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.
GOVERNOR
DEPARTMENT OF CIVIL SERVICE
ALBANY, NEW YORK 12239
www.cs.ny.gov
COMMISSIONER
PA08-18
TO: Participating Agency Health Benefit Administrators
FROM: Employee Benefits Division
SUBJECT: Empire Plan Prescription Drug Program Materials for 2009
DATE: December 15, 2008
This memorandum is designed to assist you with understanding what the correct materials are for The Empire Plan Prescription Drug Program for 2009. Please read it carefully as a number of publications have changed.
2009 Flexible Formulary Drug List
We are pleased to announce that the 2009 Flexible Formulary Drug List (AL0871) is now available and was mailed to enrollees in early December as an insert to the 2009 Empire Plan At A Glance publications. The drug list displays the most commonly prescribed generic and brandname drugs that are on either copayment level one or two; it is not the complete list of covered drugs. The Flexible Formulary Drug List also includes drugs that will be excluded from coverage in 2009.
Medco by Mail Order Forms
The Medco by Mail Order Form and prepaid envelope (AL0791 10/08) have recently been updated to change the mailing address to P.O. Box 6500, Cincinnati, OH 45273-8152. The new form also includes the optional $15 expedited shipping fee. Effective October 1, 2008, this fee was increased from $14 to $15.
Enrollee Claim Form
The enrollee claim form (AL0792) has NOT changed and continues to be the correct version to provide to enrollees who need to submit claims for prescriptions filled at non-participating retail pharmacies.
Distribution of Materials
As noted above, the 2009 Flexible Formulary Drug List was mailed to enrollee homes as an insert to the 2009 Empire Plan At A Glance. We will send each agency a supply equal to 3 percent of enrollment, along with a supply of the new mail order forms. Remember that the 2009 Flexible Formulary Drug List, as well as the Medco by Mail Order Form with prepaid envelope and the Enrollee Claim Form are included in the New Hire/New Retiree Package, which are only available to order on HBA Online.
Online Resources available
Please check our web sites for useful resources for you and your enrollees. The drug list, in both the therapeutic class and alphabetical order versions, are available in numerous locations on the public site, www.cs.state.ny.us and HBA Online. We post many of our forms on the sites as well, along with addresses where they should be mailed. As you know, we generally post publications when we sign off for printing. This means you can see the publications before enrollees start receiving them.
Ordering Publications
You may order additional copies of the 2009 Flexible Formulary Drug List and Medco by Mail Order Form and prepaid envelope by using the Publications Supply Order Forms enclosed with your shipments. Or, instead of faxing the form, you may order on HBA Online. From the homepage, open Publications and Forms, then open NYSHIP Publication Order Forms. If you need help accessing HBA Online, please call the Help Desk or your processor. Please wait until you receive your shipment before you place an order.
Recycling Old Materials
Please recycle your existing supply of Medco by Mail Order Forms and envelopes (with the P.O. Box 747000, Cincinnati, OH address) when you receive your dropshipment. You should recycle all copies of the 2008 Empire Plan Preferred Drug List (AL0790) at the end of the calendar year.
If you have questions about this distribution, please call the Communications Unit at 518-457-7577.