BENEFITS BASKET
Health care needs are different for everyone. The Catholic Health Medical Plan offers multiple options so you can choose the Plan option that’s best for you and your family.
The Benefits of Caring program offers four medical plans, administered by Anthem (previously named Empire); the plan you choose will determine what facilities, physicians, and services are covered. Read about each of these options below, and select the health care benefits that are right for you and your family. Rate sheets are available on the Enrollment Portal – log in using your Catholic Health Network credentials and navigate through the enrollment process to the Medical Plan screen.
Please click the links below to view a full plan comparison chart for each Medical Plan option:
I need specialty care that Catholic Health doesn’t offer - do I still need to pay the deductible and coinsurance?
A: Catholic Health offers full coverage for services provided at Catholic Health facilities & physician partners. Since we don’t have to pay other health systems for your treatment at Catholic Health we pass the savings to you by waiving out of pocket costs. For services Catholic Health doesn’t offer, you receive competitive coverage through the Anthem network, which includes paying deductible & coinsurance.
The cost of health care is constantly increasing. Catholic Health has kept contributions and cost share affordable while offering a robust & generous plan. The deductible & coinsurance you pay for non-Catholic Health care are part of this health plan design & we cannot offer exceptions.
Important: Member Cost Share
Member cost share (deductible, coinsurance and/or copay as applicable depending on the plan) will apply to all non-Tier 1 (non-Catholic Health) facility services, including admissions through the emergency room.
Your choices for medical coverage may include:
Select Plan
The Select Plan is free for most employees with little or no out-of-pocket costs.
The Select Plan is designed for employees who are comfortable receiving care for themselves and their families at Catholic Health facilities and by Catholic Health Providers. It also includes the 1 Gustave L. Levy Place location of Mt. Sinai Hospital in Manhattan, NY Presbyterian Columbia University Irving Medical Center in Manhattan, and the Anthem physician network.
Please note: Other Mt. Sinai locations are not covered under the Select Plan, and you will be responsible for the full cost.
You don’t need to choose a Primary Care Physician (PCP) to coordinate your care. There are no out-of-network benefits offered under this plan.
If your spouse is offered coverage by their employer, you may not enroll him/her in the Select Plan.
Empire Exclusive Provider Organization (EPO)
With the Empire EPO program, you must choose a doctor or provider within the Empire network, or choose a Catholic Health Provider, each time you or your covered dependents need care. You don’t have to choose a PCP. There are no out-of-network benefits offered under the EPO plan.
Coverage Away From Home
With both the PPO and EPO plans, if you are traveling, or you have covered dependents who are away at school, you have access to BlueCross BlueShield PPO network providers across the country. For more information, visit www.empireblue.com and click on Where To Get Care.
Empire Preferred Provider Organization (PPO)
The Empire PPO plan grants you complete flexibility to choose your doctor or other provider from a wide network each time you or your covered dependents need care. You don’t need to choose a Primary Care Physician to coordinate your care.
The PPO offers out-of-network benefits; however, certain services may not be covered out-of-network. Seek care in the Empire network or choose a Catholic Health Provider for affordable options.
Coverage Away From Home
With both the PPO and EPO plans, if you are traveling, or you have covered dependents who are away at school, you have access to BlueCross BlueShield PPO network providers across the country. For more information, visit www.empireblue.com/chs and click on Where To Get Care.
Empire Point of Service
With the Empire POS program, it is recommended that you select a Primary Care Physician (PCP) to coordinate your care. However, you can self-refer to a specialist. You have complete flexibility to choose your doctor or other provider within the Empire Local Area Network, or choose a Catholic Health Provider, each time you or your covered dependents need care. This plan offers out-of-network benefits; however, certain services may not be covered out-of-network.
Additional Information
Avoid Extra Fees for Lab Services
Tell your Empire physician to send your lab work to Catholic Health facilities, Quest Diagnostics, or LabCorp. You may have out-of-pocket expenses if your lab work is sent to a different lab.
Catholic Health Physician Partners Network
You receive the most affordable care when you go to Catholic Health Physician Partner Providers. To view the Catholic Health Physician Partners Directory, click here.
Enrolling a Spouse?
In order to control our cost and keep coverage affordable for all employees, there is a pre-tax spousal coverage surcharge for spouses enrolled in the Catholic Health Medical Plan who are offered medical coverage by their employer. It may be worth comparing your spouse’s coverage at Catholic Health with what they would pay on their employer’s plan. If your spouse is offered medical coverage by their employer, there will be a pre-tax spousal surcharge of $20 per paycheck if you cover your spouse under the Catholic Health Medical Plan (PPO, EPO, and POS options only).
Gianna of Long Island Center for Women’s Health & Fertility
Affiliated with the National Gianna Center for Women’s Health & Fertility, the Gianna of Long Island Center for Women’s Health & Fertility is the only facility of its kind on Long Island. Highly specialized restorative reproductive medicine (RRM) is offered in accordance with Catholic teaching. The scientifically based RRM incorporates the Creighton Model FertilityCare™ System and NaProTECHNOLOGY™. Conditions treated include infertility, recurrent miscarriage, endometriosis, ovarian cysts, polycystic ovarian disease, postpartum depression, PMS and other issues. Click here to learn more.
Personal Health Nurses & Conifer Value-Based Care
The Personal Health Nurse (PHN) program is available to employees enrolled in the medical plans and their covered dependents. This voluntary and confidential program helps employees and their families with specific complex healthcare needs. They can also help you find a physician suited to your individual needs.
If you are contacted to participate in this program, you will work with a Conifer PHN and your doctor(s) to ensure you get coordinated, costeffective, and high-quality care. If you believe you or a family member can benefit from working with a PHN, please call 1-866-821-7021, option 5.
Documents & Forms
Click here and then select Medical.
The information in this website is intended to provide highlights of the Benefits of Caring program, but in no way do the descriptions presented in this website supersede the provisions contained within the Catholic Health & Welfare Benefits Plan (the “Plan”), or the Plan’s Summary Plan Description, or any relevant insurance contract. In the event of any discrepancies, the actual provisions of the relevant insurance contract Plan document will prevail. Employees represented by a union should contact their union or HR benefits representative as applicable for benefit information. Catholic Health, in its sole discretion, reserves the right to amend or discontinue any or all of the benefits under the Plan and any or all of the programs within its Benefits Program at any time. Participation in the Benefits of Caring Program does not give you any right to continued employment. In addition, note that this Plan is intended and designed to be administered consistent with the tenets of the Catholic faith. Therefore, the Plan will not cover any costs or benefits that do not comply with the Ethical and Religious Directives of the Catholic Church.
