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.
ANDREW M. CUOMO
LOLA W. BRABHAM
TO: Participating Agency Health Benefits Administrators
FROM: Employee Benefits Division
SUBJECT: 2018 Summary of Benefits and Coverage (SBC)
DATE: November 8, 2017
The Patient Protection and Affordable Care Act (PPACA) requires all insurance plans to make available a Summary of Benefits and Coverage (SBC) for benefits-eligible employees, retirees, and dependents. Current enrollees were notified of the availability of these resources in the September 2017 Empire Plan Report and Excelsior Plan Report. Note: The SBC Reminder postcards will not be mailed this year as a result. The 2018 SBC and Uniform Glossary are available online at www.cs.ny.gov/employee-benefits/sbc.
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 2018 At A Glance This publication will be mailed to enrollee homes in December 2017 and will 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, due to a qualifying event.
Attachment:PA New Employee Welcome Letter