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.
ELIOT SPITZER
GOVERNOR
DEPARTMENT OF CIVIL SERVICE
ALBANY, NEW YORK 12239
www.cs.ny.gov
DANIEL E. WALL
COMMISSIONER
NY06-47
PE06-36
PA06-28
TO: New York State Health Benefits Administrators Participating Agency Health Benefits Administrators Participating Employer Health Benefits Administrators
FROM: Employee Benefits Division
SUBJECT: Empire Plan Reports, NYSHIP General Information Book and Empire Plan Certificates, HMO Reports
DATE: January 18, 2006
We will soon mail the December 2006 Empire Plan Reports, NYSHIP General Information Book/Empire Plan Certificate Amendments and HMO Reports to the following groups: CSEA, PEF, DC 37, Council 82, NYSCOPBA, PBA Supervisors, PBA Troopers, PIA, UUP, Unified Court System, M/C Legislature, Retirees, Participating Employers, Participating Agencies, (Participating Agencies with CORE benefits will receive the Empire Plan Report and Certificate Amendments. Participating Agencies with CORE Plus Enhancements will receive only the Empire Plan Report.) The reports vary by group.
The Empire Plan Report includes:
Empire Plan Benefits
Hospital Benefits Program: Copayments; Medical/Surgical Benefits Program: Copayment, Deductible and Coinsurance, HPV Immunization, LabCorp; Mental Health and Substance Abuse Program: Copayments, Depression Management Program
Additional Empire Plan Amendments for Council 82 Subject to Binding Arbitration: Hospital Benefits Program: Network/Non-network Hospitals, Hospital Extension Clinics; Benefits Management Program: Hospital Coverage; Medical/Surgical Benefits Program: Radiology, Anesthesiology, Pathology, Prostheses and Orthotic Devices, External Mastectomy Prostheses, Hearing Aids, Basic Medical Provider Discount Program, Centers of Excellence for Cancer Program, Infertility Benefits Maximum; Mental Health and Substance Abuse Program: Substance Abuse Lifetime Maximum; Prescription Drug Program: Copayments, Mandatory Generic Substitution
New York State Health Insurance Program (NYSHIP) Change for Council 82 subject to binding arbitration: Domestic Partner Eligibility
Empire Plan News and Reminders
Claims Deadlines, The Empire Plan At A Glance and Copayment Cards, Pre-retirement Seminars, Medicare, Participating Providers, Annual Notice, Web Site, Fraud
Empire Plan Certificate Amendments
Hospital Benefits Program: Non-network Benefits, Physical Therapy, Copayment for Emergency Care, Transplants Program; Medical/Surgical Benefits Program: Copayment, Coinsurance, HPV Immunization, Deductible, Hearing Aids, Cancer Program; Mental Health and Substance Abuse Program: Emergency Services, Copayments; Prescription Drug Program.
Additional Empire Plan Certificate Amendments for Council 82 Subject to Binding Arbitration: Benefits Management Program: Hospital Coverage; Hospital Benefits Program: Network/Non-network Benefits, Outpatient MRI, Chemotherapy, Infertility Benefits; Medical/Surgical Benefits Program: Hospital Extension Clinic, Infertility Benefits, Adult Immunizations, Prostheses and Orthotic Devices, Basic Medical Provider Discount Program, Anesthesiology/Radiology/Pathology, Mastectomy Prostheses; Mental Health and Substance Abuse Program: Emergency Services, Outpatient Rehabilitation Program, Substance Abuse Lifetime Maximum.
NYSHIP General Information Book Changes
Changing Options, Family Coverage, Exception for Court Order, IRS Regulations.
Additional NYSHIP General Information Book Changes for Council 82 Subject to Binding Arbitration: Domestic Partner, Identification Card
The HMO Report includes:
NYSHIP Reminders
Annual Notice, Pre-Retirement Seminars, Medicare, Fraud
NYSHIP General Information Book Changes
Changing Options, Family Coverage, Exception for Court Order, IRS Regulations.
Additional NYSHIP General Information Book Change for Council 82 Subject to Binding Arbitration: Domestic Partner
Distribution of Reports
These publications will be mailed to enrollee homes December 2006 through January 2007. We will send you a supply of each publication equal to 3 percent of your enrollment.
Publications available on our web site: 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 Reports, including Amendments, by using the Publications Supply Order Forms enclosed with your shipment. Or, instead of faxing the form, you may order on HBA Online (formerly known as ebd_online). From the Department of Civil Service homepage, www.cs.state.ny.us, select the Benefits Programs button from the left hand navigation. Then click on HBA Online. Open Publications & Forms, then open NYSHIP Publication Order Forms. If you need help accessing HBA Online, please call the Help Desk or your processor.
If you are unsure of how to order publications or have questions about this distribution, please call the Communications Unit at 518-457-7577.