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.

GEORGE E. PATAKI
GOVERNOR
DEPARTMENT OF CIVIL SERVICE
ALBANY, NEW YORK 12239
www.cs.ny.gov
DANIEL E. WALL
COMMISSIONER
JOHN F. BARR
EXECUTIVE DEPUTY COMMISSIONER
PA05-04
TO: Participating Agency Health Benefits Administrators
FROM: Robert W. DuBois, Director of the Employee Benefits Division
SUBJECT: NYSHIP Policy Memo 127 and Verification Form
DATE: May 20, 2005
Available on this site is a copy of a letter sent to the Chief Executive Officers regarding NYSHIP Policy Memo 127 that addresses the withdrawal of Medicare-eligible retirees from NYSHIP, a copy of the policy memo and a verification form that your agency must complete and return to the Employee Benefits Division. The letter also includes information about Medicare Part D and NYSHIP.
We would appreciate your assistance in ensuring that your agency’s managers who are responsible for benefit administration are aware of this policy and, if necessary, take steps to comply with it. Also, please ensure that the verification form, as well as any requested documentation, is completed and returned to us by June 17, 2005.
If you have any questions about this policy, please contact Ms. Mary Frye, Director of Employee Insurance Programs at (518) 485-1771.
Thank you for your cooperation.
Attachments
Letter to the Chief Executive Officers