurance due to l o ss of other covera g e, you may do so within 31 da y s of the loss. See Making Changes Durin g the Year at left You may also enroll f o r heal t h and supplemental benefits, or ma k e changes t o current ben e fits during the annual open enroll m ent period. A n y open enrollment chan g es are ma d e in Workday. Non - Union Buy - out Waiver Pr o gram You may app l y f o r the Non - Union Buy - Out Waive r Program i f you a re covered u nder another m edical plan (such as yo u r spouse’s p lan), pr o vided th e plan is not a Libra r y or City of New York health plan , Medica r e, M edicaid, or a h e alth care exchange program, T h e Non - Union B u y - Out Waive r Progr a m p r o v id e s e li g i b l e e m pl o y ee s w h o w a i v e c o ver a g e an annual cash pay m ent of: Individual: $ 50 0 Family: $1 , 00 0 Payments are considered taxable income, and a re paid in two installments — h alf in Ju n e and half i n D e c e m b e r e a c h y e a r T h e a m oun t s a r e p r o r a t e d f o r mid - ye a r e n rollments and c hanges. An e n rollment form and p r o of of other covera g e a r e n ecessa r y to obtain the p a y m e n t Eligibility & E n r o l l m e nt Coordination of Benefits I f y ou or y our depe n dents a r e co v ered unde r the L ibrar y ’ s m edical plan and another group m edical plan, pa y m ent f o r clai m s will be deter m ined as follows: F or You. E m plo y er - paid coverage is alwa y s pri m ar y Therefore, an y clai m s for y ou will be paid b y the Librar y plan first, and the other pla n (such as y our spouse or do m estic partner’s plan in which y ou are co v ered) will pa y s ec ond F or Your Spouse / Do m estic Partner. You r s pou s e / do m e s t i c partner’s e m plo y er - paid plan will be pri m ar y for the m Therefore, an y clai m s paid b y The L ibrar y plan, on behalf of the spouse will be secondar y to y our spouse/do m estic partner’s e m plo y er paid co v erage. F or Your Depe n dent Children. Pri m ar y and secondar y co v erage is deter m ined b y the m onth and d a y of birth of the parents who are co v ering the d e pend e nt child(ren). The pla n of the par e nt whos e birthda y falls earlier in the y ear will be the pri m ar y co v erage for the d epen d ent c h il d (r e n ) Re v iew each plans’ coordina t ion of b e nefits rules carefull y if y ou are considering co v erage u n der m ore than one p l a n N o t e : N o n - un i o n e m p l o yee s h i r e d a f t e r J un e 30 , 2015 w ill n o t b e e li g i b l e f o r r e ti r ee h e a lt h b e n e f it s a t N YP L C u rr e n t e li g i b ilit y i s ou tli n e d i n t h e Su mm a r y P l an D e s c r i p ti on R e ti r ee h e a lt h b e n e fit s a r e no t ve s t e d b e n e fit s , and t h e L i b r a r y r e s e r ve s the right to a m e nd or modify coverage at a ny time * P l e a s e v i s it L a i r f o r add iti ona l d e t a il s on y ou r N Y P L b e n e fit s and Su mm a r y o f B e n e fi t s 5 About Your Con t ribu t ions To help ma k e covera g e as a f fordable as possible , an y c o n t r ib u t i o n s f o r h e a l t h c a re c o ver a g e, f l e x ibl e spending accounts and commuter ben e fits will be deducted f rom yo u r payc h e c k automatically on a pre - tax basis — b e fore Fe d eral and Social Security taxes are withheld. By p a yi n g for covera g e on a p re - t ax b a s i s , t ax a b l e inc o m e i s l o w ere d A s a re s ul t , you will pa y less in taxes at t he end o f the ye a r. Contributing to the above p l ans on a pre - tax basis is automatic. Note: Pre - tax d eductions reduce yo u r salary use d to calculate your Social Security ben e fit at reti r ement. T h e impact o n your Social Sec u rity is typically minor and most of the time, t h e mon e y you save through p r e - tax d e ductions outweighs the benefit gaine d by waiving t h e deduction. You m a y want to consult with your t a x adviser if you ha v e qu e s t i o n s All