Department of Civil Service

PA04-12

TO: Participating Agency Health Benefits Administrators
FROM: Employee Benefits Division
SUBJECT: 2004 NYSHIP Empire Plan PA Benefit Statement: Communications and Transaction Information
DATE: September 18, 2004

We are pleased to send you a copy of the 2004 NYSHIP Empire Plan PA Benefit Statement that we will mail to your employees (active and non-active) by first class mail in late September. Also included for your use is a blank Benefit Statement and a Statement with printed sample data (see explanation below).

The NYSHIP Empire Plan Benefit Statement is designed to reduce New York State Health Insurance Program (NYSHIP) costs by correcting enrollment records. This is the third time we have produced the Benefit Statements for enrollees of Participating Agencies. Statements are produced by extracting data from the New York Benefits Eligibility and Accounting System (NYBEAS) and laser printing it to create a personalized Benefit Statement for each enrollee.

Health Insurance data was pulled from NYBEAS for transactions processed by close of business September 2, 2004.

Sample Data
The enrollee data on your sample is fictitious. It demonstrates the placement of the data on the actual Benefit Statement. The 2004 NYSHIP Empire Plan PA Benefit Statement will show an enrollee's health insurance record as it appeared on NYBEAS as of September 2, 2004.

Enrollees are asked to make corrections to their record using the Benefit Statement Correction Form that is provided on page three. If corrections are needed, enrollees must tear off page three, sign and return this portion to you.

Correction Deadline
We have asked enrollees to contact you to correct their enrollment records by October 29, 2004.

Printout of Enrollee Data for HBAs
We will send you a master printout of your enrollees' records in late September. The printout will show enrollee NYSHIP benefits. To make this printout easier for you to use, we have sorted the enrollee names alphabetically listing Active enrollees first, followed by Retired and other non-Active enrollees. If an employee has health insurance through NYSHIP as of September 2, 2004, they should receive the 2004 NYSHIP Empire Plan PA Benefit Statement. If an enrollee does not receive a statement, this master list will help you review the information with the enrollee. You must keep all of the information confidential and give the enrollee only his or her information. If you need an additional report, please fax a request on your fax form or letterhead to EBD Communications at (518) 457-2494. We will send the additional report within 7-10 days. Please be sure to include your agency code on the fax.

Benefit Statement Posters
We will send you posters informing enrollees of the project in late September equal to five percent of your active enrollment. Please post them immediately and leave them up until October 29, 2004. If you have questions about the PA Benefit Statement or this distribution, please call the Communications Unit at (518) 457-7577.

TRANSACTION INFORMATION AND PRIORITIES

Benefit Statement Mail Dates and Deadlines
As noted above, 2004 NYSHIP Benefit Statements are being mailed to all Active and non-Active employees (Retirees, Dependent Survivors, etc.) beginning in late September, 2004. The statement shows the enrollee's NYBEAS information as of September 2, 2004. Any transaction entered on NYBEAS after September 2, 2004 will not be reflected on the enrollee's statement.

Transaction Priorities
Our experience with the Benefit Statements project has shown that, although this is not the first year we are sending statements, 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.

In some cases, changes will require a correction transaction to be processed on NYBEAS. Agencies with access to NYBEAS should enter the correction request on the NYBEAS correction panels. Non-NYBEAS agencies will still need to send a letter to EBD requesting the required change to the file. This circumstance will occur if a transaction date has to be changed or needs to be inserted before a transaction already on the file.

Name Changes and Identification Cards
Due to the anticipated high volume of name changes (adding full first names to the NYBEAS files) card production continues to be suspended for name change transactions. If the change made is significant (i.e. changing from Smith to Johnson), a new benefit card should be ordered for the enrollee or dependent. Changes of just a first name (i.e. changing from R Smith to Robert Smith) do not require a new benefit identification card.

Although addition of an enrollee's full first name should not be treated as a priority change, these changes need to be processed.

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 Operations Unit at EBD: 518-457-2364

Thank you for your assistance with this project.

Report - PDF Version