Once the enrollee, enrolled spouse or domestic partner, or all dependent
children combined have incurred $500 in annual non-network hospital expenses, a
claim may be filed with the Empire Plan medical carrier for reimbursement of
out-of-pocket non-network hospital expenses incurred above the $500 and up to
the balance of the annual Hospital coinsurance maximum amount. Effective
January 1, 2009, once the enrollee, enrolled spouse or domestic partner, or all
dependent children combined have incurred $500 in annual non-network hospital
expenses, a claim may be filed with the Empire Plan medical carrier for
reimbursement of out-of-pocket non-network hospital expenses incurred above the
$500 and up to $1,000. Effective