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
NY21-08
TO: New York State Health Benefits Administrators
FROM: Employee Benefits Division
SUBJECT: NYSHIP Health Benefit Publications for employees of New York State in APSU represented by PBANYS, effective August 1, 2021
DATE: May 18, 2021
As a result of an interest arbitration award between the State of New York and the Agency Police Services Unit (APSU) represented by the Police Benevolent Association
of New York State (PBANYS), there will be Empire Plan benefit changes and NYSHIP premium rate changes, effective August 1, 2021. The June 2021 Empire Plan Special
Report and the NYSHIP Rate Changes flyer for APSU are now available online and will soon be mailed to enrollee homes and agencies. The enrollee mailings include the June 2021 NYSHIP Rate Changes flyer and the Special Report with new 2021 copayment cards and the April 1, 2021 Empire Plan Advanced Flexible Formulary. An August 1, 2021, Empire Plan At A Glance will also be mailed to enrollees in late July as well as a Dental/Vision brochure that summarizes August 1 benefit enhancements.
Note: The April 1, 2021 Empire Plan Advanced Flexible Formulary is only posted online and is not available to order from inventory. The January 1, 2021 Empire Plan Advanced Flexible Formulary will be included in quick order packages ordered after APSU’s August 1, 2021 effective date. Since these benefits will result in rate changes effective August 1, 2021, health insurance option changes may be made during the Special Option Transfer Period from July 1 through July 30, 2021. Please note that any enrollee considering an option change should be referred to the 2021 Choices for active enrollees (AL1716).
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 Special Option Transfer until you have received and carefully reviewed the upcoming memo.
The June 2021 Empire Plan Special Report for APSU (NY1322) includes: Copayment changes, out-of-network deductible and coinsurance amounts and information about the new 2021 Empire Plan Advanced Flexible Formulary.
The copayment cards for APSU (NY1325) include: New Empire Plan copayments for the group as a result of an interest arbitration award between PBANYS and the State, effective August 1, 2021.
The NYSHIP August 1, 2021 Rate Changes flyer (NY1324) includes: New rates for August 1, 2021 and information on the Special Option Transfer Period. Note: Due to the cap of the State’s dollar contribution for the non-prescription drug components of the HMO premium, August 1, 2021 biweekly rates for some HMOs will be slightly higher than the January 1, 2021 rates.
The August 1, 2021 Empire Plan At A Glance (NY1323) includes: Useful information that serves as a summary guide to Empire Plan benefits. This version will replace the January 1, 2021 version and the enrollee mailing will include the settled version of the Out-of-Network Reimbursement Disclosures (AL1779) and the 2021 Empire Plan Preventive Care Coverage Chart (AL1778).
The August 1, 2021 Dental/Vision brochure (NY1331) includes: Details of dental and vision benefit enhancements that were included in the interest arbitration award between PBANYS and the State. New ID cards for the dental program will also be mailed to enrollees prior to the effective date.
Distribution
The June 2021 publications will begin to mail to enrollees’ homes later this month. The mail file was pulled from NYBEAS on May 8, 2021 so any enrollee who was not on the file on that date should be provided copies. The mail files for the At A Glance and Dental/Vision brochure will be pulled from NYBEAS at the end of the Special Option Transfer Period. We will send you two copies of each publication, when they are available.
Publications Available on NYSHIP Online: www.cs.ny.gov/employee-benefits
You can also access the publications online under Using Your Benefits from the NYSHIP Online home page. Note: The Dental/Vision brochure is available under the Other Benefits tab.
Ordering Publications
You may order additional copies of the publications and copayment cards on HBA Online under Publications & Forms. Please do not order copies until you have received your shipment. If you need help accessing HBA Online, contact the ITS Service Desk at 844-891-1786, fixit@its.ny.gov or via chat at https://chat.its.ny.gov. If you are unsure of how to order publications or have questions about this distribution, please call the EBD Communications Unit at 518-457-7577.