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.
PAEX15-20
TO: Health Benefits Administrators of Participating Agencies with The Excelsior Plan
FROM: Employee Benefits Division
SUBJECT: The Excelsior Plan Annual Maximum Out-of-Pocket, Deductible and Coinsurance Amounts for 2016
DATE: November 30, 2015
The Excelsior Plan has annual maximum out-of-pocket limits for covered, in-network services/supplies and combined annual deductible and coinsurance maximum amounts for non-network (Basic Medical Program) services. In 2016, the maximum out-of-pocket limits for covered, in-network services/supplies will be split between the Prescription Drug Program and the Hospital, Medical/Surgical and Mental Health and Substance Abuse Programs, combined. The combined annual deductible and coinsurance maximum amounts for non-network (Basic Medical Program) services will be shared among the Medical/Surgical, Home Care Advocacy Program (deductible only) and outpatient expenses for the Mental Health and Substance Abuse Program.
Attached is a chart showing the annual maximum out-of-pocket, deductible and coinsurance maximum amounts for 2016. Please distribute or post this chart within your office.