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.
NY15-34
PE15-28
PA15-28
SEHP15-11
PAEX15-24
TO: Health Benefits Administrators
FROM: Employee Benefits Division
SUBJECT: January 2016 At A Glance
DATE: December 8, 2015
We are pleased to announce the publication of the January 2016 At A Glance. The At A Glance is a summary guide to Empire Plan benefits. Encourage employees to use this guide together with their Empire Plan Certificate, Certificate Amendments and Empire Plan Reports.
The 2016 Empire Plan Flexible Formulary Drug List is included with each of the At A Glance mailings (Excelsior Plan enrollees will receive the 2016 Excelsior Plan Drug List). The 2016 Empire Plan Preventive Care Coverage Chart, a summary of current federal Patient Protection and Affordable Care Act (PPACA) coverage requirements, is included for all groups except PIA. An insert containing information on Out-of-Network Reimbursement Disclosures related to the Emergency Medical Services and Surprise Bills law is also enclosed in the version mailed to enrollees.
Distribution
We will mail the At A Glance to enrollee homes in early December. The file for this mailing was pulled from NYBEAS on November 24, so any enrollee not on NYBEAS as of this date should be provided with a copy. We will send a supply equal to 1% of your agency enrollment to you for new employees or retirees. See below for specific ordering information.
We will send a separate shipment of the Preventive Care Coverage Chart, Empire Plan Flexible Formulary Drug List or Excelsior Formulary Drug List, and Out-of-Network Reimbursements Disclosures in one shipment to agencies.
Publications Available on Our Web Site: https://www.cs.ny.gov/employee-benefits
Please check our web site for new publications. We generally post publications when we sign off for printing. Publications are available under Using Your Benefits.
Ordering Publications
You may order additional copies of the At A Glance on HBA Online under Publications & Forms. This publication is included in the Quick Order packages, which are only available to order on HBA Online. (They can be mailed directly to the enrollee’s home.) Please wait until you receive your shipment of the new publications before you place an order.
If you need help accessing HBA Online, e-mail its.sm.esd.ags@its.ny.gov. If you are unsure of how to order publications or have questions about this distribution, please call the EBD Communications Unit at 518-457-7577.