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
PA07-21
TO: Participating Agency Chief Executive Officers
FROM: Robert W. DuBois, Director of the Employee Benefits Division
SUBJECT: NYSHIP Self-Audit for Participating Agencies
DATE: September 10, 2007
It has been some time since the Employee Benefits Division has conducted an audit of NYSHIP Participating Agencies. Section 73.9 of the President’s Regulations authorizes the Employee Benefits Division to periodically conduct an inspection of records which have any bearing on the administration or operation of the health plan. In accordance with this regulation, we have opted to administer an audit via a self-reporting mechanism to all NYSHIP Participating Employers/Agencies.
Some sections of the Self-Audit contain text boxes that detail NYSHIP rules or policies. These are for your reference to highlight particular laws, regulations or policies in effect. If any of your responses require additional pages, we have attached an extra page for your use. However, feel free to attach additional pages if needed. Please note that the Self Audit is only for responses concerning your NYSHIP coverage; please do not include information regarding other health insurance plans your agency may offer.
In addition to serving as a report to the Division, we hope that the Self-Audit assists your agency in better understanding NYSHIP rules and prompts a review of your agency’s policies. As always, we encourage each agency to formally adopt health benefit policies administratively or by resolution and maintain documentation of those policies. Although your agency may have long standing administrative practices, if your policies are not documented, it may be difficult to defend any challenges to them.
Although you may have your agency’s health benefits administrator (HBA) or other staff complete the audit, please note that your signature attesting that the information is true and correct is required. Your agency HBA also will receive a copy of the document.
The enclosed Self-Audit is also available on HBA online https://www.cs.ny.gov/employee-benefits/hba (NYSHIP Self-Audit for Participating Agencies). If you choose to complete the online audit, you must print it and send to us by fax or mail; please note that completed online Audit forms may NOT be sent to us electronically. Our fax number and address appear on the last page of the Self-Audit. We strongly recommend you keep a completed copy for your permanent records.
Please complete and return the Self-Audit by October 31, 2007. If your agency does not complete the Self-Audit, the Employee Benefits Division, at our discretion, may elect to conduct an on-site audit of your agency’s records.
If you have any questions or concerns, please feel free to contact our Public Employer Liaison Unit at (518) 485-1771.