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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

PA09-32

TO: Health Benefits Administrators of Participating Agencies with The Empire Plan
FROM: Employee Benefits Division
SUBJECT: 2010 Empire Plan At A Glance with Copayment Cards and 2010 Drug List
DATE: December 7, 2009

We are pleased to announce the 2010 Empire Plan At A Glance for Participating Agencies 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 2010 Empire Plan At A Glance publication will be mailed with a new 2010 Copayment (copay code D) Card. The 2010 Empire Plan Flexible Formulary list will also be included with the At A Glance.

Distribution

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

Ordering Publications

You may order additional standalone copies of the 2010 Empire Plan At A Glance, Copayment (D) Cards and the 2010 Empire Plan Flexible Formulary Drug using the Publications Supply Order Form enclosed with your shipments. Or, instead of faxing the form, you may order on HBA Online at https://www.cs.state.ny.us/ebdonline. Open Publications & Forms, select PA, then open NYSHIP Publication Order Forms with The Empire Plan. Please wait until you receive your initial shipments before ordering more. If you need help accessing HBA Online, please call the Help Desk at 1-800- HBA-EMS1 (800-422-3671) 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.