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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.

State Seal
ANDREW M. CUOMO
GOVERNOR
STATE OF NEW YORK
DEPARTMENT OF CIVIL SERVICE
ALBANY, NEW YORK 12239
www.cs.ny.gov

NY11-28

TO: New York State Health Benefits Administrators
FROM: Employee Benefits Division
SUBJECT: NYSHIP Rate Changes Effective October 1, 2011 flyer, August 2011 Empire Plan Special Report and NYSHIP HMO Special Report for NY Retirees
DATE: September 1, 2011

We will soon mail the NYSHIP Rate Changes Effective October 1, 2011 flyer [AL1100], the August 2011 Empire Plan Special Report [AL1098] and NYSHIP HMO Special Report [AL1101] for Retirees and Vestees of New York State Government and their enrolled dependents. These publications describe the changes affecting NYSHIP coverage and rates effective October 1, 2011 as a result of the collective bargaining agreement that was administratively extended to Retirees and Vestees of New York State Government and their enrolled dependents. As a result of these changes, there will be a Special Option Transfer Period during the month of September.

The NYSHIP Rate Changes flyer includes:
New rates for October 1, 2011; the Special Option Transfer Deadline (September 30); and a NYSHIP Option Transfer Request Form.

The Empire Plan Special Report includes:
Changes Effective October 1, 2011; NYSHIP Changes; Empire Plan Preventive Care Coverage chart (insert); Federal Health Care Changes and October 1, 2011 Benefit Changes.

The NYSHIP HMO Special Report includes:
Changes Effective October 1, 2011 and NYSHIP Changes.

Distribution of Reports
Each publication will be mailed to NY Retiree homes in late August to early September. We will send you a supply of each publication equal to 1 percent of your active NYSHIP enrollment at the same time.

Mail files for these publications were pulled from NYBEAS on August 18. Any retiree not on the file will NOT receive the correct mailings. You may, however, order a Quick Order (QO) Retiree Package on HBA Online for a new retiree as it will include these publications. Otherwise, you should include a copy of each publication in the package of information you give to employees when they retire.

Publications available on our web site: https://www.cs.ny.gov
Please check our 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
To order additional copies of these publications during the Special Option Transfer Period, please use the Special Order Form enclosed with the dropshipment of the NYSHIP Rate Changes flyer and fax it to the Communications Unit at (315) 272-2444. For orders after the Special Option Transfer Period, go to HBA Online and select Publications & Forms to order online.

If you are unsure how to order publications or have questions about the distribution, please call the Communications Unit at 518-457-7577.