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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

NY12-07

TO: New York State Health Benefits Administrators
FROM: Employee Benefits Division
SUBJECT: NYSHIP Rate Changes Effective April 1, 2012 flyer, April 2012 Empire Plan Report and NYSHIP HMO Report for APSU (formerly ALESU) Enrollees Represented by PBANYS
DATE: February 27, 2012

We will soon mail the NYSHIP Rate Changes Effective April 1, 2012 flyer [NY0956], the April 2012 Empire Plan Report [NY0900] and NYSHIP HMO Report [NY0957] for Agency Police Services Unit (APSU) enrollees. These publications describe the changes affecting NYSHIP coverage effective October 1, 2011 and rates effective April 1, 2012 as a result of the collective bargaining agreement ratified on January 31, 2012. As a result of these changes, there will be a Special Option Transfer Period from March 1, 2012 - March 30, 2012.

You will receive a memo from the Division that provides complete details for Health Benefits Administrators regarding the rate change and how the Special Option Transfer Period will be administered. Please hold any questions you may have about the rate change and option transfer until you have received and carefully reviewed memo NY12-06.

The NYSHIP Rate Changes flyer includes:
New rates for April 1, 2012; the Special Option Transfer Deadline (March 30, 2012) and payroll deduction dates.

The Empire Plan Special Report includes:
Changes Effective October 1, 2011; NYSHIP Changes; Empire Plan Preventive Care Coverage chart (insert); Retroactive Health Insurance Special Adjustment Information; Federal Health Care Changes and April 1, 2012 Benefit Changes.

The NYSHIP HMO Special Report includes:
NYSHIP Changes: Biweekly Premium Contribution Rate; Updated Life Expectancy Table; Special Option Transfer Period; Opt-out Program; Young Adult Children and Young Adult Option Coverage; Reminders.

Distribution of Reports
Each publication will be mailed to enrollee homes in late February. We will send you a supply of each publication equal to one percent of your NYSHIP APSU enrollment at the same time.

Mail files for these publications were pulled from NYBEAS on February 23. Any enrollee not on the file will NOT receive the mailings. You may, however, order a Quick Order (QO) Package on HBA Online for a new hire as it will include these publications. Otherwise, you should include a copy of each publication in the package of information you give to new hires.

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.