Department of Civil Service

NY06-30
PE06-24

TO: New York State Agency Health Benefits Administrators and Health Benefits Administrators of Participating Employers
FROM: Employee Benefits Division
SUBJECT: 2006 NYSHIP Active Benefit Statement: Communications and Transaction Information
DATE: September 27, 2006

We are pleased to send you a copy of the 2006 NYSHIP Benefit Statement that we will mail to your employees by first class mail beginning in early October. Two copies of the statement, one blank*and one with printed sample data (see explanation under "Sample Data" below) are included with this memo.

The NYSHIP Benefit Statement project is designed to reduce New York State Health Insurance Program (NYSHIP) costs by correcting enrollment records. The NYSHIP Benefit Statements are produced by taking data from the New York Benefits Eligibility and Accounting System (NYBEAS) and laser printing it to create personalized statements for each enrollee.

The 2006 NYSHIP Benefit Statement contains medical information only. Dental and Vision Benefit Statements were not included in this mailing.

The 2006 NYSHIP Benefit Statement will show an enrollee's medical benefit information as it appears on NYBEAS as of close of business August 31, 2006. Any transaction entered after August 31, 2006 will not show on these statements.

Sample Data
The sample data is fictitious. It demonstrates the placement of the data on the actual Benefit Statement forms.

Enrollees are asked to make corrections to health insurance records using the Benefit Statement Correction Form provided on page three of the statement. If corrections are needed, enrollees must correct the errors on page three, providing all information requested, sign the correction page and return it to you. They should keep the other half of the statement for their records.

Correction Deadline
We have asked enrollees to contact you to correct their NYSHIP enrollment records by November 1, 2006.

Printout of Enrollee Data for HBAs
We will send you a master printout of your enrollees' records in late September. The printout will show enrollee NYSHIP benefits. To make this printout easier for you to use, we have sorted the enrollee names alphabetically. If an employee has health insurance through NYSHIP as of August 31, 2006, he or she should receive the 2006 NYSHIP Benefit Statement. If an enrollee does not receive a statement, this master list will help you review the information with the enrollee. You must keep all of the information confidential and give the enrollee only his or her information. You may write an enrollee’s information onto a photocopy of the blank Statement included with this memo to provide a copy to the enrollee. If the enrollee is in The Empire Plan, be sure to write his/her Empire Plan ID on page 2 below “Social Security Number” as it appears on the sample statements. If you need an additional report, please fax a request on your fax form or letterhead to EBD Communications at (518) 402-4697. We will send the additional report within 7-10 days. Please be sure to include your agency code on the fax.

Benefit Statement Posters
We will send you posters informing enrollees of the mailing in late September equal to three percent of your active enrollment. Please post them immediately and leave them up through November 1, 2006.

*Note: “Empire Plan ID” is printed on page 2 under “Social Security Number” for those enrolled in The Empire Plan. “Empire Plan ID” does not appear on the blank statement provided in your sample packet. See the statement with sample data for placement of “Emprire Plan ID”.

TRANSACTION INFORMATION AND PRIORITIES

As noted above, Benefit Statements are being mailed to all active enrollees.  The statements show enrollee file information as of close of business August 31, 2006. Any transaction entered after August 31, 2006 will not be included on the statements.

Prioritize Transactions
You will most likely receive a heavy response from enrollees concerning these statements. You may process changes to name, address, telephone number, DOB, etc. on NYBEAS.  Changes that require a transaction on NYBEAS, such as changes in coverage or adding or deleting a dependent, may also be done by you if the transaction is top of stack.  Changes that require a transaction on NYBEAS that are not top of stack can be accomplished through the completion of the NYBEAS Correction Request Panels. Remember, you must have a signed correction form or health insurance transaction form from the enrollee before making any changes on their enrollment record.

The large number of NYBEAS transactions that will need to be processed requires you to prioritize your work and handle the most critical corrections first. We have developed a suggested prioritization scheme to help you. If you have questions about how to correct a file, please call your processor.

The following are priority transactions and should be processed as soon as possible:

• Dependent ADDs and DELETEs
• Changes in Coverage
• Changes in Address
• Changes in Negotiating Unit
• Incorrect enrollee status, (i.e. retirements, terminations, vests, leaves)
• Incorrect name (misspelled or changed)
• Incorrect date of birth (enrollee and dependents)
• Incorrect marital status

Social Security Numbers
Dependent Social Security numbers should be updated after priority transactions are processed. If dependent Social Security numbers are missing, we are printing “Please Provide” in the space, hoping the enrollee will provide the dependent SSN.

In order to correct the enrollee’s Social Security number, a written request and a copy of the Social Security card must be forwarded to EBD.

Duplicate Dependents
You may receive several benefit statement correction forms requesting that a dependent, listed a second time in error, be removed from the file. To process this request, simply delete the duplicate dependent under the appropriate plan.

Please note:  It is not necessary for the dependent to be listed with the same person #, under the different plan types (i.e.: a dependent can be #2 on the medical plan and #3 on the dental plan).

If you have transaction questions, please contact your EBD processor.

If you have questions about the NYSHIP Benefit Statement or this distribution, please call the Communications Unit at (518) 457-7577. Thank you for your assistance with this project.