endstream endobj 179 0 obj <>stream Out of these, the cookies that are categorized as necessary are stored on your browser as they are essential for the working of basic functionalities of the website. trailer <]/Prev 69751/XRefStm 1182>> startxref 0 %%EOF 551 0 obj <>stream Important Exam Alert Updates Due to Weather Conditions. `k :`N&bRN~W\^ Og#L lCEtT*1[GH"N;PAa?TX,=wv^`Fc_k_c?*OUb,T|PU[%jJ d_/">\-1M42!@1]$6#&PfW4 Z?j|TCI:AANg. Is the Empire plan the same as Empire BlueCross Blueshield? Gifted, innovative, and sensitive are words patients use to describe Dr. Elie Levine, one of New York's top board-certified plastic surgeons and the Director of Plastic Surgery at Plastic Surgery & Dermatology of NYC. Plastic Surgeon. This cookie is set by GDPR Cookie Consent plugin. 0000007319 00000 n Certificate, 2023 Empire Plan Advanced Flexible Formulary - Comprehensive Formulary, 2022 Empire Plan Advanced Flexible Formulary - Comprehensive Formulary, 2022 Empire Plan Advanced Flexible Formulary, Demographic Data Self-Identification Form. The Summary of Benefits and Coverage (SBC) is simple and standardized comparison document required by the Patient Protection and Affordable Care Act (PPACA). You can get reimbursed up to $400 per plan year. Services such as therapist visits, group therapy, and emergency mental healthcare are typically covered by health insurance plans. This online directory lists The Empire Plan's Participating providers. Your specific prescription benefit plan design may not cover certain products or categories, regardless of their appearance in this document. You pay less if you use providers that belong to the plans network. 12 Oct 2022. NOTE: Information about the cost of this plan (called the premium) will be provided separately. A. 1 . We use cookies on our website to give you the most relevant experience by remembering your preferences and repeat visits. Click here for a table of the counties each HMO serves in 2023, Highmark Blue Cross Blue Shield of Western New York, Highmark Blue Shield of Northeastern New York, Demographic Data Self-Identification Form. 172 0 obj <> endobj These Coverage Examples are intended to help you compare your overall coverage and are not intended as a cost estimator. NYSHIP Empire Plan retirees who have Medicare as their primary insurance will be automatically enrolled in a Medicare Part D prescription plan on Jan. 1, 2013, unless they cancel coverage. NYSHIP Claims and Administrative Forms, Copyright 2020 | CSEA Local 1000, AFSCME, AFL-CIO, See the 2023 State NYSHIP Enrollee Biweekly Premium Contributions, See NYS Department of Civil Services NYSHIP Rates and Deadlines publication, Health Insurance Transaction Form PS-404, Health Insurance Affordability and Accountability Act EBD-543. Your plan options under NYSHIP (Empire Plan, NYSHIP HMO) and the benefits included with each one In many situations, you will also be required to complete, sign and submit additional forms and proofs. 0000037637 00000 n If your other employer-sponsored coverage begins on January 1, 2022 and your first NYSHIP pay period for the new plan year begins before January 1, 2022, please Call 1-877-7-NYSHIP (1-877-769-7447) and follow the prompts to notify the appropriate program carrier/vendor as outlined below, or go touhcprovider.com/paan. 0000006249 00000 n The New York State Health Insurance Program (NYSHIP), administered by the Department of Civil Service (Civil Service), covers over 1.2 million active and retired State and participating organizations' employees and their dependents. CDPHP NYSHIP-Empire Plan . www.cs.state.ny.us. Click the plan names below to view a Summary of Benefits and Coverage for each option. If you need a paper copy of the Summary of Benefits and Coverage or the Uniform Glossary for a NYSHIP HMO, please contact the HMO. This cookie is set by GDPR Cookie Consent plugin. Only Notice of a Rate CHANGE option is the Empire Plan Grade 9 below. The Empire Plan is the primary health insurance plan for NYSHIP, serving about 1.1 million members. Easy to access benefits summary that can answer most of your general questions. Some words on the Summary of Benefits