County of Orange � Division of Risk Management Michael T. Morris Risk Management Officer Edward A. Diana 18 Seward Avenue Middletown, New York 10940 County Executive Tel: (845) 615-3600 Fax: (845) 346-1169 www.orangecountygov.com October 7, 2008 Risk Management has learned that an Empire Plan Report, which will be mailed to enrollees� homes in the comings weeks, will be announcing important Empire Plan changes for 2009. PARTICIPATING PROVIDER COPAYMENT $20 OUTPATIENT SURGERY LOCATIONS COPAYMENT $30 EMERGENCY ROOM SERVICES COPAYMENT $70 DIAGNOSTIC OUTPATIENT SERVICES COPAYMENT $40 OUTPATIENT SURGERY COPAYMENT $60 NON-PREFERRED DRUG COPAYMENT 30 DAY SUPPLY � RETAIL AND MAIL $40 90 DAY SUPPLY � RETAIL $70 90 DAY SUPPLY � MAIL $65 The Empire Plan will be moving to a Flexible Formulary. A Half-Tablet Program (at half copay) went into effect 10/01/08. A Specialty Drug Program (limited use drugs for specific illnesses) will be implemented in Spring �09. United Healthcare/Optum will be the new Mental Health and Substance Abuse insurer/administrator, replacing GHI/Value Options. OptumHealth Call Center will begin taking calls (1-877-769-7447) November 3, 2008. There will be a transition period for benefits. MRA, CT, PET and Nuclear Medicine diagnostic procedures, as well as MRI, will need pre-notification. Center of Excellence for Bariatric Surgery Program and Diabetes Education Center Chronic Kidney Disease Management Program for Empire Plan Primary individuals. Herpes Zoster (Shingles) Vaccine will be a covered NETWORK benefit (No Non-Network coverage). Please note that the Empire Plan will be issuing new cards to all current enrollees that will have a new COPAYMENT code for January 2009. There are no changes in membership ID numbers. These cards should be arriving at enrollee homes in December 2008. The Empire Plan Report will explain these and any other changes in detail, so please read the brochure carefully when you receive it.