health plan deductions w i ll be taken retroacti v ely to your e f fecti v e date o f coverage. A Note Abo u t Volu n tary & E m plo y er - Paid P la n s Voluntary p rograms are a va i lable to you all y ear and are pai d by you. Eligibility for these be n efits is not based on a qualifying event. Note: Voluntary programs are f o r acti v e em p loyees only. The N ew Y o rk Public Libra r y provides employer - paid programs to assist you whe n you n e ed hel p for l i fe challenges. There is no cost for these b enefits and you can utilize t h em w h en n ecessary during your employment with NYPL Medical Plan O p t io n s You ha v e two m edical plan options fro m which to choose through Unite d Healthcare ( UHC). UHC Choice (In - Network Only P l an) The UHC Choice option provides nationwide coverage without the need for a referral. You must use in - network providers and facilities to receive coverage under the plan. With the UHC Choice plan, you pay a copay for doctor’s office visits as well as urgent and emergency care services. G e n e r a l l y , t h e r e a r e no b e n e f i t s p a y a b l e o u t s i d e t h e network except in the cas e of a true e m ergenc y UHC Choice Plus (In - and Out - of - Network P l a n ) The UHC Choice Plus option also provides nationwide coverage without the need for a referral. With the UHC Choice Plus plan, you have access to in - network providers as well as out - of - network providers. However, when you use an out - of - network provider, you will pay more out - of - pocket through higher deductibles and coinsurance. In addition, non - network doctors do not accept negotiated fees, which means you may also be balanced billed for amounts above what the plan will pay. 6 Preve n tion is the be s t med i cine. Whe n y ou elect a m edical plan, y ou ha v e full co v erage for i m portant pre v enti v e care ser v ices. Taking pre v enti v e m easures now can help keep y ou health y and identif y an y potential health issues earl y . Plus, m edical benefits help protect y ou and y our fa m il y in the e v ent y ou need non - pre v enti v e care — illnesses, injuries, a n d health co n ditions/ d i s e a s e s So, whether y ou need to see a doctor, ha v e outpatient surger y , v isit the e m ergenc y roo m or an urgen t care facilit y , or get a prescription, y ou can rest eas y knowing y ou ha v e co v erage. The pla n y ou choose will depend o n y our personal needs so be sure to re v iew this section and additional m aterials a v ailable on L air. Note: I f y ou ha v e m edical co v erage a v ailable fro m another source , y ou do not h a v e to elect an NYP L m edical plan. Plus, if y ou ha v e co v erage through y our spouse’s e m plo y er, y ou can appl y for the Non - Unio n Bu y - Out Progra m (see page 4) pro v ided it is not a Cit y health plan Medical Plan Design O p t io n s 7 Preve n tion is the be s t med i cine. Whe n y ou elect a m edical plan, y ou ha v e full co v erage for i m portant pre v enti v e care ser v ices. Taking pre v enti v e m easures now can help keep y ou health y and identif y an y potential health issues earl y . Plus, m edical benefits help protect y ou and y our fa m il y in the e v ent y ou need non - pre v enti v e care — illnesses, injuries, a n d health co n ditions/ d i s e a s e s So, whether y ou need to see a doctor, ha v e outpatient surger y , v isit the e m ergenc y roo m or an urgen t care facilit y , or get a prescription, y ou can rest eas y knowing y ou ha v e co v erage. The pla n y ou choose will depend o n y our personal needs so be sure to re v iew this section and additional m aterials a v ailable on L air. Note: I f y ou ha v e m edical co v erage a v ailable fro m another source , y ou do not h a v e to elect an NYP L m edical plan. Plus, if y ou ha v e co v erage through y our spouse’s e m plo y er, y ou can appl y for the Non - Unio n Bu y - Out Progra m (see page 4) pro v ided it is not a Cit y