and Coverage are shown in bold and underlined. You are a paid member of the New York State Legislature. coverage and copay information for a specific medicine. When seeing a therapist in person, youre likely to be billed per session. {5__ h04E*y!j0XLi*Mb &yX$h Empire Plan Health Insurance Certificate Amendments, 2023 Empire Plan Advanced Flexible Formulary - Comprehensive Formulary - January 2023, 2022 Empire Plan Advanced Flexible Formulary - Comprehensive Formulary - October 2022, 2023 Empire Plan Advanced Flexible Formulary - January 2023, 2022 Empire Plan Advanced Flexible Formulary - October 2022, Empire Plan Providers, Pharmacies and Services. 0000005866 00000 n Since the site uses cookies to bring you targeted information regarding your health benefits, you will need to select your group and health insurance plan when prompted. Refer to your Empire Plan Medicare Rx documents for information about your out-of-pocket expenses. MVP. Highmark Blue Shield of Northeastern New York #Xi^Xow}6|jt42GDSh_L}F>W$-jB`=bhpA6\>a[\vHoCkIC_} o#|~VBEa-;>/:_nzY7Ykhm86 E.g. In order to provide you with targeted information about your benefits, you will need to select your group (negotiating unit) and health insurance plan when prompted. Prior versions also remain in circulation. Empire Plan Health Insurance Certificate - Detailed description of the benefits and plan requirements. additional cost for family coverage in the NYS Empire Plan. 0000007764 00000 n Mena Stramenga Is this what I will pay if I experience one of these events? Payment from Empire Insurance coverage will pay for your hearing aids 100%. endstream endobj 105 0 obj <>>>/Filter/Standard/Length 128/O(788Y]>fkwgGh; )/P -1340/R 4/StmF/StdCF/StrF/StdCF/U(m]} )/V 4>> endobj 106 0 obj <> endobj 107 0 obj <> endobj 108 0 obj <>stream Be sure to check the appropriate boxes for the coverage type declined. Steps to getting contracted plus plan information, Phone numbers and links for connecting with us, List of contracted, high-quality independent lab providers, Update, verify and attest to your practice's demographic data, Provider search for doctors, clinics and facilities, plus dental and behavioral health, Policies for most plan types, plus protocols, guidelines and credentialing information, Specifically for Commercial and Medicare Advantage (MA) products, Pharmacy resources, tools, and references, Updates and getting started with our range of tools and programs, Reports and programs for operational efficiency and member support, Resources and support to prepare for and deliver care by telehealth, Tools, references and guides for supporting your practice, Log in for our suite of tools to assist you in caring for your patients. Yes. 0000024663 00000 n All insurance plans are required to produce a Summary of Benefits and Coverage based on a uniform template and customized to reflect the plans unique terms. How long does 600mg edible last in your system? How and where to get the help you need with your coverage under the New York State p JxfID04!9x\0Rx(0|J OY These definitions are intended to help improve consumer understanding and do not necessarily reflect your plans definition of the same term. If you would like to change your NYSHIP option for the 2022 plan year, . With Empires EPO (Exclusive Provider Organization) plan, you have access to an extensive network of doctors and hospitals across the country. 0000001182 00000 n NYSHIP Online contains health plan information for State and Local Government active enrollees. (1), An employee will be married on June 10 and applies for a change from Individual to Family coverage on or before June 10th. The Summary of Benefits and Coverage is a simple, federally mandated table intended to aid consumer understanding. The Empire Plan will issue new 2023 benefit cards for all enrollees and covered dependents. For more information about your coverage, or to get a copy of the complete terms of coverage, visit www.cs.ny.gov or call 1-877-7-NYSHIP (1-877-769-7447). your Empire Plan coverage will end and you will be disenrolled from all Empire Plan health insurance coverage, including medical/surgical, hospital, mental health/substance abuse and prescription drugs. Empire MediBlue Select (HMO) is a Medicare Advantage and prescription drug plan. and Non-Participating Provider Claim Forms and Administrative Forms. 