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
PA22-15
TO: Participating Agency Health Benefits Administrators
FROM: Employee Benefits Division
SUBJECT: Annual Employee Benefit Card Mass Reissue
DATE: November 2, 2022
Each year the federal Patient Protection and Affordable Care Act sets new amounts limiting total network out-of-pocket costs. This federal law requires the inclusion of annual out-of-pocket costs on employee health insurance benefit cards and impacts all NYSHIP plans.
Empire Plan Benefit Cards
EBD will issue new Empire Plan benefit cards for all enrollees and covered dependents beginning in mid-November of each year. New benefit cards will also be issued when there is a change to the annual out-of-pocket costs due to collective bargaining. Cards for the Excelsior Plan will also be reissued, and details will be shared as soon as they are available.
Enrollees can begin using the new benefit cards immediately and securely shred or destroy all other cards. Enrollees do not need to activate this card or place a call to the Department or the Empire Plan administrators prior to use.
What is Different
The new benefit cards will include annual deductible and out-of-pocket maximum information based on the enrollee’s Benefit Program. To accommodate differences in these amounts, there will be two versions of the cards (Individual and Family). Note that the in-network out-of-pocket drug maximum does not apply to Empire Plan Medicare Rx enrollees and dependents.
The Empire Plan Individual Coverage benefit cards will appear as follows:
The Empire Plan Family Coverage benefit cards will appear as follows:
If you have questions regarding the new benefit cards, please call the HBA Helpline at (518) 474-2780.