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MT. SINAI/ANTHEM CONTRACT NEGOTIATIONS – WHAT YOU NEED TO KNOW

Anthem’s contract with Mt. Sinai hospitals ends on December 31, 2025. Negotiations are underway, and are expected to be concluded before the current contract expires. Even if a contract is not reached, there should be no adverse effect as Anthem covers emergency services wherever our participants seek care.

This negotiation does not impact any services covered under The Empire Plan’s Medical/Surgical Program,

administered by UnitedHealthcare.

If Mt. Sinai leaves Anthem’s network and you are being treated for a serious or complex condition that will continue past December 31, 2025, you may contact The Empire Plan at 1-877-7-NYSHIP (1-877-769-7667) and press or say 2 for the Hospital Program. You may be able to continue your care at Mount Sinai after that date if you are receiving certain types of care.

Updates on the progress of the negotiations are available at: https://www.anthembluecross.com/nys

COVID VACCINES REMAIN COVERED BY THE HEALTH PLAN

You may have read about the FDA changing their COVID vaccination recommendation. The PWGA follows the CDC’s Advisory Committee on Immunization Practices (ACIP) recommendations for vaccines. The ACIP has not modified their COVID vaccine policy.

As a result, the PWGA continues to cover COVID vaccinations as before – nothing has changed.

SUMMARY OF MATERIAL MODIFICATIONS UPDATE

A new Summary of Material Modifications (SMM) has been approved by the Board.

This expands the infertility benefits for pre-surrogacy services.

To see the SMM and learn the details of the newly expanded benefit, please click HERE.

The PWGA App is Now Available!
 
Also, Big Changes to MyPlans on the PWGA Website! 

For the very first time, you can access Health and Pension Plan information through an app on your favorite mobile device whether it be your phone or tablet. We have updated the website and made MyPlans significantly more capable and secure as well. One registration, two great ways to see your information.