health plan Choice Plus Plan Choice Plan Plan Provisions In - Network Out - of - Network In - Network CY Deductible Single/Family $0 / $0 $1,000 / $2,000 $0 / $0 Coinsurance 100% (no member cost) 50% 100% (no member cost) Out of Pocket Max. Single/Family $1,600 / $3,200 $3,000 / $6,000 $1,600 / $3,200 PCP/Spec OV Copay $20 / $40 Ded & coin $20 / $40 Emergency Room $100 copay then 100% $100 copay then 100% Inpatient Hospital $350 copay then 100% Ded & coin $350 copay then 100% Outpatient Facility Surgery 100% (no member cost) Ded & coin 100% (no member cost) Urgent Care $35 copay Ded & coin $35 copay Retail Prescription Drugs (Mail Order 2.5x Retail) $10 / $35 / $60 $10 / $35 / $60 Note: For care received out - of - network, UHC will pay Reasonable & Customary (R&C) charges based on 300% of Medicare equivalence until you reach your out - of - pocket maximum. You are responsible for paying all charges above R&C; those amounts do not apply to your out - of - pocket maximum. Out - of - pocket maximum: the most you have to pay for covered services in a plan year. After you spend this amount on deductibles, copayments, and coinsurance for care and services, your health plan pays 100% of the costs of covered benefits. Use In - Network Providers! In general, it is beneficial to use in - network providers, including labs, whenever possible. If you don’t, you will pay more out - of - pocket and may be balance - billed as well; or, services could even be denied. The UnitedHealthcare - approved in - network lab is LabCorp and additional participating labs based upon geographic location. To locate network providers near you, visit myuhc.com Medical Plan R e s o u r ce s Get access to a doct o r anywhere — at ho m e, at the office or even on vacation! Plus, take advantage of UnitedHealthcare’s self - service web tools anytime, anywhere. UHC’s V i rtua l V i s i t s Through UHC, you h a ve acc e ss to virtual visits, which lets you get t h e care y ou need (including most prescriptions) for a wi d e ran g e of min o r, n o n - li fe - t h r e a t e n i n g c o n d i t i o n s s u c h a s so r e t h r o a t , h e a d a ch e, f ev e r , c o ld / f lu , a ll er g i e s , r a s h , an d m o re. A virtual visit lets you see a n d talk to a doctor from your mobile d e vice or c omputer without an appointment. Most visits take about 10 - 15 m in u t e s an d d o c t o r s ca n w r i t e a p r e s c r ip t i o n *, i f n ee d e d , t h a t you can pick up at your local pharmacy. And, it’s part o f your health benefits T h i s i s a c o s t - e f fe c t i v e a l t e r n a t i v e t o a c o n v e n i e n c e c a r e clinic , u r g e n t c a re c e n t er or eve n t h e e m er g e n c y r oo m Access V i rtual V i s i t s Log in to myuhc.com® an d c hoose from p rovid e r sites where you can register for a virtual visit. After registering an d requesting a visit you will p a y a $10 copay , and t h en you will en t er a virtual waiting room. During yo u r visit you will be ab l e to talk to a doctor about your h e alth concerns, symptoms and treatment options. Use v i rtual visits w h e n : Your doctor is not a v a il a bl e You become ill whi l e t r a ve li n g You are considering visiting a hospital emer g ency room for a non - e m er g ency h ealth condition Virtual visits are not good f o r : Anything requiring an exa m or t e s t Complex o r c h ronic c o ndi t i o n s In j u r i e s r e q u i r i n g ba n d a g i n g o r s p r a i n s / b r o k e n b o n e s *Prescription service s may n ot be available in all s t a t e s My U HC.c o m: S elf - S erv i ce Web T oo l s Ad m inistrati v e S e r v i ce s Print tempora r y ID cards o r o rder replace m ent ID c a r d s F in d o u t a b o u t w h a t s erv ic es re qui re p r e - n o t i f i c a t i o n Esti m ate Costs for Ser v ices That Appl y to Your I n - Network & Out - of - Network Ded u ctibles Estimate medical costs for c ommon medical conditions and services