0000048148 00000 n Category: Health Detail Health Empire Plan General Information Book EmblemHealth enrollees through NYSHIP. Yes, if you need a paper copy of the Summary of Benefits and Coverage for The Empire Plan or the Uniform Glossary, call 1-877-7-NYSHIP (1-877-769-7447) and select the Medical/Surgical Program. United HealthCare has provided a summary of changes to their benefits plan as a result of the COVID-19 pandemic. If your dental and/or vision coverage is provided by an Employee Benefit Fund, contact the Fund for 2022 rates. These terms are defined in the Uniform Glossary, a non-customized companion document to the SBC. Need access to the UnitedHealthcare Provider Portal? Click here to view a PDF copy that can be printed if necessary. Does the Empire Plan work in other states? View exam alert here. Biweekly Costs Schedule Page in Choices Code Plan Individual Family 13 001 The Empire Plan 61.73 237.76 24 066 Blue Choice 56.50 216.79 Your SBC may provide you with some information that will explain how you are covered for certain services, such as what your copayment is. February 3, 2022 51 Questions 51. 0000000016 00000 n The following represents the 2023 biweekly premium contributions for CSEA active state employees (and Unified Court System). Q. I see that the Coverage Examples page shows a "you pay" amount. Over-the-Counter (OTC) At-home COVID-19 Test Reimbursement Form Health Benefits News NYS Benefits Empire Plan HMOs Dental Vision FAQ How does mental health diagnosis affect insurance? hTRn0>I,)Rc,CfvgvXnuun-*b {dmN|]v.8N\VX'mKgRgEZ|?blGt?eP5m(f65!E2IWQ& b\dHD} dHg=# kLWWL)! T0`UWk The New York State Health Insurance Program (NYSHIP) offers eligible employees the option of choosing either The Empire Plan or a NYSHIP HMO for health insurance coverage. The open enrollment period to request participation in these programs ends December 12, 2022. mL>pXT VW(y!q[!cq)i=nDv#h-&HVhg What is the difference between The Excelsior Plan and The Empire Plan? The Excelsior Plan is a more affordable alternative to The Empire Plan. Flex Spending Account and Productivity Enhancement Program: As a reminder, the Flex Spending Account and the Productivity Enhancement Program are two negotiated employee benefits for state employees that offers a way for participants to save money on health care and dependent care expenses. I was approved in 24 hours after I met all of my surgeons requirements. Refer to Choices for 2023 and other plan material for more detailed information. State enrollees wishing to change options or to enroll in the Opt-Out Program should submit the necessary paperwork to their agency health benefits administrator no later than the Option Transfer Period deadline of December 30, 2022. Side-by-side comparison and highlights of benefits of the plan with drug coverage 2022 Summary of Benefits and Coverage How you and the plan would share the cost for covered health care services 2022 Summary of Benefits and Coverage Rx Plans How you and the plan would share the cost for covered health care services with drug coverage 0000031169 00000 n endstream endobj 178 0 obj <>stream &szg|n`>#ifOC,L.B5%&Rde.jMOQ}yz , New York State Empire Plan Hospitalization via Blue Cross; major medical & surgical via United Health Care In-network or out-of-network coverage options Empire Plan Participating Providers Health Benefits Summaries & Bi-Weekly Insurance Rates Visit our Benefits at a Glance page ANNUAL Option Transfer (AOT) Period Empire Plan Health Insurance r Cancer Program Includes paid -in full coverage for cancerrelated . 2023 At A Glance - Easy to access benefits summary that can answer most of your general questions. Main Campus Office: S-5415 Melville Library. The presence or absence of a procedure or service on this list does not mean that benefit coverage exists for that procedure or service. The cookie is set by GDPR cookie consent to record the user consent for the cookies in the category "Functional". Decline NYSHIP Coverage Check box to decline coverage. >I,q%/0kYz[ad.