Department of Civil Service

NY05-21
PE05-16
PA05-14

TO: New York State, Participating Employer and Participating Agency Health Benefits Administrators
FROM: Employee Benefits Division
SUBJECT: August/September 2005 NYSHIP and Empire Plan Amendments
DATE: September 9, 2005

We will mail the August and September 2005 NYSHIP General Information Book and Empire Plan Amendments in September through October. Enrollees in The Empire Plan will receive both General Information Book and Empire Plan amendments; enrollees in NYSHIP health maintenance organizations will receive only General Information Book amendments.
The amendments apply to the following groups: CSEA, PEF, DC 37, Council 82, NYSCOPBA, PBA-Supervisors, PBA-Troopers, PIA, UUP, Unified Court System, M/C and Legislature, Participating Employers, New York State and Participating Employer Retirees, and Participating Agencies with CORE Empire Plan benefits. (Participating Agencies with CORE Plus Enhancements benefits will receive their amendments at a later date.)

Amendments vary according to groups. Amendments include:

NYSHIP General Information Book Changes
Domestic Partner, Pre-Tax Contribution Program, Identification Card, Disability Retirement, COBRA Coverage

Empire Plan Certificate Amendments
Benefits Management Program: Hospital Coverage; Hospital Benefits Program: Network/Non-network Benefits, Outpatient MRI, Physical Therapy, Chemotherapy, Copayments, Centers of Excellence for Transplants Program, Infertility Benefits, Recovery of Overpayments; Medical/Surgical Benefits Program: Copayments, Coinsurance and Deductible, Hospital Extension Clinic, Infertility Benefits, Meningitis Immunization, Adult Immunizations, Prostheses and Orthotic Devices, Basic Medical Provider Discount Program, Anesthesiology/Radiology/Pathology, Ambulance Service, Hearing Aids, Mastectomy Prostheses, Centers of Excellence for Cancer Program, Recovery of Overpayments; Mental Health and Substance Abuse Program: Emergency Services, Outpatient Rehabilitation Program, Copayment, Substance Abuse Lifetime Maximum; Prescription Drug Program: Copayments, Federal Legend Drugs, On-premises Pharmacies, Coordination of Benefits.

Reporting On Centers of Excellence
This publication will be mailed to Empire Plan enrollees (except Council 82, NYSCOPBA and UCS NU SY) as a wrap around the amendments. It describes the benefits of Centers of Excellence for cancer, transplants and infertility.

Empire Plan Copayment Cards
Empire Plan copayment cards will be mailed inside the amendments for Empire Plan enrollees (except Council 82, NYSCOPBA and UCS NU SY). Enrollees can punch out the cards and carry one for easy reference.

You will receive The Empire Plan copayment cards as stand-alone cards. The blue cards (Copay Code A) are for DC 37, M/C, Legislature, Retirees, PEF, Participating Agencies, Participating Employers, PBA-Supervisors, PBA-Troopers, PIA and UUP. The green cards (Copay Code B) are for CSEA and Unified Court System (except NU SY).

Distribution of Reports
These publications will be mailed to enrollee homes September through October. We will send you a supply equal to 3 percent of your enrollment. The amendments, the Reporting On… and the copayment cards will be mailed to agencies as three separate documents. Be sure to give all three documents to new hires.

Publications available on www.cs.state.ny.us
Please check this web site for new publications. We generally post publications when we sign off for printing. That means you can see the publications before enrollees start receiving them.

Ordering Publications
You may order additional copies of the amendments, the Reporting On… and the copayment cards as stand-alones only by using the Publications Supply Order Forms enclosed with your shipment. Or, instead of faxing the form, you may order on this site. From the homepage, open Publications & Forms, then open NYSHIP Publication Order Forms. If you need help accessing PA-MARKET, please call the Help Desk or your processor.

Please wait until you receive your shipments of the new publications before you place an order. Please note the correct code for the stand-alone Reporting On Centers of Excellence is AL0571. The code for the blue card (Copay Code A) is AL0560. The code for the green card (Copay Code B) is AL0561.

If you are unsure of how to order publications or have questions about this distribution, please call the Communications Unit at 518-457-7577.