KATHY HOCHUL
Governor
TIMOTHY R. HOGUES
Commissioner
PE25-17
TO: Health Benefits Administrators of Participating Employers (PEs)
FROM: Employee Benefits Division
SUBJECT: 2026 Summary of Benefits and Coverage
DATE: November 19, 2025
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. The SBCs for The Empire Plan and all NYSHIP HMOs are posted online at cs.ny.gov/employee-benefits/sbc/pe. 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 of the SBC for The Empire Plan. Employees who need a copy for a NYSHIP HMO should contact the HMO.
Empire Plan enrollees looking for a more comprehensive summary of benefits should review their 2026 At A Glance. This publication will be mailed to enrollee homes in January, orderable through HBA Online and available to view online.
Employees who are newly eligible to enroll in NYSHIP must receive a copy of the attached notice at the time you provide enrollment information to NYSHIP 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 the annual Option Transfer Period due to a qualifying event.