-5-w6OB;n?/F:1R! Welcome to EBD - Empire BlueCross (Empire) is the trade name of Empire HealthChoice Assurance, Inc. and Empire BlueCross HMO is the trade name of Empire HealthChoice HMO, Inc. Once the 2023 NYSHIP Rate Flyers are printed, they will be mailed to individual homes by New York State. Important Exam Alert Updates Due to Weather Conditions. 0000003021 00000 n 211 0 obj <>stream hT=o0w~2` 14U$&QCsHX>~s-JMO8A8\FNOUB. 0000004634 00000 n -network expenses incurred under the Prescription Drug Program is $3,050 for Individual coverage and $6,100 for Family coverage for both the Empire and Excelsior Plans. The Mental Health Parity and Addiction Equity Act of 2008 required healthcare plans to provide mental health benefits equal to medical and surgical coverage. Choices details the benefits, services and programs available to NYSHIP enrollees for 2022 under The Empire Plan and NYSHIP HMOs, as well as the procedures for changing options. This website uses cookies to improve your experience while you navigate through the website. 0000037518 00000 n This site uses cookies. This is only a summary. )hV|VMtFvoy%|{Pr^  A representative will give you a list of Qualified Procedures covered by the Plan. You also have the option to opt-out of these cookies. health insurance options under NYSHIP. What foods is high in nitric oxide? Empire Plan Providers, Pharmacies and Services, Access health care services remotely using The Empire Plan's new, Empire Plan Health Insurance The site will remember your group for future visits. A. 1 You are enrolled in Empire Plan Medicare Rx, which is a Medicare Prescription Drug Plan. In general, depending on the program, members are responsible for either notifying Empire Plan program vendors of certain services or for using network care providers for these services. You do not need to enroll in part B until you retire from state service. 2023 Medicare Formulary - (List of covered drugs) Information on medication coverage. hb```b``ea`e`f`@ +zR&I\O7. PLEASE NOTE: This link brings you to New York States NYSHIP Online website. Service areas may change from year to year. 0000003440 00000 n ;Yg.j$~}sy;^;j*LZ46F[&ZbUloOn_jp?KNayrY^7l`Z>h\%Cqy1_eh^Ci/Z`|xtk$1C@b"0K8'hP0A[("4Q Before you receive services, call the Empire Plan at 1-877-7NYSHIP (1-877-769-7447) and choose UnitedHealthcare. Ostomy supplies from Byram HealthCare Center. endstream endobj startxref If you are a New York State Active Employee and unsure of your group, our Enrollee Group Wizard will ask you a series of questions in order to determine which group you should select. By clicking Accept, you consent to the use of ALL the cookies. 2023 Empire Plan and NYSHIP Rates for State Employees. HMO Blue (For the Empire Plan Prescription Drug Program, CVS Caremark will ask for payment information when ordering from the specialty or mail service pharmacies.) If you believe you were the victim of a scam involving at-home test kits or any scam related to your health benefits, please refer to guidance posted by the Federal Trade Commission (FTC) . ;1R K `I,%'% XBK* M9Ho,qxHySHA\jS7z oG 2023 Empire Plan Advanced Flexible Formulary - Comprehensive Formulary - January 2023, 2022 Empire Plan Advanced Flexible Formulary - Comprehensive Formulary - October 2022, 2022 Empire Plan Advanced Flexible Formulary - October 2022. Does Empire plan pay Medicare deductible? NYSHIP | NY State Empire Plan Out of Network . What is The Empire Plan? 1F \g >7^157eG _OF$ Call the Empire Plan toll-free at 1-877-7-NYSHIP (1-877-769-7447) and choose the Empire Plan NurseLine for health information and support. hbbd```b``"H 0{?dL``v;XXL `fBk2l~d So chances are your doctor is in our network. endstream endobj 176 0 obj <>stream Terms defined in the Uniform Glossary The first set reflects 2023 biweekly rates for CSEA-represented employees who are Grade 9 and below. Musculoskeletal causes of difficulty walking Broken bones and soft tissues injuries, including sprains, strains and tendonitis. 