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
SEHP08-03
TO: Student Employee Health Plan Health Benefits Administrators
FROM: Employee Benefits Division
SUBJECT: SEHP 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 SEHP Prescription Drug Program for 2009. Please read it carefully as a number of publications have changed. As you know, SEHP enrollees receive materials that are branded for The Empire Plan. This is the case for all of the prescription drug materials under SEHP.
2009 Preferred Drug List
We are pleased to announce that the 2009 Preferred Drug List (AL0872) is now available and will be mailed to enrollees in late December-early January as an insert to the 2009 SEHP Benefit Update. The drug list displays the most commonly prescribed generic and brand-name drugs that are on either copayment level one or two; it is not a complete list.
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 pharmacies.
Distribution of Materials
As noted above, the 2009 Preferred Drug List will be mailed to enrollee homes as an insert to the 2009 SEHP Benefit Update. 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 Preferred 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 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 the therapeutic class and alphabetical order, 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 Preferred 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.