so y o u know the cost of servi c es bef o re you are trea t ed. C o m p a re h os pi t a l s b y c o s t , n u m b er o f p r o c e du re s perf o rmed , patient outcomes. Health & Wellness R e s ou r c e s Find information on health c onditions, first a id , m e dic a l e xa m s , w e lln es s an d m o re w i t h an interactive medical library Get th e facts yo u nee d to make infor m ed d ecisions about specific procedures and treatments WebMD ® Personal H ealth R ecord. Keep your m e dic a l hi s t o r y a t y o u r f in g e r t ip s b y a u t o m a t ic a ll y storing and tracking medica l conditions, medications, allerg i es, p roc e dures, immun i zations and em e rgen c y contacts online. Preventive C a r e Fo r a l l plan o p t i o n s , a nnu a l p reve n t i ve c a r e e xa m s an d a g e - a pp r o p r i a t e h e a l t h s c ree n i ng s a r e c o vere d 1 0 0 % B e s u r e to schedule your annual ph y sical and health screenings! Pre v ention is the best m edicine 8 B e havioral Health R e s o u r c e s NYP L recognizes the i m portance of m ental health an d is offering high - qualit y mental health resources a nd solutions. Traditional b e ha v ioral health car e is a v ailable through t h e UHC m edical pl a ns. P r o v iders are accessibl e for office v isits and/or v irtual care. Pleas e be sur e to filter the search f u nction o n the l i v eandworkwell.co m Resources B e l o w a r e v a r i o us t oo ls a nd r e s o u r c e s t o h e lp y o u m a int a in o r r e g a in y o u r e m o ti o n a l w e llb e ing. Emo t ional Suppor t Line • 86 6 - 34 2 - 6892 , a v a i l a bl e 24 /7 • Fr ee o f ch a rg e a nd a v a i l a bl e t o a ny o ne Sub s t ance U s e Di s orde r Helpline • 85 5 - 78 0 - 5955 • A n o nym o us a nd a v ai l a bl e 24 /7 T alk s pa c e talk s pace.c o m/ c onne ct • A d i g i t a l pl a tf o rm th a t o ff e rs a n a lt e rn a t i v e t o f a ce - t o - f a c e th e r a py wi th o v e r 5000 l i c e ns ed b e h a v i o r a l h ea lth cl i n i c ia ns T elephon e & W eb s i t es • 84 4 - 63 6 - 5298 o r myuhc.c o m t o f i nd pr o v i d e rs • myuhc.com > l i v ea nd wo rk w e ll.c o m t o f i nd m e nt a l h ea lth r e l a t e d c o nt e nt AbleTo • On - demand access to self - help for stress and emotional well - being AbleTo is a top - rated self - help app t hat provides access to self - care techniques, coping tools, meditations and more — anytime, anywhere. With Self Care, you’ll get personalized content that’s designed to help you boost your mood and shift your perspectives. Talkspace is a digital platform that offers an eff e cti v e alternati v e to face - to - face therapy w ith over 5,000 licensed beha v ioral health clinicians, giving indi v iduals greater fle x ibilit y to engage w ith their care and i mp r ove their o v erall he a l t h 9 Healthc a re A s s is ta nce Health A d v o c a t e: Access to Health Care H e l p Health Ad v ocate is an inde p endent ser v ice that can help y ou m anage ti m e - consu m ing health care issues. Trained Per s onal Health Ad v ocates a re a v ailable 24/7 to support y o u r n ee d s A l l NY P L e m p l o y ee s a r e e li g i b l e f o r t h i s s e r v i ce A Pers o nal Health Ad v ocate can hel p y ou : F ind doctors, hospitals and o t her health care p r o v i d e r s Researc h a n d locate treat m ents for m edical c ond i t i on s U nd e r s t a n d t e s t r e s u l t s , t r e at m e n t r ec o m m e nd a t i on s and prescribed m edication s Pro v ide esti m ates on com m on m edical ser v ices and t r ea t m e n t s Address elder care i ss u e s A Persona l H e alth Ad v ocate can explain h ow t o : C oo r d i n a t e b e n e f i t s b e tw ee n p h y s i c i a n s an d i n s u r a n ce c o m p a n i es Schedule s p ecialist treat m ent and t e s t s D ea l wit h i n s u r a n c e c o m p a ny p r e - ce r ti f i ca t i on s and other appro v als for ser v ices Transfer m edical records, X - ra y