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.
KATHY HOCHUL
Governor
REBECCA A. CORSO
Acting Commissioner
NY22-10
PE22-08
TO: Health Benefits Administrators at New York State and Participating Employer Agencies
FROM: Employee Benefits Division
SUBJECT: NYBEAS Tab – Hold Harmless
DATE: June 6, 2022
This memo is to advise you of a Hold Harmless tab in NYBEAS Update History to indicate when the New York State Health Insurance Program (NYSHIP) is paying primary on an enrollee or dependent who would typically have claims paid as Medicare primary.
When an enrollee or dependent is held harmless this means that claims are paid as NYSHIP primary instead of Medicare primary. Guidance for when someone may be held harmless is documented in Policy Memo 70r4. With the creation of this new tab, EBD will process a transaction in NYBEAS that will then be reflected on the tab and communicated to the NYSHIP vendors to instruct to pay as primary on claims during the time the member is being held harmless. The Hold Harmless transaction will also be visible on the Events tab in NYBEAS Update History. Please see attached instructions on how to read the Hold Harmless tab.
For more information on the hold harmless process, please refer to Policy Memo 70r4.