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.
GOVERNOR
DEPARTMENT OF CIVIL SERVICE
ALBANY, NEW YORK 12239
www.cs.ny.gov
COMMISSIONER
NY09-12
PE09-08
TO: New York State Health Benefits Administrators; Participating Employer Health Benefits Administrators
FROM: Employee Benefits Division
SUBJECT: January 2009 Empire Plan Reports and NYSHIP General Information Book/Empire Plan Certificate Amendments
DATE: March 30, 2009
We will soon mail the January 2009 Empire Plan Reports and NYSHIP General Information Book/Empire Plan Certificate Amendments to the following groups: CSEA, DC-37, MC, PE, PEF, Retiree, UCS and UUP.
The Empire Plan Report includes:
Empire Plan Benefits
Mental Health and Substance Abuse Program: New Insurer and Administrator, Transition Benefits, What’s New, Non-Network Inpatient Care (2009 At A Glance Correction) and Questions and Answers; Prescription Drug Program: Flexible Formulary (except CSEA and UCS), Instant Rebate for generic Prilosec (except CSEA and UCS), Half-Tablet Program and Flexible Formulary Questions and Answers (except CSEA and UCS); Basic Medical and Non-Network Mental Health Practitioner Services – Annual Deductible and Coinsurance Maximums; Reminders: Empire Plan At a Glance and Copay Cards, Pre-Retirement Seminars and Participating Provider Directories; Other Articles: IRMAA, Annual Notice of Mastectomy and Reconstructive Surgery Benefits, NYSHIP Dependent Eligibility Verification Project; CAM Program Discontinued and Waiver of Out-of-Pocket Costs
NYSHIP General Information Book Changes
Health Care Spending Account (except PE), COBRA: Continuation of Coverage (PE Only) and Medicare Reimbursement
Empire Plan Certificate Amendments
Hospital Benefits Program: Copayment and Annual Coinsurance Maximum; Medical/Surgical Benefits Program: Copayment, Plan Overview, Meaning of Key Terms, Chronic Care, Basic Medical Program, Annual Deductible, Non-Network Hospital Program Expenses, Exclusions, Coordination of Benefits, Medicare and Medicare Coverage; Mental Health and Substance Abuse Benefit Program: Copayment, Overview, Meaning of Terms Used, Coinsurance Maximum, Medicare Coverage; How, Where, When and Appeals.
Distribution of Reports
These publications will be mailed to enrollee homes in early April 2009. We will send you a supply of each publication equal to 2 percent of your affected 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.