s and lab r e s u lt s A rr a ng e f o r ho m e - ca r e e q u i p m e n t f o l l o wi n g a ho s p i t a l s t a y How to Access Health Advocate You c a n ac c ess Health Ad vo cate for health care help as f o ll o w s : Phone: 8 66 - 695 - 862 2 Website: www .h ea l t h a d v o c a t e c o m / n y p l E m ail: a n s w e r s @ H ea lt h A dvo ca t e c o m A m obile app is also a v ailable for Apple and Android de v ices so y ou can access s e r v ices on the go Confidentiality Health Ad v ocate is an ind e p endent third - part y co m pan y , not conn e cted to an y pro v ider. Your personal infor m ation will be kept strictl y confidential under the p r o v isions of the Health I nsurance Portability and Ac c ountabilit y Act of 1996 ( H I PAA ) 10 2023 Med i c a l C o n tr i b u tio n s 2023 Pre - Tax Employee Contributions: UHC Choice and UHC Choice Plus P l a n s Annual S a l ary Medical P l a n Coverage Level 2023 Monthl y C o n t r i b u t i ons 2023 Se m i - Monthly C on t r i b u t i ons Under $50,000 E m plo y ee O n l y $97.75 $48.88 UHC C hoi c e Employee + Child(ren) $171.07 $85.54 Employee + S pouse $205.29 $102.64 Fa m ily $298.14 $149.07 E m plo y ee O n l y $242.84 $121.42 UHC Choice P l u s Employee + Child(ren) $424.97 $212.48 Employee + S pouse $509.97 $254.98 Fa m ily $740.66 $370.33 $50,000 – $ 7 9,99 9 E m plo y ee O n l y $136.85 $68.42 UHC C hoi c e Employee + Child(ren) $239.49 $119.75 Employee + S pouse $287.39 $143.69 Fa m ily $417.41 $208.70 E m plo y ee O n l y $253.40 $ 126.70 UHC Choice P l u s Employee + Child(ren) $443.45 $221.72 Employee + S pouse $532.14 $266.07 Fa m ily $772.87 $386.43 $80,000 – $ 1 24,99 9 E m plo y ee O n l y $175.95 $87.98 UHC C hoi c e Employee + Child(ren) $307.92 $153.96 Employee + S pouse $369.51 $184.76 Fa m ily $536.66 $268.33 E m plo y ee O n l y $263.95 $131.98 UHC Choice P l u s Employee + Child(ren) $461.93 $230.96 Employee + S pouse $554.31 $277.16 Fa m ily $805.06 $402.53 $125,000 – $ 159,99 9 E m plo y ee O n l y $215.05 $107.52 UHC C hoi c e Employee + Child(ren) $376.34 $188.17 Employee + S pouse $451.61 $225.81 Fa m ily $655.92 $327.96 E m plo y ee O n l y $295.63 $147.81 UHC Choice P l u s Employee + Child(ren) $517.36 $258.68 Employee + S pouse $620.83 $310.41 Fa m ily $901.68 $450.84 Over $160,000 E m plo y ee O n l y $263.93 $131.97 UHC C hoi c e Employee + Child(ren) $461.88 $230.94 Employee + S pouse $554.26 $277.13 Fa m ily $804.99 $402.49 E m plo y ee O n l y $337.87 $168.93 UHC Choice P l u s Employee + Child(ren) $591.27 $295.63 Employee + S pouse $709.52 $354.76 Fa m ily $1,030.48 $515.24 11 Prescription Drug C o v e r a ge Prescription d r ug b e nefits are a co m ponent of UHC’s c o m prehensi v e m edical plans. As a UHC m e m ber, both the UHC Choic e an d UHC Cho i ce Plus inclu d e the followin g prescription dru g benefits, which are c ategorized into thr e e ti e r s. UHC Choice UHC Choice P l u s In - Network O n ly In - Network Out - of - Network Prescription Drug C o v era g e R e t a il ( 30 - da y s u p p l y ) T i e r 1 Tier 2 Tier 3 $10 copa y $35 copay $60 c op a y $10 copa y $35 copay $60 c op a y Your cost share w ill be the copa y plus the a m ount over the In - Net w ork allo w ed a m ou n t Mail Order (90 - da y s upp l y ) Your cost share w ill be t h e T i e r 1 Tier 2 Tier 3 $25 c op a y $87.50 copa y $150 copa y $25 c op a y $87.50 copa y $150 copa y copa y plus the a m ount o v er the In - Net w ork allo w ed a m ou n t To deter m ine the out - of - pocket cost for y our prescriptions, y ou m a y view the UHC Pre s cription Drug L isting at www. m y uhc.co m and selecting the Ad v antage 3 Tier PD L , or y ou m a y also v iew it on L air Note: UHC will directl y contact an y m e m bers affected b y an y prescription drug for m ular y c h a ng e s 1 2 Choose Home Delivery By going online : visit myuhc.com , register and follow the simple step - by - step instructions. By phone : Call the