Department of Civil Service

NY09-25

TO: New York State Health Benefits Administrators
FROM: Employee Benefits Division
SUBJECT: July 2009 Empire Plan Reports and NYSHIP General Information Book/Empire Plan Certificate Amendments for NYSCOPBA Enrollees who are Subject to Binding Arbitration
DATE: July 21, 2009

We will soon mail the July 2009 Empire Plan Reports and NYSHIP General Information Book/Empire Plan Certificate Amendments and Copay A Copayment Cards for NYSCOPBA enrollees who are subject to the April 30, 2009 binding arbitration award.

The Empire Plan Report includes:

Empire Plan Benefits
Mental Health and Substance Abuse Program: New Insurer and Administrator and What’s New, What’s the Same; Prescription Drug Program: Half-Tablet Program; Medical/Surgical Benefits Program: $30 Copayment for Non-Hospital Outpatient Surgical Locations, Herpes Zoster Vaccine for Shingles, Prosthetic Wig Benefit, Participating Diabetes Education Centers and Diabetic Shoes, Centers of Excellence for Transplants and Cancer, Kidney Resource Services Program, Annual Deductible and Coinsurance Maximums, Prospective Procedure Review and 2009 Copayment Changes; NYSHIP Changes: Leaving School Before Graduation and Workers’ Compensation, Reminder and Pre-Retirement Seminars; Other Articles: Participating Provider Directories, The Empire Plan Carriers and Programs, NYSHIP Dependent Eligibility Verification Project and Waiver of Out-of-Pocket Costs

NYSHIP General Information Book Changes
Leaving School Before Graduation, When Your Family Coverage Begins, Health Care Spending Account, Workers’ Compensation and Medicare Reimbursement

Empire Plan Certificate Amendments
Benefits Management Program: Benefits Management, Prospective Procedure Review and Benefits Management Program; Hospital Benefits Program: Copayment, Outpatient MRI, MRA, CT, PET and Nuclear Medicine tests, Skilled Nursing Facility Care and Transplant Programs; Medical/Surgical Program: Copayment, Plan Overview, Outpatient MRI, MRA, CT, PET and Nuclear Medicine Tests, Meaning of Terms Used, Adult Immunizations, Outpatient Surgical Locations, Chronic Care, Diabetes Education Centers, Basic Medical Program, Annual Deductible, Prosthetic Wigs, Diabetes Education Centers, Prospective Procedure Review, Diabetic Shoes, Cancer Program, Exclusions, Coordination of Benefits and Medicare and Medicare Coverage; Mental Health and Substance Abuse Program: Copayment, Overview, Meaning of Terms Used, Coinsurance Maximum, Medicare Coverage, How, Where and Appeals; Prescription Drug Benefits Program: Copayments

Distribution of Reports
These publications will be mailed to enrollee homes in late July 2009. We will send you a supply of each publication equal to 2 percent of your affected enrollment.

Publications available on our web site: https://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 Report, including Amendments (NY0829), 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, https://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 and select NYSCOPBA. 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.