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AEMs
Documents and Forms for EMHP Members
All Employee Memoranda
2023 AEMs
File
AEM 22-2023 Pre-Tax Open Enrollment Reminder
AEM 21-2023 Safeguardrx and Cobra Disability Retirement Payments
AEM 19-2023 Attachment - Premium Assistance Under Medicaid Attachment_2024
AEM 19-2023 - CHIP PREMIUM ASSISTANCE - 2024
AEM 18-2023 - Womens Health 2024
AEM 17-2023 - MENTAL HEALTH PARITY AND ADDICTION EQUITY ACT OF 2008_2024
AEM 16-2023 - ENROLLMENT IN MEDICARE PARTS A Hospital and B Medical_2024
AEM 15-2023 - ANNUAL OPEN ENROLLMENT FOR 2024
AEM 14-2023 Suffolk County Marathon
AEM 13-2023 - EMHP WELLNESS EVENTS 10-23 THROUGH 10-26-23
AEM 12-2023 Pre-Tax Flexible Benefits Open Enrollment - 2024
AEM 11-2023 Mental Health - Self Care by AbeTo for Teens
AEM 08-2023 EMHP Telephonic Visits
AEM 07-2023 EMHP Telephonic Visits
AEM 05-2023 EMHP End of COVID-19 Public Health Emergency Effective 5/11/23
AEM 01-2023 Mental Health FAQs
2022 AEMs
File
AEM 31-2022 Change in Mental Health Providers
AEM 27-2022 Mental Health Parity
AEM 26-2022 CHIP
AEM 26-2022 CHIP Attachment
AEM 25-2022 Annual Open Enrollment
AEM 24-2022 Women's Health
AEM 23-2022 Enrollment in Medicare
AEM 15-2022 EMHP Extension of Telephonic Medical Visits 12-31-2022
AEM 13-2022 EMHP Cost Sharing Deductibles
AEM 12-2022 EMHP Extension of Telephonic Medical Visits
AEM 11-2022 COVID-19 Home Tests
AEM 09-2022 Weekly COVID-19 Drive-Through Testing
AEM 07-2022 Updated Employee Mask Mandate
AEM 06-2022 Employee Mask Mandate
AEM 05-2022 Updated Employee Testing Information
AEM 04-2022 Updated Mask Mandate
03-2022 Updated Employee Mask Mandate
02-2022 Updated RTW protocol
01-2022 COVID-19 Leave Requests and Updated Return-to-Work Protocols for Essential Vaccinated Employees
2021 AEMs
File
49-2021 Weekly Rapid COVID-19 Testing
48-2021 Employee Mask Mandate
47-2021 Pre-Tax Flexible Benefits Program
45-2021 EMHP Prescription Benefits
45-2021 - FAQs ESI - 2021
43-2021 Attachment - Premium Assistance Under Medicaid 2021
43-2021 Premium Assistance under Medicaid and CHIP
42-2021 Mental Health Parity and Addiction Equity Act of 2008
41-2021 Enrollment in Medicare Parts A (Hospital) and B (Medical) 2022
40-2021 EMHP Annual Notice of Women's Health and Cancer Rights Act of 1998
39-2021 Well-being Coach
38-2021 Annual Open Enrollment for 2022
37-2021 Surprise Billing Notice
36-2021 EMHP Extension of Telephonic Medical Visits
35-2021 Changes to Your EMHP Prescription Benefits & The Prescription Benefits Manager
34-2021 Launch of the New EMHP Website
33-2021 Infusion Site of Care Change Clarification
30-2021 EMHP Mental Health or Sustance Use Disorder Benefits
25-2021 Infusion Site of Care Change
24-2021 - Reminder - EMHP Tele-Medicine Enrollment Giveaway
24-2021 - Access Plus - Tele-Medicine Enrollment Giveway
23-2021 - 24-7 EMHP NurseLine and Sydney App
19-2021 EMHP Telephonic Medical Visits
09-2021 EMHP Paperless Communications
09-2021 Paperless Communications - Notice of Disclosure Form
35-2020 - In Network Providers Utililzing Out Of Network Labs
34-2020 - Increases in In-Network Specialist Copays and Out-of-Netweork Deductible for Medical-Surgical Benefits
EMHP - Specialty Prior Authorization List - 9-1-21
Open Enrollment for 2021
2020 AEMs
File
Well-being Coach