member phone number on the back of your plan ID card. It’s helpful to have your plan ID card and medication bottle available. By ePrescribe : Your doctor can send an electronic prescription. Prescriptions for controlled substances such as opioids, can only be ordered by ePrescribe. Dental B e n e f i ts Good oral care is essential to maintaining overall health. Dental benefits offer co m prehensi v e co v erage to help keep y ou and y our fa m il y smiling. You h a v e access to pre v enti v e dental services such as routine exa m s and cleaning s as well as b asic and m ajor restorati v e ser v ices and orthodontia Note: I f y ou ha v e dental co v erage through a nothe r source, y ou do not ha v e t o elect the NYP L dental p l a n Dental benefits are offered t h rough the Unite d Healthcare (UHC) Dental Preferre d Pr ov ider Organization (DPPO). Dental Plan Fe a tures UHC DPPO I n - Network. Y o u will ha v e access to dentists who participate in UHC’s PPO Network. I f y ou utilize these dentists, y ou will be subject to the in - network deductible and coinsuran c e. UHC’s I n - Network PPO dentists also sub m it clai m for m s on y our behalf and charge onl y the patient share at the ti m e of treat m ent. Out - of - Network. Under the UHC D e ntal PPO, y ou also ha v e the freedo m to use an y pro v ider outside the network. When y ou do, y ou m a y be required to pa y the entire a m ount of the bill for ser v ices in ad v ance, sub m it the clai m on y our own to UHC Dental, and wait for rei m burse m ent. Out - of - network pro v iders ma y balance bill abo v e the Reaso n able & Custo m ar y (R&C) char g e for ser v ices, which result in higher out - of - pocket costs. Details on the differenc e in o ut - of - pocket costs between n etwork and non - network dentists can be found b y v isiting www m y uh c c o m The c h art below outlines a b r ief sum m ar y of dental co v erage. F or plan details, refer to the UHC d ental benefi t s sum m ar y a v ailable on L air U H C PP O In - Network Out - of - Network Calendar Year D ed u c t i b l e I n di v i d u al F a m i ly $5 0 $1 5 0 $1 0 0 $3 0 0 Calendar Year Benefit Ma x imum $1,50 0 Diagnostic & Pre v e n t i v e Oral exa m & cleaning, f luoride tr e atments, sealants on per m anent m olars, x - ra y s 10 0 % 10 0 % Basic R es t ora t i v e Scaling & root planning, a m algam f illin g s , c o m po s it e f illing s ( a nte r io r t ee th ) unco m plicated extractions Plan pays 80% after ded u c ti bl e Plan pays 60% * after ded u ct i b l e Major R e s t ora t i v e Inla y s, onla y s, cro w ns, dentures, r oot canal therap y , surgical tooth re m oval Plan pays 60% after ded u ct i bl e Plan pays 50% * after ded u c t i b l e O r t h odo n t ia Plan pays 60% after ded u ct i bl e Plan pays 50% * after ded u c ti b l e Orthodontia Lifetime Maxi m um $1,500 (dependent children to age 1 9 ) *Sub j ec t t o R e a s onab l e & C u s t o m a r y ( R & C ) c h a r g e s 13 Dental B e n e f i ts Transitioning from Another P la n Pr o cedures that ar e in proce s s (opened or prepar e d) — such as crowns, r oot canals, dentures and bridgework — prior to the effecti v e date of UHC’s d ental co v erage are considered to be the res p ons i bilit y of the pre v ious carrier. UHC assu m es responsibilit y for clai m s for procedures that began after the effecti v e dat e of UHC’s dental co v erage T y pical procedures that m a y o v erlap carriers include: orthodontics, en d odontics ( r oot canals), an d p r o s t hodon ti c s an d m a j o r r e s t o r a t i v e s e r v i ce s ( c r o w n s ) Pre - Treatment Estimates I f y our dental bill is expected to be $ 2 0 0 or m ore, before t h e dentist starts the treat m ent you can find out what dental ser v ices will be paid under t h e plan and what the p atient responsibilit y will be. 2023 Pre - Tax Employee Contributions: UnitedHealthcare DPPO Coverage Level Monthly Contribution E m plo y ee O n