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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 Department of Civil Service

KATHY HOCHUL
Governor

REBECCA A. CORSO
Acting Commissioner

NY21-26

TO: New York State Health Benefits Administrators
FROM: Employee Benefits Division
SUBJECT: October 2021 Empire Plan Special Report for PEF
DATE: October 29, 2021

The October 2021 Empire Plan Special Report for PEF is now available online and will soon be mailed to enrollee homes and agencies. This publication describes 2022 Empire Plan benefit changes as a result of a collective bargaining agreement between the Public Employees Federation (PEF) and the State of New York. The mailing also includes updated 2022 copayment cards.

Since these changes are effective January 1, 2022, health insurance option changes may be made during the regular Option Transfer Period, which will be announced when rates are approved. Refer to HBA memo NY 21-20 for additional information about the 2022 Option Transfer publications and watch for a future memo with processing instructions when rates are approved.

The October 2021 Empire Plan Special Report for PEF includes:
Copayment changes, 2022 formulary change and out-of-network deductible and coinsurance amounts.

The copayment cards for PEF (NY1408) include:
New Empire Plan copayments as a result of negotiated changes effective January 1, 2022.

Distribution
This Report will begin to mail to enrollees’ homes in late October to early November. The mail file was pulled from NYBEAS on October 25, 2021, so any enrollee who was not on the file on that date should be provided with a copy. We will send you two copies each of the Report and the 2022 copayment cards for PEF.

Publications Available on NYSHIP Online: www.cs.ny.gov/employee-benefits You can also access the Report online under Using Your Benefits from the NYSHIP Online home page.

Ordering Publications
You may order additional copies of the Report 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.