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.
DAVID A. PATERSON
GOVERNOR
DEPARTMENT OF CIVIL SERVICE
ALBANY, NEW YORK 12239
www.cs.ny.gov
NANCY G. GROENWEGEN
COMMISSIONER
PA10-22
PAEX10-19
TO: Participating Agency Health Benefit Administrators
FROM: Robert W. DuBois, Director of the Employee Benefits Division
SUBJECT: NYSHIP Policy Regarding Retroactive Refunds
DATE: July 5, 2010
Enclosed are a copy of a Letter to Participating Agency Chief Executive Officers and a copy of Policy Memo #140 which establishes a six-month limit on refunds that result from retroactive enrollment transactions. Please review these materials carefully and share them with others within your agency who are responsible for benefit administration and/or agency finances.
Effective September 1, 2010, except as noted in the policy memo, there will be no retroactive refunds granted beyond a six-month period. Therefore, it is critical that you carefully check your NYSHIP billing statement and compare it to the enclosed quarterly reconciliation listing to ensure that your NYBEAS records correctly reflect the status of all enrollees and dependents. If you find any discrepancies or errors, notify the Participating Agency Operations Unit (PA Unit) in writing prior to September 1. These will be reviewed in accordance with our former policy of reviewing retroactive transactions greater than six months and determining whether a refund is warranted for up to a one year period. In the future, you should review agency bills and reconciliation statements routinely upon receipt to ensure that you meet the six month time limit.