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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.

New York State of Opportunity


TO: Participating Agency Health Benefits Administrators
FROM: Employee Benefits Division
SUBJECT: 2017 Summary of Benefits and Coverage (SBC)
DATE: June 7, 2017

The Patient Protection and Affordable Care Act (PPACA) requires all insurance plans to make available a Summary of Benefits and Coverage (SBC) for employees/retirees who are enrolled in benefits or who are eligible for benefits and their eligible dependents. Current Empire Plan and Excelsior Plan enrollees were mailed a postcard in late November to announce the availability of the SBC and Uniform Glossary online at

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. Enrollees looking for a more comprehensive summary of benefits should be directed to review their 2017 At A Glance. This publication was mailed to enrollee homes in December 2016 and is also available online.

Important: Employees who are newly eligible to enroll 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 begins work 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 open enrollment, e.g. because of a qualifying event.


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