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.
SEHP15-09
TO: Student Employee Health Plan Health Benefits Administrators
FROM: Employee Benefits Division
SUBJECT: 2016 Summary of Benefits and Coverage (SBC)
DATE: December 7, 2015
The Patient Protection and Affordable Care Act (PPACA) requires all insurance plans to make available a Summary of Benefits and Coverage (SBC) for employees who are enrolled in benefits or who are eligible for benefits and their eligible dependents. Current enrollees will be notified via annual mailings, including the rate notification letter for 2016, that the Summary of Benefits and Coverage and Uniform Glossary are available online, at https://www.cs.ny.gov/sbc/sehp/index.cfm.
Employees who do not have internet access may call 1-877-7-NYSHIP (1-877-769-7447) and select the Medical Program to request a copy of the SBC for the Student Employee Health Plan. The 2016 At A Glance publication, which provides a comprehensive summary of benefits for the coming year, will be sent to enrollees in December.
Important: Employees who are newly eligible for enrollment in NYSHIP must receive a copy of the attached notice at the time you provide NYSHIP enrollment information and no later than the first day the employee is in a benefits eligible position. In addition, the notice must be made available when a previously eligible employee is enrolling in NYSHIP or when an enrollee is seeking an option change outside of the option transfer period, e.g. because of a qualifying event.