Introduction
This employee benefits guide highlights various benefit plans offered at Cold Spring Harbor Laboratory (CSHL). As you look to make decisions regarding medical benefits for you and your family, you should be aware that the available medical plans provide you with access to one of the country’s largest provider networks, United Healthcare (UHC). You also have the freedom to select any provider in their network without obtaining a referral. CSHL remains committed to providing excellent health coverage for our employees. As part of that commitment, we continuously monitor the health plans to ensure an appropriate balance between coverage and cost. In 2024, the operating costs for our health plans continued to rise, which necessitated changes to our health plans. The change will result in streamlining your choices in healthcare providers while simultaneously providing cost savings to the Laboratory. We are changing the UHC Choice Tiered plan to the UHC Choice plan. On the UHC Choice plan, rather than determining co- payments based on tiers, co-payments are based on whether you use a Primary Care Physician or a Specialist. What this means to you is that you no longer need to determine what tier your physician is in. If you see a primary care physician, the co-payment will be $20, and if you see a specialist, the co-payment will be $35. Most other aspects of the plan will remain unchanged. One critical detail to keep in mind is the ongoing challenge related to the acquisition of physician practices by hospital systems. As physician practices continue to be acquired by hospitals it affects how your claims are processed and increases your financial responsibility. Because these physicians are now employed by the hospital, any scopic procedure, surgery, lab test, x-ray or scan performed in the doctor’s office will be billed as hospital based. Besides the office visit copayment, you will have an additional financial responsibility to pay for a portion of the charges for these procedures. This is not a new phenomenon, but one that is increasingly impacting patients. The following chart outlines your financial responsibility under the UHC Choice plan for these procedures and where these procedures are performed:
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