Orange-Ulster School Districts Health Plan
Harriman, NY 10926
Plan Administration Office
History and Background – When the Health Plan began in 1983, the Plan Administrator duties were part of the Orange-Ulster BOCES Business Administrator’s duties. Over time, the Health Plan became more complex and the duties more time consuming. By the late 1990s, the Health Plan duties were consuming over 50% of the BOCES’ Business Administrator’s time. In addition, reporting demands by the New York State Insurance Department increased significantly, the number of service providers grew significantly, and the need for communication with participating school districts and enrollees grew significantly. Even working half time on Health Plan matters, the BOCES’ Business Administrator was unable to complete all tasks on a timely basis.
In the 2000-2001 school year, the Superintendents recognized that change was necessary. A Blue Ribbon Committee of Superintendents and Business Officials chaired by Dr. William Bassett, District Superintendent, was established to review the future management needs of the Health Plan and make recommendations. The Committee recommended that a separate Health Plan office be established headed by a Plan Administrator with sufficient staff to deal with all Health Plan issues on a timely basis.
The proposal of the Blue Ribbon Committee was reviewed and endorsed by the school districts’ Superintendents, who in turn reviewed the proposal with their Boards of Education. The proposal of the Blue Ribbon Committee was presented to the Health Plan Board of Trustees for action and implementation.
Functions of the Plan Administration Office – The primary function of the Plan Administration Office is to act as a resource for participating school districts and enrollees. The Plan Office is responsible for coordination of the day-to-day activities of the various service providers. In addition, the Plan Office is responsible for the interaction between the New York State Insurance Department and the Plan. Among the specific duties are:
- Resource Office
- Respond to questions and needs of Health Plan Board of Trustees
- Provide Plan information to individual Trustees, school districts, and enrollees
- Prepare monthly Board of Trustee agenda, and support information
- Work with Committees
- Work with Service Providers
- Answer coverage questions of Trustees, enrollees, and school districts
- Work with Trustees to answer questions on Plan eligibility, benefit levels
- Coordinate Plan communications between service providers and participating school districts
- Work with Plan Auditor
- Work with Plan Actuary
- Interact with New York State Insurance Department
- Prepare Plan periodicals, brochures, and notifications for distribution
- Carry out the administrative duties assigned by the Board of Trustees