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
PAEX09-09
TO: Health Benefits Administrators of Participating Agencies with The Excelsior Plan
FROM: Employee Benefits Division
SUBJECT: May 1, 2009 Three-Level Preferred Drug List for Excelsior Plan
DATE: June 1, 2009
We are pleased to announce that the updated 2009 Three-Level Preferred Drug List for The Excelsior Plan (EX0006) effective May 1, 2009 is now available. A copy is enclosed for your information. It replaces the January 1, 2009 version (EX0005); please recycle any old versions on your shelves. Note: The drug list may change on January 1, May 1 and September 1 of each calendar year.
Online Resources Available
The updated 2009 Three-Level Preferred Drug List is available on the Department of Civil Service web site at https://www.cs.state.ny.us. Click on Benefit Programs, then NYSHIP Online. Choose Excelsior Plan, if prompted, click on Using Your Benefits, then Publications and select 2009 Three-Level Preferred Drug List.
Distribution
This list is not being mailed to Excelsior Plan enrollees. Please feel free to provide a copy to any enrollees who request it or refer them to the Department of Civil Service web site at https://www.cs.state.ny.us.
Ordering Publications
You may order additional copies of the 2009 Three-Level Preferred Drug List by using the Publications Supply Order Form attached to this memo. Or, instead of faxing the form, you may order on HBA Online. From HBA Online, open Publications and Forms, then open NYSHIP Publication Order Forms and select PA (Participating Agencies) with The Excelsior Plan. If you need help accessing HBA Online, please call the Help Desk at (518) 457-5406.
If you have questions about this distribution, please call the Communications Unit at (518) 457-7577.