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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

ANDREW M. CUOMO
Governor
LOLA W. BRABHAM
Acting Commissioner

NY18-27

TO: NYS Agency Health Benefits Administrators
FROM: Employee Benefits Division
SUBJECT: January 2019 At A Glance
DATE: November 30, 2018

We are pleased to announce the publication of the January 2019 At A Glance. The At A Glance is a summary guide to Empire Plan benefits. Encourage employees to use this guide together with their Empire Plan Certificate, Certificate Amendments and Empire Plan Reports.

The following group-specific information is included with the At A Glance that will be mailed to enrollee homes:

CSEA, DC-37, PBA, UCS, UUP

APSU, C-82, M/C, NYSCOBPA,
PEF, PIA, UCS-COBANC

NY Retiree

2019 Empire Plan
Advanced Flexible Formulary

2019 Empire Plan  
Flexible Formulary

2019 Empire Plan
 Flexible Formulary

2019 Empire Plan Preventive Care Coverage Chart*

2019 Empire Plan Preventive Care Coverage Chart*

2019 Empire Plan Preventive Care Coverage Chart*

EP Settled

Out-of-Network Reimbursement Disclosures**

Empire Plan

Out-of-Network Reimbursement  Disclosures**

EP Settled

Out-of-Network Reimbursement Disclosures**

Nondiscrimination Notice

Nondiscrimination Notice

Nondiscrimination Notice

 

 

2019 Copayment Cards

 * A summary of current federal Patient Protection and Affordable Care Act (PPACA) coverage requirements.
** Contains information related to the Emergency Medical Services and Surprise Bills law.

Distribution
We will mail the At A Glance to enrollee homes in early December. The file for this mailing was pulled from NYBEAS on November 20, 2018, so any enrollee not on NYBEAS as of this date should be provided with a copy. We will send a supply equal to one percent of your agency enrollment to you for new employees or retirees. See below for specific ordering information.

We will send a combined shipment of the Preventive Care Coverage Chart and Out-of-Network Reimbursements Disclosures. The drug lists and 2019 copayment cards for NY Retirees (if applicable) will also be separate shipments to agencies. Note: The Nondiscrimination Notice will not be shipped to agencies, nor will it be available to order.

Publications Available on Our Website: www.cs.ny.gov/employee-benefits
Please check our website for new publications. We generally post publications when we sign off for printing. Publications are available under Using Your Benefits.

Ordering Publications
You may order additional copies of the At A Glance and the other At A Glance inserts on HBA Online under Publications & Forms. This publication is included in the Quick Order packages, which are only available to order on HBA Online. (They can be mailed directly to the enrollee’s home.) Please wait until you receive your shipment of the new publications before you place an order.

If you need help accessing HBA Online, contact the ITS Service Desk at 844-891-1786, fixit@its.ny.gov or via chat at https://chat.its.ny.gov. If you are unsure of how to order publications or have questions about this distribution, please call the EBD Communications Unit at 518-457-7577.