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.
ELIOT SPITZER
GOVERNOR
DEPARTMENT OF CIVIL SERVICE
ALBANY, NEW YORK 12239
www.cs.ny.gov
NANCY G. GROENWEGEN
COMMISSIONER
NY07-40
PE07-29
PA07-23
TO: New York State Agency Health Benefits Administrators; Health Benefits Administrators of Participating Employers; Health Benefits Administrators of Participating Agencies
FROM: Employee Benefits Division
SUBJECT: 2008 Empire Plan Prescription Drug Program Coverage Information
DATE: November 2, 2007
Pending approval of the contract by the Office of the State Comptroller, effective January 1, 2008, UnitedHealthcare (UHC) will insure and administer The Empire Plan Prescription Drug Program. UnitedHealthcare will partner with Medco Health Solutions (Medco) for retail pharmacy network and mail pharmacy services. Only the Program insurer/administrator is changing; Empire Plan drug benefits remain the same. However, the 2007 Preferred Drug List (PDL) will expire at the end of the year and a new 2008 version will take effect. This would have occurred even if a new carrier had not been selected as the PDL is reviewed annually.
The Empire Plan Prescription Drug Program will continue to provide an extensive nationwide network of retail pharmacies and access to mail service.
The enclosed Empire Plan Prescription Drug Program Questions and Answers provides information on the transition of The Empire Plan Prescription Drug Program from Empire BlueCross BlueShield/Caremark to UHC/Medco. As indicated below, this memo provides you with additional information about when and how materials and resources will be made available to enrollees and agencies.
In November
- Effective November 1, the customer service call center (reachable via The Empire Plan toll free number, 1-877-7-NYSHIP) is available for questions regarding 2008 prescription coverage, the 2008 Empire Plan Preferred Drug List and filling prescriptions using the mail service in 2008. Enrollees may also still reach Caremark for questions regarding their current coverage and prescriptions.
- The 2008 Empire Plan Preferred Drug List was posted on the Department’s public web site (https://www.cs.ny.gov/employee-benefits/) and HBA Online on November 2. As in the past, it is available online in two versions: therapeutic class and alphabetic.
- An Option Transfer web site, available as a link from the Department web site, will go live on November 5. Enrollees who are eligible to change their options and are considering The Empire Plan will be able to view the 2008 PDL, locate participating retail pharmacies, and price medications on this site.
- Beginning November 9, UHC will mail letters to certain enrollees who are currently taking a preferred drug that will be a non-preferred drug in 2008.
In December
- A Special Empire Plan Prescription Drug Report and the 2008 Preferred Drug List (therapeutic class version) will be mailed to enrollees with the 2008 Empire Plan At A Glance. (Note to SUNY HBAs: SEHP enrollees will receive the Prescription Drug Report and the 2008 PDL only.)
- In mid-December, an introductory letter will be mailed to enrollees who are current mail order users with open refill prescriptions along with a form and a business reply envelope to aid in the transfer of refills. A Health, Allergy and Drug Questionnaire will also be included.
- A supply of the 2008 mail order forms and envelopes will be dropshipped to agencies.
A supply of the 2008 Empire Plan Preferred Drug List [AL0790] equal to 15 percent of your enrollment is enclosed with this memo. Please distribute this list to new employees or new retirees who are enrolled in The Empire Plan or any enrollees who request it. It would also be a helpful item to provide to enrollees who request Active Choices, for those who have the ability to change options. We have enclosed a Special Order Form that you may use until you receive updated publications supply order forms later this year, or you may order online on HBA Online. Please recycle the 2007 version at the end of December. The 2007 PDL will be available for order through the end of 2007.
An updated Reporting On Prescription Drugs (2008) with the new mail order form and envelope as well as a retail pharmacy chain listing are planned for next year. Reporting On Prescription Drugs (2007) can be used for health fairs and other events until mid-December and then it should be removed from your shelves and recycled. We will also remove it from our publication supply order forms at that time.
We will post additional information regarding the prescription drug carrier change on HBA Online as it becomes available. As other new materials and publications become available, you will be informed. If you have questions about this distribution, please call EBD Communications at 518-457-7577.