Womens Health and Cancer Rights - Annual Notice
Premium Assistance under Medicaid-CHIP
Mental Health Parity and Addiction Equity Act of 2008 (2)
Medicare Enrollment - Parts A (Hospital) and B (Medical)
Out-of-Network Annual Physical Changes - eff 8-1-2020
Eligibility Audit for Coverage and Dependents
COVID-19 EMHP COVERAGE CHANGES 4-24-2020
Tele-Medicine - Re-Registration Required
Tele-Medicine - Access Discount Healthcare - Coronavirus
Change to Acupuncture & Occupational Therapy Benefits
2019 AEMs
File
Chiropractic Benefits Change Effective 12-1-2019
Tele-Medicine Provider
Appeals Process (EMHP) - 8-1-2019
Chiropractic Benefits eff 6-1-2019
Changes to your Health Benefits - Issued 5-17-19
Lab Benefit Coverage
Wellmanaged Hyperinflationary Program - eff 9-1-18
Notice of Privacy Practices
Claim Forms
File
ESI ClaimForm
Hospital Medical Health Insurance Claim Form
Instructions for Hospital-Medical Care Outside U.S.A.
International Claim Form (Medical)
Mental Health Substance Use Disorder - Claim Form
Optum Claim Form
Optum Claim Form Instructions
USSC Specialty Program Prescription Form
EBU Forms
File
Affidavit of Other Available Coverage
Application for Coverage as a Disabled Dependent
Application for Waiver of Premium
Certification of Medicare Part B Premium Reimbursement
Change of Address Form
DOMESTIC PARTNERSHIP APPLICATION
Health Benefits Transaction
MEDICARE PART D - OPT-OUT FORM
Personal Representative Form - EMHP (EBU)
Termination of Domestic Partnership
EMHP Drug Lists
File
Express Scripts Formulary 2023
EMHP - Clinical Focus Formulary - 9-1-2021
EMHP - Intercept Drug List - 12-21-20
EMHP - Limited Distribution Drug List - 12-21-20
EMHP - Personalized Medicine Drug List - 12-21-20
EMHP - Quantity Level Limits - 12-21-20
EMHP - Specialty Prior Authorization List - 9-1-21
EMHP -Step-Therapy -12-21-20
EMHP Benefit Booklet
File
EMHP Benefit Booklet 7th Edition - January 2021
Summary of Benefits & Coverage
File
2022 - Summary of Benefits & Coverage (SBC)
2021 - Summary of Benefits & Coverage (SBC)
Summary of Benefits - Glossary of Coverage and Medical Terms
Archives
Benefits Booklets
File
EMHP Benefit Booklet - April 2002 - 4th Edition
General Information, Eligibility & Medicare
General Information, Eligibility and Medicare
I. TABLE OF CONTENTS
II. General Information Section
III. Hospital Major Medical Benefits
IV. Hospital Major Medical Benefits - In-Network and Out-of-Network Chart
V. Mental Health - Substance Abuse Benefits
VI. Prescription Drug Benefits
Mental Health and Substance Use Disorder
Prescription Drug Benefits for Active & Non-Medicare Eligible Retirees
Prescription Drug Benefits for Medicare Prime Eligible Retirees, Dependents and Dependent Survivors
Drug Lists - EMHP
File
EMHP - 2020 Clinical Focus Formulary List
EMHP - Clinical Focus Formulary -12-4-20
EMHP - Personalized Medicine List - 10-1-2017
EMHP - Personalized Medicine List - 1-1-2017
EMHP - Personalized Medicine List - 5-1-2017
EMHP - Specialty Drug List 2021 Alpha -12-21-20
EMHP 2014 Basic Plus Formulary List - 5-1-14
EMHP 2016 Preferred Universal Formulary List - 11-1-15
EMHP 2017 Clinical Focus Formulary List
EMHP 2018 Clinical Focus Formulary List
EMHP 2019 Clinical Focus Formulary List
EMHP Drug Quantity Level Limits (QLL) List - 7-22-14
