Page 17 - Work Force May 2022

Important to keep NYSHIP health insurance file up-to-date
If you’re a state employee, you may meet the qualifications and carry NYSHIP health insurance.
If you or your dependents have questions regarding a specific medical benefit/claim, or if you are trying to locate a participating provider, you should contact the health plan directly.
The Empire Plan can be reached toll free at 1-877-7-NYSHIP (1-877- 769-7447). Choose the appropriate program from the prompts. Health Maintenance Organization (HMO) enrollees should contact their HMO directly. The HMO’s telephone number will be on the back of the insurance card.
The General Information Book
for NY Active Employees includes information regarding NYSHIP eligibility rules, enrollment options,
requirements, and costs. A copy is mailed to all enrollees and can also be found on Civil Service’s NYSHIP online website at https://tinyurl. com/NYSHIP-Info.
It is recommended that you keep the General Information Book with your health insurance materials for reference.
The agency health
benefits administrator
(HBA) or the New
York State Business
Services Center performs
various tasks. For health insurance, the HBA serves as
the employee’s contact for health insurance information, determining you or a dependent’s eligibility and providing necessary paperwork for health insurance enrollment.
Please note that the enrollee is responsible for notifying the HBA/ Business Services Center of any changes that may affect your NYSHIP coverage. Civil Service sends
reminders to NYSHIP enrollees, with covered dependents,
reinforcing the enrollee’s responsibility to keep
their NYSHIP enrollment record up to date
and to provide timely
notification to their HBA/Business Services
Center when dependent(s) no longer meet eligibility
requirements.
Below are examples of health insurance updates an enrollee should provide to their HBA or the New York State Business Services Center:
• Change in your name, mailing address, home address or phone number
• Seeking to change your coverage type (individual/ family)
• Seeking to add/delete an eligible dependent.
• A covered dependent loses eligibility.
• You get divorced (a copy of the divorce decree must be submitted).
• Employment status changes and/or removal from the payroll.
• You are planning to retire.
As noted above, questions about plan benefits should be addressed directly with your plan. The CSEA Joint Committee on Health Benefits can be contacted at 1-800-286-5242.
On the Road with The Empire Plan
Planning a trip? It’s good to know that no matter where you or your family go, you have the protection of The Empire Plan.
Remember, plan ahead and take the 2021 On the Road with The Empire Plan with you. The updated version of On the Road with The Empire Plan is available through
the health benefits administrator at your agency or work location or can be accessed on NYSHIP’s website: https://tinyurl.com/EPontheroad.
This publication includes contact and benefits information for Empire Plan programs that enrollees can reference while they are traveling or when their dependents are away from home.
Empire Plan coverage is available worldwide and not just for emergencies. Most parts of The Empire Plan have two levels of benefits.
If you use an Empire Plan participating provider, medically necessary covered services and supplies can be accessed with little or no cost.
If you use a non-participating provider, medically necessary
covered services and supplies
can be accessed, but deductibles, coinsurance and benefit limits may apply.
The Empire Plan has nationwide participating provider networks.
For assistance locating a network Empire Plan provider, call the Empire Plan at 1-877-7-NYSHIP (1-877-769-7447) and select the appropriate program. The telephone prompts for Empire Plan programs are:
• Prompt 1: Medical/Surgical Program
• Prompt 2: Hospital Program
• Prompt 3: Mental Health/ Substance Abuse Program
• Prompt 4: Prescription Drug Program
• Prompt 5: Empire Plan Nurseline (Registered Nurses available 24 hours a day/7 days a week)
The Empire Plan’s Telemedicine Program, through LiveHealth Online, makes receiving health care convenient when at home
or traveling. LiveHealth Online allows Empire Plan enrollees and
covered dependents to seek medical or mental health appointments virtually with no out-of-pocket cost. Virtual visits with board-certified doctors (medical) or licensed therapists (mental health) can be held using a smartphone, tablet,
or personal computer. Contact LiveHealth Online at 1-888-548-3432, 24 hours a day, seven days a week.
If you plan to travel this summer, we encourage you to review the newest version of On the Road
with The Empire Plan. Be sure to bring this document along with
your doctor’s contact information and health insurance identification card(s) with you in case you or your family need medical care while away from home. Safe travels!
May 2022 The Work Force 17