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.
DAVID A. PATERSON
GOVERNOR
DEPARTMENT OF CIVIL SERVICE
ALBANY, NEW YORK 12239
www.cs.ny.gov
NANCY G. GROENWEGEN
COMMISSIONER
NY08-08
PE08-05
PA08-06
TO: New York State Health Benefits Administrators Participating Agency Health Benefits AdministratorsParticipating Employer Health Benefits Administrators
FROM: Employee Benefits Division
SUBJECT: January 2008 Empire Plan Reports and NYSHIP General Information Book/Empire Plan Certificate Amendments
DATE: May 30, 2008
We will soon mail the January 2008 Empire Plan Reports and NYSHIP General Information Book/Empire Plan Certificate Amendments to the following groups: Council 82 Represented, CSEA, DC-37, M/C, NYSCOPBA Represented, PA Plus, PBA-S, PBA-T, PE, PEF, PIA, Retiree, UCS and UUP. Larger Empire Plan Reports including October 1, 2007 benefit changes were prepared for Council 82 Contract Affected employees and NYSCOPBA Contract Affected employees. The reports vary by group.
The Empire Plan Report includes:
Empire Plan Benefits
Medical/Surgical Benefits Program: Deductible and Coinsurance and Medicare Part B Income Related Monthly Adjustment Amount (IRMAA); Timothy’s Law changes to the Mental Health and Substance Abuse Program: the Disease Management Program, and new carrier and insurer for the Empire Plan Prescription Drug Program.
Additional Empire Plan articles for Council 82 Contract Affected employees and NYSCOPBA Contract Affected employees
Hospital Benefits Program: Copayments, Network/Non-network Hospitals; Benefits Management Program: Hospital Coverage; Medical/Surgical Benefits Program: Copayments, 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; Prescription Drug Program: Copayments, Mandatory Generic Substitution
New York State Health Insurance Program (NYSHIP) Change for Council 82 Contract Affected and NYSCOPBA Contract Affected enrollees
Domestic Partner Eligibility
Empire Plan News and Reminders
Guaranteed Access to Network Benefits, Q&A on New Benefits, Mental Health Coverage, Planning for Retirement video, Participating Providers, Annual Notice.
Empire Plan Certificate Amendments
Timothy’s Law changes to the Mental Health portion of the Mental Health and Substance Abuse Program (replaces entire Mental Health and Substance Abuse Certificate).
Highlights of additional Empire Plan Certificate Amendments for Council 82 Contract Affected employees and NYSCOPBA Contract Affected employees
Benefits Management Program: Hospital Coverage; Hospital Benefits Program: Network/Non-network Benefits, Outpatient MRI, Chemotherapy, Infertility Benefits; Medical/Surgical Benefits Program: Copayment, Coinsurance Maximum, Infertility Benefits, Prostheses and Orthotic Devices, Basic Medical Provider Discount Program, Anesthesiology/Radiology/Pathology, Mastectomy Prostheses, Infertility Benefits, Cancer Program.
NYSHIP General Information Book Changes for Council 82 Contract-Affected employees and NYSCOPBA Contract-Affected employees
Domestic Partner, Identification Card
Copayment Cards and Reporting on Centers of Excellence for Cancer for Council 82 Contract Affected Employees and NYSCOPBA Contract Affected Employees
Distribution of Reports
These publications will be mailed to enrollee homes in June 2008. 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. From the Department of Civil Service homepage, www.cs.state.ny.us, select the Benefit 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.