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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

NY19-23

TO: New York State Agency Health Benefits Administrators
FROM: Employee Benefits Division
SUBJECT: Workers' Compensation Worklist
DATE: September 6, 2019

HBAs now have a worklist in NYBEAS titled “HBA Workers Compensation WL” Employees in your agency will appear on this worklist when the following transactions are entered on the Job Panel: LOA/WCD, LOA/WCL, LOA/WCM or LOA/WCR. 

HBA Responsibility

HBAs are required to “work” items from the worklist and enter information concerning whether the injury is eligible for a “One Year” leave, or, a contractual allowance of “Two Years” due to an on-the-job assault. Please see the attached instructions on how to process. Your action will assist EBD representatives in identifying enrollees in Workers’ Compensation status and when that status ends. This will help ensure that premiums are deferred timely, if applicable, and will reduce the need for EBD representatives to reach out to HBAs or refer enrollees back to their agency concerning their Workers’ Compensation leave. 

NYSTEP and Non-NYSTEP Agencies – Updating Leaves of Absence

When updating an enrollee’s status from one type of Leave to another, through NYSTEP, or directly through Workforce Administration, please process the new leave directly after the existing leave. Do not process a Return from Leave (RFL) in between the two types of leave.  Example:  An enrollee on Family Medical Leave, who has exhausted their 12 weeks and is then placed on a Leave of Absence, should not have a Return from Leave (RFL) processed.  This processing will generate incorrect billing for Active employee premiums.  The Staffing Services Division within Civil Service has confirmed this process with EBD.If you have questions about this memo, please contact the HBA Helpline at 518-474-2780.

See attached HBA Workers’ Compensation Leave Worklist Instructions for more information.