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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.

State Seal
DAVID A. PATERSON
GOVERNOR
STATE OF NEW YORK
DEPARTMENT OF CIVIL SERVICE
ALBANY, NEW YORK 12239
www.cs.ny.gov
NANCY G. GROENWEGEN
COMMISSIONER

PA08-17

TO: Health Benefits Administrators of Participating Agencies
FROM: Employee Benefits Division
SUBJECT: 2009 Empire Plan At A Glance with Copayment Cards and 2009 Drug List
DATE: December 2, 2008

We are pleased to announce the 2009 Empire Plan At A Glance for Participating Agencies with The Empire Plan is at the printer and will soon be mailed to enrollees. The At A Glance is a useful guide to Plan benefits for new employees, conferences and health fairs. Encourage employees to use this guide together with their Empire Plan Certificate and Amendments.

The 2009 Empire Plan At A Glance publication will be mailed with a new 2009 Copayment (D) Card. As a result of NYSHIP benefit and copayment changes occurring on January 1, 2009, PA enrollees will be changing from copayment code A to D. They will receive a new identification card with this code on it in early December. The 2009 Empire Plan Flexible Formulary Drug List will also be included with the At A Glance.

Distribution

This publication will be mailed to enrollee homes in early December. We will send you, in separate shipments, a supply of the publication equal to 2 percent of your Empire Plan enrollment for new hires or for those enrollees changing their option to The Empire Plan. A dropshipment of the At A Glance enclosures will be delivered to agencies in early December. These publications will also be included in group-specific new hire and new retiree Empire Plan packages, which are only available to order on HBA Online.

Ordering Publications

You may order additional standalone copies of the 2009 Empire Plan At A Glance, Copayment (D) Cards and the 2009 Empire Plan Flexible Formulary Drug List by using the Publications Supply Order Form enclosed with your shipments. Or, instead of faxing the form, you may order on this web site. Open Publications & Forms, then open NYSHIP Publication Order Forms and choose PA (Participating Agencies) with The Empire Plan. If you need help accessing HBA Online, please call the Help Desk or your processor.

If you are unsure of how to order publications, or if you have questions about this distribution, please call the Communications Unit at 518-457-7577.