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
DANIEL E. WALL
EXECUTIVE
DEPUTY COMISSIONER
NY00-05
PE00-03
PA00-03
TO: Health Benefits Administrators of New York State, Participating Agencies and Participating Employers
FROM: Employee Benefits Division
SUBJECT: Empire Plan Medical Insurer
DATE: March 22, 2000
IMPORTANT INFORMATION FOR ENROLLEES NEW TO THE EMPIRE PLAN.
UnitedHealthcare Is Medical Benefits Insurer for the Empire Plan
Effective January 1, 2000, UnitedHealthcare Insurance Company of New York is the insurer for administering Empire Plan medical benefits. This change replaces Metropolitan Life Insurance Company as the insurer. Your benefits have not changed because of the new insurer. The address and phone numbers for information on medical benefits stay the same.
Certificate page mailing to homes of Empire Plan enrollees whose coverage began November 11, 1999 - March 9, 2000.
The certification page on the back of this memo has been sent to the homes of enrollees new to the Empire Plan, during the period of November 11, 1999 through March 9, 2000.
Please copy this memo and the certificate page below for new hires that select the Empire Plan after March 9, 2000.
UnitedHealthcare CERTIFICATE OF INSURANCE
Group Policy Nos. 30500-G and 30501-G
CERTIFICATE AMENDMENT
for
The Empire Plan
- THIS CERTIFICATE AMENDMENT AFFECTS YOUR RIGHTS AS AN ELIGIBLE ENROLLEE UNDER THE EMPIRE PLAN. PLEASE READ IT CAREFULLY.
- THIS IS TO NOTIFY YOU THAT THE EMPIRE PLAN MEDICAL BENEFITS INSURANCE OBLIGATIONS OF METROPOLITAN LIFE INSURANCE COMPANY, UNDER THE GROUP POLICIES LISTED BELOW, SHALL ON AND AFTER JANUARY 1, 2000 BE TRANSFERRED TO UnitedHealthcare INSURANCE COMPANY OF NEW YORK.
- THIS CERTIFICATE AMENDMENT IS ISSUED TO YOU BY UnitedHealthcare INSURANCE COMPANY OF NEW YORK. IT IS TO BE ATTACHED TO AND WILL FORM A PART OF YOUR GENERAL INFORMATION BOOK AND EMPIRE PLAN CERTIFICATE.
Group Insurance Policy Numbers: 30500-G, 30501-G and 30502-G, all three collectively referred as the "Group Policies".Group Insurance Policy Numbers: 30500-G, 30501-G and 30502-G, all three collectively referred as the "Group Policies".
Policyholder of the Group Policies: State of New York.
Transfer of Obligations: Effective January 1, 2000, the medical insurance benefits obligations of Metropolitan Life Insurance Company under the Group Policies and all Certificates issued under the Group Policies are transferred to UnitedHealthcare Insurance Company of New York ("UnitedHealthcare"). UnitedHealthcare agrees to pay each eligible enrollee in the Empire Plan the medical insurance benefits described in the Certificates, subject to the provisions and conditions contained in the Certificates.
Name of Insurer: Effective January 1, 2000, if any reference is made in any Certificates to Metropolitan Life Insurance Company (including "Metropolitan" or "MetLife" or any other reference) the reference shall mean "UnitedHealthcare Insurance Company of New York."
Insurers' Address: The addresses of the corporate headquarters for the former and succeeding insurers are respectively:
Former Insurer:
Metropolitan Life Insurance Company
One Madison Avenue
New York, New York 10010
Insurer on and after January 1, 2000:
UnitedHealthcare Insurance Company of New York
2929 Expressway Drive North, Suite 300
Hauppauge, New York 11788