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.
ANDREW M. CUOMO
GOVERNOR
DEPARTMENT OF CIVIL SERVICE
ALBANY, NEW YORK 12239
www.cs.ny.gov
JERRY BOONE
COMMISSIONER
PA13-02
SEHP13-01
PAEX13-02
TO: Health Benefits Administrators of Participating Agencies and the Student Employee Health Plan
FROM: Employee Benefits Division
SUBJECT: Enhanced Flu Vaccine Benefit
DATE: January 29, 2013
On January 12, 2013, Governor Andrew Cuomo declared a Public Health Emergency in response to this year's severe flu season. In an effort to mitigate the effects of this severe flu season, and in support of Governor Cuomo's initiative, The Empire Plan, Excelsior Plan and Student Employee Health Plan (SEHP) will cover influenza vaccines received from a licensed pharmacist or from a participating provider in The Empire Plan. This enhanced benefit is effective February 1, 2013 through May 31, 2013.
At pharmacies in the UnitedHealthcare (UHC) national vaccination program network vaccinations will be provided at no out-of pocket cost to the enrollee or covered dependents. Chain pharmacies included in UHC's national vaccination program are:
- CVS
- Rite Aid
- Safeway
- Target
- Walgreens
Basic Medical (SEHP non-network) coverage, not subject to deductible or coinsurance, is also available for vaccines received from other pharmacies and from non-participating physicians. Enrollees who choose to be vaccinated at a nonparticipating pharmacy or by a nonparticipating physician will need to submit a claim for reimbursement. These charges are subject to reasonable and customary charges but not deductible or coinsurance.
Please distribute and/or post the attached poster where your employees can view it. The attached flyer and FAQ explaining this temporary benefit can be used as handouts or distributed to these enrollees as a useful resource to answer any questions. Enrollees with questions about this benefit should call The Empire Plan at 1-877-7-NYSHIP (1-877-769-7447) and press 1 for the Medical Program.
Attachment – Empire Plan Enhanced Flu Vaccine Poster
Attachment – Enhanced Flu Vaccine Benefit Flyer | PDF Version
Attachment – Empire Plan Influenza Vaccinations: Benefit Enhancement FAQ | PDF Version