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.
ANDREW M. CUOMO
Governor
LOLA W. BRABHAM
Commissioner
PA21-01
TO: Health Benefits Administrators at Participating Agencies with The Empire Plan
FROM: Employee Benefits Division
SUBJECT: Name and Date of Birth Mismatch Letters
DATE: January 6, 2021
This memo is written to advise you of letters being mailed out from the New York State Health Insurance Program (NYSHIP) regarding a mismatch of a member’s name or date of birth (DOB) between information supplied by the Centers for Medicare and Medicaid Services (CMS) and information in NYBEAS for NYSHIP enrollees and dependents. If a discrepancy is found between the member’s date of birth or name, a letter is mailed to that member. An example of this letter is attached to this memo.
It is important that information in NYBEAS be kept up to date. While members with name and DOB discrepancies can typically be enrolled into the Empire Plan’s Medicare Rx Prescription Drug Program without any issues, the member may experience issues with their claims or when picking up prescriptions.
If an enrollee reaches out to you for help, let the enrollee know that if any of their information is incorrect with CMS, they should contact the Social Security Administration (SSA) to correct. SSA may be reached by calling 1-800-772-1213 or visiting their website at www.ssa.gov. However, if their information is incorrect in NYBEAS, the member is directed to provide you, their Health Benefits Administrator, with proof to update NYBEAS. Proof may include a drivers’ ID, a passport, a copy of their Medicare card or other official documents.
If you have any questions about what proofs are acceptable, please call the HBA Help Line at 518-474-2780.
Attachment:
Name Discrepancy Letter