l y $ 5 F a m i ly $ 1 0 In - Network & Out - o f - N e tw o rk Difference — Impo r tant N ote: UHC PPO network p rov i ders a r e contracted with UHC and not subject to R&C. T h ere is a higher o verall le v el of benefits in - n etwork Out - of - networ k provi d ers a r e sub j ect to R&C and b alance billing a nd will lead to high e r out - of - pocket costs for you About UHC Network P r ovi d e r s! T o s e a r ch f o r a n e t w o r k d e n t i s t b y n a m e , s p e ci a l t y o r l o c a t i o n , v i s i t ww w m y uh c.c o m ( r e g i s t r a t i o n i s re qui re d ) A f t er you log in, click on “Find a D entist” at the right side of t h e page an d elect PPO National Netw o rk; then, enter your search c riteria. Note: You c a n also use the m yuhc mobi l e app on your smartphon e to locate a provi d er ne a r you 14 Vision B e n e f i ts Vision be n efits are offered through Unite d Healthcare. The UnitedHealthcar e v ision plan pro v ides both in and out - of - network co v erage, howe v er, i n - network pro v iders offer a higher le v el of benefits as the y accept disco u nted fees for se r v ice. Out - of - network ser v ices will lead to higher out - of - pocket costs for y ou. The chart below outlines a brief sum m ar y of vision co v erage. F or plan details, refer to the Unite d Healthcare v ision benefits sum m ar y a v ailable on L air UnitedHealthcare Vision P lan In - Network Out - of - Network E y e Exam (ever y 12 m onth s ) $0 copa y Up to $40 rei m b u r s e m e n t Standard Plastic Lenses (ever y 12 m onth s ) Single V i s i on B i f ocal Tr i f ocal S t a nd a r d Pro g re s s i ve $0 copa y $0 copa y $0 copa y $7 0 Up to $80 rei m bursement Up to $90 rei m bursement Up to $120 rei m bursement Up to $90 rei m bursement Standard Fra m es (every 12 m onth s ) $150 a ll o w a n ce; 30% off balance over $1 5 0 Up to $100 re i m b u r s e m ent Contact Lenses (ever y 12 m onth s ) $200 a ll o w a n ce Up to $200 rei m b u r s e m e n t Additional Purchases & Out - of - Pocket Discounts I n addition to co v erage abo v e, UnitedH e althcare also pr ov ides co v erage and discounts on other ser v ices such as le n s options and L asik v ision correction surger y Me m bers can recei v e a 30% discount (at certain locations) on e y eglass purchase s once the fu n ded b enefit has been used Additional discounts do n ot appl y to Unite d Healthcare pro v iders’ professional ser v ices or disposable contact lenses 2023 Pre - Tax Employee Contributions: UnitedHealthcare Coverage Level Monthly Contribution E m plo y ee O n l y $ 1 F a m i ly $ 2 Getti n g your e yes checke d r outin e ly will hel p you se e clearly. E y e health is just as i m portant as m aintaining y our o v erall health. Vision be n efits offer co m prehensi v e co v erage such as routine e y e exa m s, e y ewear and other discounts Note: I f y ou ha v e v ision co v erage throu g h a nother sour ce , y ou do not ha v e to elect th e NYP L v ision plan. 1 5 Flexible Spending A cc o u n t s With F lexible Spending Ac c ounts ( F SAs), y ou can e xp e r i e n c e v a l u a b l e t a x s a v i n gs w h il e gu a r a n t e e i n g m on e y is a v ailable for i m portant expenditures. I f y ou anticipate out - of - pocket health care a n d depe n dent care expen s es during the y ear, y ou m a y want to consider contributing to one or bot h F SAs. Ther e are two t y pes of F S A s : Health Care FS A Dep e ndent Care F S A You deter m ine whether to c o ntribute to one or b oth accounts. I f y ou participate, y our contributions are deducted fro m y our pa y on a pre - tax basis. I m portant! If y ou wish to participate in an F SA in the next plan y ear, y ou m ust m ake a new election during the ope n enroll m ent period. F SA elections do not carr y o v er fro m y ear to y ear. Health Care FS A This acc o unt allows y ou to set aside m one y to help pa y for unrei m bursed out - of - pocket m edical, dental and