EMHP Drug Quantity Level List (QLL) - 5-13-15
EMHP Drug Quantity Level List (QLL) - 8-17-15
EMHP Drug Quantity Level Lists (QLL) - 12-3-2014
EMHP Drug Quantity Level Lists (QLL) - 2-17-2015
EMHP Drug Quantity Level Lists (QLL) 9-12-14
EMHP Drug Quantity Level Lists (QLL)
EMHP Drug Quantity Levels List (QLL) - 7-1-16
EMHP Drug Quantity Levels List (QLL) - 11-16-15
EMHP Drug Quantity Levels List (QLL) - 1-8-16
EMHP Drug Quantity Levels List (QLL) 4-1-16
EMHP Intercept Drug List - 1-1-19
EMHP Intercept Drug List_4-1-19
EMHP Limited Distribution Medications - October 2018
EMHP Limited Distribution Medications 1-1-19
EMHP Limited Distribution Medications List - 4-1-19
EMHP Personalized Medicine List - 10-1-16
EMHP Personalized Medicine List - 10-1-18
EMHP Personalized Medicine List - 11-16-15
EMHP Personalized Medicine List - 1-1-2018
EMHP Personalized Medicine List - 12-19-2014
EMHP Personalized Medicine List - 1-8-16
EMHP Personalized Medicine List - 4-1-16
EMHP Personalized Medicine List - 4-1-18
EMHP Personalized Medicine List - 4-1-19
EMHP Personalized Medicine List - 4-1-2015
EMHP Personalized Medicine List - 5-1-15
EMHP Personalized Medicine List - 7-1-16
EMHP Personalized Medicine List - 8-17-15
EMHP Personalized Medicine List 1-1-19
EMHP Personalized Medicine List
EMHP Quantity Level Limits - 10-1-2017
EMHP Quantity Level Limits (QLL) 1-1-19
EMHP Quantity Level Limits (QLL) List - 10-1-16
EMHP Quantity Level Limits (QLL) List - 10-1-18
EMHP Quantity Level Limits (QLL) List - 1-1-2017
EMHP Quantity Level Limits (QLL) List - 1-1-2018
EMHP Quantity Level Limits (QLL) List - 4-1-18
EMHP Quantity Level Limits (QLL) List - 5-1-2017
EMHP Quantity Level Limits List - 4-1-19
EMHP Specialty Prior Authorization List - 4-1-19
EMHP Specialty Prior Authoirzation List
EMHP Specialty Prior Authoization List - 10-1-16
EMHP Specialty Prior Authorization List - 10-1-18
EMHP Specialty Prior Authorization List - 10-1-2017
EMHP Specialty Prior Authorization List - 11-16-15
EMHP Specialty Prior Authorization List - 1-1-2017
EMHP Specialty Prior Authorization List - 1-1-2018
EMHP Specialty Prior Authorization List - 1-8-16
EMHP Specialty Prior Authorization List - 2-17-2015
EMHP Specialty Prior Authorization List - 4-1-16
EMHP Specialty Prior Authorization List - 4-1-18
EMHP Specialty Prior Authorization List - 5-1-2017
EMHP Specialty Prior Authorization List - 5-13-14
EMHP Specialty Prior Authorization List - 5-13-15
EMHP Specialty Prior Authorization List - 7-1-16
EMHP Specialty Prior Authorization list - 8-17-15
EMHP Specialty Prior Authorization List - 8-25-14
EMHP Specialty Prior Authorization List 1-1-19
EMHP Standard and Enhanced Prior Authorization List - 5-13-15
EMHP Standard and Enhanced Prior Authorization Lis-2-17-2015
EMHP Standard and Enhanced Prior Authorization List - 1- 1-2017
EMHP Standard and Enhanced Prior Authorization List - 10-1-16
EMHP Standard and Enhanced Prior Authorization List - 10-1-2017
EMHP Standard and Enhanced Prior Authorization List - 11-16-15
EMHP Standard and Enhanced Prior Authorization List - 12-3-14
EMHP Standard and Enhanced Prior Authorization List - 1-8-16
EMHP Standard and Enhanced Prior Authorization List - 4-1-16
EMHP Standard and Enhanced Prior Authorization List - 5-1-2017
EMHP Standard and Enhanced Prior Authorization List - 7-1-16
