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Empire Plan Summary of Benefits available online The U.S. Patient Protection & Affordable Care Act requires all insurance plans to make available a Summary of Benefits and Coverage (SBC) for employees eligible for benefits and potential enrollees. The New York State Department of Civil Service Employee Benefits Division recently notified enrollees of the availability of the Empire Plan’s Summary of Benefits and Coverage, as well as the Uniform Glossary online at https://www. cs.ny.gov/sbc/index.cfm. You can also get the summary through the annual mailings, including the 2015 rate notification. Employees who do not have Internet access may call 1-877-7-NYSHIP (1-877-769-7447) and select the medical program to request a copy of the SBC for The Empire Plan. Employees who need a copy for a New York State Health Insurance Program (NYSHIP) HMO should contact the HMO. Empire Plan enrollees will receive the 2015 At A Glance publication, which provides a comprehensive summary of benefits for the year. The Summary of Benefits and Coverage is a simple, standardized multi-page comparison tool intended to help consumers better understand and compare available health insurance options. While this information may be helpful, employees should refer to other plan material, such as the Choices booklet for more comprehensive coverage and benefit information before making a decision regarding choosing a health plan. Get the Summary of Benefits and Coverage and Uniform Glossary online at https://www.cs.ny.gov/sbc/index.cfm. The Uniform Glossary and the cover of the 2015 Choices gulde. April 30 is deadline for 2014 Empire Plan claims Empire Plan enrollees have until April 30, 2015 (120 days after the end of the calendar year) to submit medical expenses that were incurred during the 2014 plan year to one of the following: United HealthCare Service Corp. P.O. Box 1600 Kingston, N.Y. 12402-1600 For the Empire Plan Basic Medical Program, the Home Care Advocacy Program (HCAP) and for non-network physical therapy or chiropractic services. Empire Blue Cross and Blue Shield NYS Service Center (Code YLS) P.O. Box 1407 – Church Street Station New York, N.Y. 10008-1407 For Empire Plan and non-network inpatient or outpatient hospital services. Value Options P.O. Box 1800 Latham, N.Y. 12110 For non-network mental health and substance abuse services. The Empire Plan Prescription Drug Program c/o CVS Caremark P.O. Box 52136 Phoenix, AZ 85072-2136 For prescriptions filled at non-participating pharmacies or at participating pharmacies without using your New York Government Employee Benefit Card. Enrollees can call the Empire Plan at 1-877-7NYSHIP (1-877-769-7447) with questions or to get claim forms. As a reminder, when using the Empire Plan’s toll-free telephone number, please pay extra attention to the choices offered by the automated system. Network providers/pharmacies will submit claims directly to the appropriate insurance carrier on your behalf when provided with all necessary information. If you have a non-network claim submission, complete the requested subscriber information on the claim form, include the original billing or receipt, if requested, and sign the claim form. 16 The Work Force February 2015


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To see the actual publication please follow the link above