Department of Civil Service

PA01-10

TO: Participating Agency Health Benefits Administrators
FROM: Employee Benefits Division
SUBJECT: 2001 NYSHIP Empire Plan PA Benefit Statements Transaction Processing Instructions
DATE: June 19, 2001

You received with memo PA 01-06 a sample of the PA Benefit Statement being sent to your enrollees in the New York State Health Insurance Program (NYSHIP). Benefit statements will be sent to all active and non-active enrollees of your agency beginning on June 22, 2001. This memo will address your responsibility in processing those forms returned to your agency with corrections and general questions you may receive from your enrollees.

Enrollees Who Do Not Receive Statements

You received with memo PA01-06 a blank benefit statement form. Additionally, you will receive a printout of all of your agency's benefit statement records. If you have an enrollee who does not receive a benefit statement, you may use your blank statement as a duplicating master and produce a statement for them using the information on the master printout.

Remember that the information on the printout is confidential and should be kept in a secure manner. Provide each enrollee only the information that pertains to his/her own coverage.

Benefit Statement Mail Dates and Deadlines

As noted above, 2001 NYSHIP Benefit Statements are being mailed to all active and non-active employees (retirees, dependent survivors, etc.) beginning on June 22, 2001. The statement shows the enrollees NYBEAS information as of May 10, 2001. Any transaction entered on NYBEAS after May 10, 2001 will not be reflected on the enrollee's statement.

Transaction Priorities

Since this is the first time Benefit Statements are being sent to PA NYSHIP enrollees, you are likely to receive a high volume of corrections. The number of benefit statements you receive may require you to prioritize your work and handle the most critical transactions first. We have developed a suggested prioritization list to help you.

The following are priority transactions and should be processed as soon as possible:

Dependent Adds and Deletes
Changes in Coverage
Changes in Address
Incorrect Enrollee Status (i.e.; retirements, terminations, dependent survivors)
Incorrect Enrollee or Dependent Name (misspelled or changed)
Incorrect Enrollee or Dependent Date of Birth
Incorrect Marital Status (the marital status date is now required to change status)

If you are a NYBEAS agency, transactions may be processed directly into the NYBEAS enrollment system. Non-NYBEAS agencies should complete a PS-503.1 for each transaction, and send them with a completed PS-516 to: NYS Department of Civil Service, Employee Benefits Division, The State Campus, Albany, NY 12239

To process a correction, a letter to EBD may be required. This will occur if a transaction date has to be changed or needs to be inserted before a transaction already on the file.

Social Security Numbers and Phone Numbers

Dependent social security numbers and enrollee telephone numbers should be updated after priority transactions are completed. If dependent social security numbers are missing, we are printing "please provide" on the enrollee's statement to encourage the enrollee to provide this information to you.

Process Transactions in Order

In NYBEAS you can process all changes the enrollee needs at one time. However, you must process all transactions in chronological order (oldest one first) to insure all transactions will process correctly.

Questions?

Questions regarding transaction processing should be referred to the PA unit processors at EBD:

Gail Schultz (518) 485-6619
Theresa Bartlett (518) 457-5847
Darci Jo Riddle (518) 457-5766
Jessica Dougrey (518) 485-6618

Thank you for your assistance with this project!