EMHP Standard and Enhanced Prior Authorization List - 8-17-15
EMHP Standard Prior Authorization List - 10-1-18
EMHP Standard Prior Authorization List - 1-1-2018
EMHP Standard Prior Authorization List - 4-1-18
EMHP Standard Prior Authorization List - 4-1-19
EMHP Standard Prior Authorization List - 5-13-14
EMHP Standard Prior Authorization List - 8-25-14
EMHP Standard Prior Authorization List 1-1-19
EMHP Step Therapy Drug List - 5-18-16
EMHP Step Therapy Drug List - 10-1-16
EMHP Step Therapy Drug List - 10-1-18
EMHP Step Therapy Drug List - 10-1-2017
EMHP Step Therapy Drug List - 1-1-2017
EMHP Step Therapy Drug List - 1-1-2018
EMHP Step Therapy Drug List - 3-9-2015
EMHP Step Therapy Drug List - 4-1-18
EMHP Step Therapy Drug List - 4-1-19
EMHP Step Therapy Drug List - 5-1-2017
EMHP Step Therapy Drug List - 5-13-14)
EMHP Step Therapy Drug List - 7-1-16
EMHP Step Therapy Drug List - 8-17-15
EMHP Step Therapy Drug List - 9-12-14
EMHP Step Therapy Drug List - 9-24-15
EMHP Step Therapy Drug List 1-1-19
EMHP Step Therapy Drug List 5-13-15
EMHP Step Therapy Drug List
EMHP Step Therapy List - 11-16-15
EMHP Step Therapy List - 1-8-16
EMHP Step Therapy List - 4-1-16
EMHP Wellmanaged Hyperinflationary Drug List - effective 9-1-18
Eligibility Updates
File
Continuing Health Benefits as Retiree or Vested Participants - 2010
Coverage for Dependents Up to Age 26
Domestic Partner Coverage - 2004
EMHP Benefit Updates
File
Acupuncture Benefit Change
Alternate Network for POS Members -2012
Appeals Process (EMHP) - 8-1-2019
Change in Prescription Benefit Manager (Eff 5-1-14)-Dependent Coverage Up to Age 26
Chiropractic Benefits Change Effective 12-1-2019
Closed Diabetic Formulary
Closed Specialty Pharmacy Network & Oral Oncology Program - eff 12-1-14
Compound Management Program - eff 1-1-2016
Corrected AEM - Vaccinations Available at In-Network Pharmacies
EMHP Changes to Chiropractic Benefits effective June 1 2019
EMHP Health Benefits Changes - December 2008
E-Presscribing Law for New York State Prescriptions
FAQ re Change to WellDyneRx - eff 5-1-14
Health Benefits Update - 2006
Hospital Medical Benefits Administrator Change - 11-1-05
Important Changes to your Health Benefits - eff 1-1-2013
Important Update - Condition Care Disease Management Progams
Important Updates to Prescription Drug Benefits - Drug Lists and Personalized Medicine Program
IN-NETWORK PROVIDER COPAY CHANGES EFFECTIVE SETPEMBER 1 2017
Mental Health Benefits Administrator Change - 2006
Personalized Medicine Program
Prescription Benefits - Addition of ADHD Medications to Step Therapy Program
Rescue Inhalers at Retail - eff. 4-1-19
Rx Intercept Program - eff 1-1-2016
Telepsychiatry Benefits - effective 7-1-2017
Voluntary Pre-Determination for Diagnostic Testing Reminder - 2013
Voluntary Pre-Determination for Diagnostic Tests - 2010
Wellmanaged Hyperinflationary Program - eff 9-1-18
Medicare Reminder
File
Medicare Enrollment -Part A (Hospital) and B (Medical)
Medicare Part A and B Reminder
Medicare Part A and Part B Reminder - 2007
Medicare Part A and Part B Reminder - 2008
Medicare Part A and Part B Reminder - 2009
Medicare Part A and Part B Reminder - 2010
Medicare Part A and Part B Reminder - 2011
Medicare Part A and Part B Reminder - 2012
Medicare Part A and Part B Reminder - 2013
