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The Empire Plan is a unique health insurance plan designed especially for public employees in New York State. Empire Plan benefits include inpatient and outpatient hospital coverage, medical/surgical coverage, Centers of Excellence for transplants, infertility and cancer, home care services, equipment and supplies, mental health and substance abuse coverage and prescription drug coverage.

The Empire Plan State Logo Man Reading

Customer Service

Efficiency

The Empire Plan offers public employers and enrollees superior customer service. The New York State Health Insurance Program (NYSHIP) features a paperless online health insurance enrollment system, the New York Benefits Eligibility and Accounting System (NYBEAS).

Orientation - Instruction - Guidance

When an employer joins The Empire Plan, a representative is available to conduct an orientation session for new enrollees to explain their new benefits. Training on NYBEAS (the NYSHIP enrollment system) for health benefits administrators of new Participating Agencies is offered at the Department of Civil Service in small group settings or on a one-on-one basis. Regional meetings are scheduled as needed to provide Participating Agency employer health benefit administrators with the opportunity to ask questions, receive Empire Plan updates and meet Participating Agency representatives.

Employer Planning Information

Comprehensive Empire Plan Quarterly Experience Reports are mailed to Participating Agency employers. The reports provide projected Empire Plan experience based on claims paid through the previous quarter and projected premium rates. The reports explain the basis for the projection.

Regularly Updated Enrollment Information

NYSHIP Empire Plan Benefit Statements are mailed annually to Participating Agency Empire Plan enrollees. The statements are designed to reduce NYSHIP costs by correcting enrollment records. NYBEAS data is laser-printed on the statement to create a personalized Benefit description for each enrollee.

With You Worldwide

Covered inpatient services at Blue Cross and Blue Shield network hospitals are paid in full worldwide. The Empire Plan offers over 15,000 network hospitals, skilled nursing facilities and hospice care facilities worldwide plus over 170,000 medical, mental health and other participating providers nationwide. For medical, mental health and other providers, see the Participating Provider Directory. The Empire Plan Prescription Drug Program has participating pharmacies nationwide and a mail service pharmacy.

Leading Communications

Since 1995, the New York State Department of Civil Service has won 282 awards recognizing excellence in health communications effectiveness. In addition to detailed benefits information, materials range from benefits newsletters and web sites to provider directories. There are also specialized publications on topics such as the management of certain illnesses, diabetes and asthma for example, and helpful guides to the Employee Benefits Division web site.

Comprehensive Coverage

Empire Plan benefits are available for a wide spectrum of services:

  • Inpatient and outpatient hospital coverage for medical, surgical and maternity care. Covered inpatient services at BlueCross and BlueShield network hospitals are paid in full.
  • Medical and surgical coverage under the Participating Provider network, or under the Basic Medical Program for non-participating providers.
  • Home care services, diabetic supplies, durable medical equipment and certain medical supplies paid in full through the Home Care Advocacy Program (HCAP).
  • Chiropractic and physical therapy coverage through the Managed Physical Medicine Program.
  • Protheses and orthotic devices paid in full through network providers.
  • Programs for managing including cardiovascular disease, asthma, depression, diabetes, chronic kidney disease, eating disorders and ADHD.
  • Centers of Excellence for Transplants, Infertility, and Cancer.
  • Managed Mental Health and Substance Abuse Program.
  • Prescription Drug Program.
  • The Empire Plan NurseLineSM for health information and support 24 hours a day, 365 days a year through a toll-free telephone number.