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
TIMOTHY R. HOGUES
Commissioner
PA22-10
PAEX22-09
TO: Participating Agency Health Benefits Administrators
FROM: Employee Benefits Division
SUBJECT: 2022 Summary of Benefits and Coverage (SBC)
DATE: June 23, 2022
The Patient Protection and Affordable Care Act (PPACA) requires all insurance plans to make available a Summary of Benefits and Coverage (SBC) for benefits-eligible employees, retirees and dependents. Current Empire Plan and Excelsior Pan enrollees are notified of the availability of the SBC and Uniform Glossary online at www.cs.ny.gov/employee-benefits/sbc via annual mailings such as The Empire Plan Report and Excelsior Plan Report.
Employees who do not have internet access may call 1-877-7-NYSHIP (1-877-769-7447) and select the Medical/Surgical Program to request a copy. Enrollees looking for a more comprehensive summary of benefits should be directed to review their 2022 At A Glance. This publication was mailed to enrollee homes late last year and is included in Quick Order packages and is also available online.
Important: Employees who are newly eligible to enroll in NYSHIP must receive a copy of the attached notice at the time you provide NYSHIP enrollment information and no later than the first day the employee begins work in a benefits-eligible position. In addition, the notice must be made available when a previously eligible employee is enrolling in NYSHIP or when an enrollee is seeking an option change outside of open enrollment due to a qualifying event.