Department of Civil Service

NY08-38

TO: New York State Agency Health Benefits Administrators
FROM: Employee Benefits Division
SUBJECT: Empire Plan Prescription Drug Program Materials for 2009
DATE: December 15, 2008

This memorandum is designed to assist you with understanding what the correct materials are for The Empire Plan Prescription Drug Program for 2009. Please read it carefully as a number of publications have changed.

2009 Preferred Drug List and 2009 Flexible Formulary Drug List

We are pleased to announce that the 2009 Preferred Drug List and 2009 Flexible Formulary Drug List are now available and were mailed to enrollees in early December as an insert to the 2009 Empire Plan At A Glance publications. The drug lists display the most commonly prescribed generic and brand-name drugs that are on either copayment level one or two; they are not the complete list of covered drugs. The Flexible Formulary Drug List also includes drugs that will be excluded from coverage in 2009. The 2009 Preferred Drug List and Flexible Formulary Drug List apply to the following groups:

Please be certain to distribute the correct version to your enrollees who may request it. If the unsettled groups (see *) settle their contract during 2009, it is likely that their Drug List will change. We will notify you if and when this occurs.

Medco by Mail Order Forms

The Medco by Mail Order Form and prepaid envelope (AL0791 10/08) have recently been updated to change the mailing address to P.O. Box 6500, Cincinnati, OH 45273-8152. The new form also includes the optional $15 expedited shipping fee. Effective October 1, 2008, this fee was increased from $14 to $15.

Enrollee Claim Form

The enrollee claim form (AL0792) has NOT changed and continues to be the correct version to provide to enrollees who need to submit claims for prescriptions filled at non-participating retail pharmacies.

Distribution of Materials

As noted above, the appropriate 2009 Preferred Drug List or 2009 Flexible Formulary Drug List was mailed to enrollee homes as an insert to the 2009 Empire Plan At A Glance. We will send each agency a supply equal to 3 percent of enrollment based on your employee groups, along with a supply of the new mail order forms. Remember that the appropriate 2009 Preferred Drug List or 2009 Flexible Formulary Drug List, as well as the Medco by Mail Order Form with prepaid envelope and the Enrollee Claim Form are included in the New Hire and New Retiree Packages, which are only available to order on HBA Online.

Online Resources available

Please check our web sites for useful resources for you and your enrollees. The drug lists, in both the therapeutic class and alphabetical order versions, are available in numerous locations on the public site, www.cs.state.ny.us and HBA Online. We post many of our forms on the sites as well, along with addresses where they should be mailed. As you know, we generally post publications when we sign off for printing. This means you can see the publications before enrollees start receiving them.

Ordering Publications

You may order additional copies of the 2009 Preferred Drug List, 2009 Flexible Formulary Drug List and Medco by Mail Order Form and prepaid envelope by using the Publications Supply Order Forms enclosed with your shipments. Or, instead of faxing the form, you may order on HBA Online. From the homepage, open Publications and Forms, then open NYSHIP Publication Order Forms. If you need help accessing HBA Online, please call the Help Desk or your processor. Please wait until you receive your shipment before you place an order.

Recycling Old Materials

Please recycle your existing supply of Medco by Mail Order Forms and envelopes (with the P.O. Box 747000, Cincinnati, OH address) when you receive your dropshipment. You should recycle all copies of the 2008 Empire Plan Preferred Drug List (AL0790) at the end of the calendar year.

If you have questions about this distribution, please call the Communications Unit at 518-457-7577.