Department of Civil Service

NY05-04
PE05-02
PA05-03

TO: Health Benefits Administrators of New York State Agencies; Participating Employers and Participating Agencies
FROM: Employee Benefits Division
SUBJECT: Empire Plan Identification Card Reissue
DATE: February 18, 2005

Earlier this year we advised you that Empire Plan enrollees will receive new identification cards (NY05-02, PE05-01, PA05-01) with a new alternate identification number. The cards are expected to mail shortly. They will be mailed in three batches over three consecutive weeks. The target mail dates are as follows:

March 14 – NYS Retirees and NYS Active in Groups Without Settled Contracts
March 21 – NYS Active (Settled Contracts) and Active Participating Employers
March 28 – Participating Agencies Actives and Retirees

For all enrollees except those in NYS groups without settled contracts, the card has a new look; refer to the NYSHIP Card pdf. The Empire Plan and NYSHIP are prominently displayed on the card. The card includes the new alternate identification number and contains up to six names. This means that instead of issuing a separate card for each family member, there will be two cards issued when there is family coverage with all dependent names on each card. Additional cards can be requested if needed. A Copay Code shown on the front of the card represents the copayment amounts associated with enrollee’s benefit program. Refer to the Copay Code listing. The Copay Code will help Empire Plan providers determine the appropriate copayment due at the time of service.

The back of the card also contains important information to assist providers with filing claims. The Empire Plan toll free number is displayed in the upper left hand portion of the card. The YLS Blue Cross prefix now appears on the back of the card.

The card carrier also has a new look. The carrier holds up to four Empire Plan benefit card(s). If an enrollee has individual coverage, one card is attached to the carrier. If an enrollee has family coverage, up to two sets of cards are attached. If an enrollee has family coverage and our records indicate that a dependent(s) resides at an address different than the enrollee’s address, a separate card with the name(s) of that dependent(s) will be mailed to the other address. If an enrollee has more than 11 dependents at the same address, additional cards will be sent automatically in a separate envelope.

Since we are issuing new identification numbers for all Empire Plan enrollees, employees in NYS groups without settled contracts (bargaining units ALESU, PBA, NYSCOPBA, Council 82 and Negotiating Unit SY in the Judicial Branch) will receive new cards in the current “New York Government Employee” design. Enrollees in the groups without settled contracts will continue to receive one card for each covered person. Each envelope will contain up to 4 card carriers. Cards will be mailed to the address on record. Enrollees in groups without settled contracts have a new YLA Blue Cross prefix for out of state hospital claims which appears on the front of the card.

Card transactions that you enter through NYBEAS after February 16, 2005, will not be processed until the card reissue is completed. While weekly card production is suspended you should continue to process enrollment updates. Transactions that require a new benefit card will be “pended.” Once the reissue mailing is complete, we will provide the card vendor with a file to process card transactions that you entered during the card reissue process. After that regular weekly maintenance will resume.

Note: If an employee has an enrollment update that necessitates a new benefit card after the reissue file is created, they will receive a second card(s). If the change affects the copay code (i.e., certain changes between bargaining units or certain changes from employee to retiree status) the member will receive two different cards within a short period and you may need to tell the enrollee which card to use and which card to destroy, based on benefit effective dates. Similarly, if the enrollee receives two cards with different ID numbers, they may not know which card to use. Generally, the correct card is the last card received.

Two letters linked in the bulleted list will be mailed to enrollees in advance of the card reissue. One letter is directed to enrollees in settled groups and the other to enrollees in groups that have not settled. The letters will be mailed in three batches approximately one week apart beginning February 22, 2005 as follows:

• NYS Retirees and NYS Active in Groups Without Settled Contracts
• NYS Active (Settled Contracts) and Active Participating Employers
• Participating Agencies Actives and Retirees

Refer to the materials that enrollees in settled groups will receive with their new card. The materials instruct all enrollees to contact the Empire Plan toll free number with their ID card questions. A new prompt is being added to direct callers to a special unit established at UnitedHealthcare to handle questions about the card. However, if an enrollee tells you that the information on the card is not correct and you can correct the information by entering a transaction on NYBEAS, enter the correct the information on NYBEAS. Except for removing dependents from the record, this action will generate a new card once the card reissue process is complete. (Transactions involving the deletion of dependents will not generate a new card and new cards should not be requested to reflect a deletion of a dependent.)

If an enrollee states they did not receive a card, check the NYBEAS address and if it is not correct, update the record and order a card. If the address is correct, refer the enrollee to the Empire Plan toll free line. If the enrollee wants a duplicate card, order the duplicate card through NYBEAS and the card will be issued once the card reissue process is completed. Tell the enrollee that the new card that you are ordering may take up to four weeks to be delivered since the request will not be sent to the card vendor until the entire card reissue process is complete. Any enrollee question or concern that you are not able to respond to may be referred to the Empire Plan toll free number. Refer to the UnitedHealthcare telephone script in “Questions and Answers” format.

Depending on the amount and types of calls received on the NYSHIP toll free line about the new ID cards, we may be forwarding the information that we gather as a result of these calls so that you may resolve outstanding issues with your enrollees.

We have established a Post Office Box to direct cards that are undeliverable. As a result, you will not receive reports for the reissue as you usually do when you request cards through NYBEAS.

For the reissue mailing only, we are handling the returns and incorrect addresses in a different way:

• Cards returned by the U.S. Post Office with a forwarding address. Cards with a forwarding address will be re-mailed by EBD to the enrollee with an enclosure instructing the enrollee to see you to correct the address in the enrollment record.
• Cards returned by the U.S. Post Office without a forwarding address. Cards that are returned with no forwarding address will be sent to you in an individually sealed envelope. Please make an attempt to deliver this card to the enrollee. The envelope also will contain an enclosure instructing the enrollee to see you to correct his or her address.

When we return to normal weekly processing, card distribution and reporting will return to normal processes.

If you have any questions, please call your processor.

Enclosures: NYSHIP Card
Copay Code Listing
Letter to NYS Retirees and NYS Active in Groups Without Settled Contracts
Letter to NYS Active (Settled Contracts) and Active Participating Employers
Letter to Participating Agencies Actives and Retirees
UnitedHealthcare telephone script in “Questions and Answers” format
Materials that enrollees in settled groups will receive with their new card