Medicare Part A and Part B Reminder - 2014
MEDICARE PART A AND PART B REMINDER - 2015
Mental Health Parity
File
Mental Health Parity - 2011
Mental Health Parity - 2013
Mental Health Parity - 2014
MENTAL HEALTH PARITY - 2015
Mental Health Parity - Issued 2018
Mental Health Parity - Issued 2019
Miscellaneous
File
04-2021 EMHP Members - Well-being Coach - Raffle
05-2021 Extended Weekly Schedule for Drive-Through Rapid testing
Acid-Reflux Medications & Counterirritants
Annual Notice of Premium Assistance under Medicaid and CHIPS
Anti-Discrimination Notice
Anti-Discrimination Taglines
Clarification on Filing of IRS Form 1095-C for 2015
Health Insurance Exchanges
Important Info Regarding the Cyber-Attack on Anthem, Inc
PPACA - IRS Employer Reporting
Premium Assistance under Medicaid and CHIPS
WellDyneRx Protected Health Information Form
Notice of Creditable Coverage
File
Notice of Creditable Coverage for 2006
Notice of Creditable Coverage for 2007
Notice of Creditable Coverage for 2008
Notice of Creditable Coverage for 2009
Notice Of Creditable Coverage for 2010
Notice Of Creditable Coverage for 2011
Notice of Creditable Coverage for 2012
Notice of Creditable Coverage for 2013
Open Enrollment
File
Open Enrollment - 2006
Open Enrollment - 2007
Open Enrollment - 2008
Open Enrollment - 2009
Open Enrollment - 2010
Open Enrollment - 2011
Open Enrollment for 2013
Open Enrollment for 2014
Open Enrollment for 2015
OPEN ENROLLMENT - 2016
Open Enrollment for 2019
Open Enrollment for 2020
Summary of Benefits & Coverage - AEM
Summary of Benefits & Coverage
Prescription Drugs
File
Announcing ESI as PBM and Mandatory Mail Program eff 6-1-2013
EMHP Drug Quantity Management DQM FAQ - 2009
Prescription Drug Benefits - 2006
Prescription Drug Benefits - 2007
Prescription Drug Benefits - 2008
Prescription Drug Benefits - 2009
Prescription Drug Benefits - 2010
Prescription Drug Benefits - 2011
Prescription Drug Copayments, Step Therapy & $0 Copay Programs - 2007
Privacy Notice
File
Notice of Privacy Practices - 2006
Notice of Privacy Practices - 2009
Notice of Privacy Practices - 2012
Notice of Privacy Practices - 2013
Summary of Benefits & Coverage
File
Summary of Benefits & Coverage for 2012
Summary of Benefits & Coverage for 2013
Summary of Benefits & Coverage for 2015
Summmary of Benefits and Coverage for 2017
Summary of Benefits & Coverage - 2018
Summary of Benefits & Coverage - 2019
Summary of Benefits and Coverage - 2020
Women's Health
File
Annual Notice of Women's Health - 2007
Annual Notice of Women's Health - 2008
Annual Notice of Women's Health - 2009
Annual Notice of Women's Health - 2010
Annual Notice of Women's Health - 2011
Annual Notice of Women's Health - 2012
Annual Notice of Women's Health - 2013
Annual Notice of Women's Health - 2014
ANNUAL NOTICE OF WOMENS HEALTH - 2015
Annual Notice of Women's Health - 2019
Women's Health -2020
Women's Health Correction to AEM 19-2019
Agencies
Suffolk AME
SC Correction Officer Association
SC Deputy Sheriff
Suffolk Police Benevolent Association
Detective Investigators PBA
Probation Officers Association
Suffolk Detective Association
Superior Officers Association
SCCC Guild of Administrative Offices
Faculty Association Suffolk County Community College
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2024