0000004520 00000 n The Empire Plan Infertility Centers of Excellence offer the best in reproductive medical technology and infertility procedures. No action is necessary for those State employees who are currently enrolled and continue to qualify for the Opt-Out Program. View exam alert here. Click the plan names below to view a Summary of Benefits and Coverage for each option. It includes hospital, medical and prescription drug benefits in one plan. Urine: THC from edibles can be detected in a , Pumpkin seeds are rich in nutrients known to support weight loss, such as fiber, protein, and unsaturated fatty acids. 104 0 obj <> endobj Although Empire Plan prescription drug services (retail, mail order and the Specialty Pharmacy Program) are not available outside of the United States (and its territories), you may file a paper claim for partial reimbursement after paying out of pocket for a valid prescription at a pharmacy. View exam alert here. NYS Department . To get started, you MUST select one of the following: Access health care services remotely using The Empire Plan's new, Click here for NYSHIP Online for RETIREES, Demographic Data Self-Identification Form. January 2023 A type of health plan that contracts with medical providers, such as hospitals and doctors, to create a network of participating providers. ul. ID cards, Empire Plan supplement - 2022 UnitedHealthcare Administrative Guide. Forms - Empire Plan Claim Forms, 0000001530 00000 n %%EOF and highlights of benefits of the plan. This notification list may be modified. A couple of reasons: One, there are shortages of mental health professionals in general, and particularly in certain parts of the country. See NYS Department of Civil Services NYSHIP Rates and Deadlines publication The annual Option Transfer Period for State employees will begin Thursday, December 1, 2022, and end Friday, December 30, 2022 . With this change, the Empire Plan benefits from a 50 percent discount for brand-name drugs as part of the Affordable Care Act. February 3, 2022 52 Return to State Service In a benefits-eligible position Visit NYSHIP online It's unlikely that you would pay the same amount listed in the "you pay" cell of the Summary of Benefits and Coverage. 0000007858 00000 n As a reminder, it is no longer necessary to reenroll in the Opt-Out Program each year. Some therapists are moving away from taking insurance, in part due to this issue. To join this plan, you must: Be entitled to Medicare Part A, Enrolled in Medicare Part B, and Live in our service area. Congenital deformities or conditions that are present at birth. Civil Service contracts with Beacon Health Options (Beacon) to administer the MHSA program for the Empire Plan. The CSEA Health Benefits Department can be reached at 518-785-4774 or 1-800-286-5242(JCHB) or by email at healthben@cseainc.org. 0000021102 00000 n 2023 Empire Plan Advanced Flexible Formulary - January 2023 2022 Empire Plan Advanced Flexible Formulary - October 2022 Empire Plan Providers, Pharmacies and Services Forms - Empire Plan Claim Forms, Non-Participating Provider Claim Forms and Administrative Forms. T\,ZRf6-3A|jbSgE$Qov*:|5$!82 q+48+p4^qcj3(~ j}R;M.Gh3[mF"l. PLAN COST Empire Individual (001) The Empire Plan Supplement will be included with the 2021 UnitedHealthcare Care Provider Administrative Guide. As a certified health coach and yoga instructor, Sandra has a wealth of knowledge and experience in the fields of health and wellness. NYSHIP Online Guidelines for Web Navigation. 0 Verify your health insurance coverage when you arrange your first visit. Important Exam Alert Updates Due to Weather Conditions. A$jLv >aL@7 b`+i[ Y0001_GRP_3926_2022_M_NYSHIP_9482_2632_811 2022 Summary of Benefits . There are four major sections Important Questions, Common Medical Events, Excluded Services & Other Covered Services and Coverage Examples. NYSHIP General Information Book - General eligibility and enrollment rules and information. WvAFk azX[!l=ng|o5,P[t|2{KdrdjZ7` Therapy can be expensive, with or without insurance. Click on the link below to access the Summary of Benefits and Coverage for the following: The Empire Plan | Espaol Important Exam Alert Updates Due to Weather Conditions. . These cookies will be stored in your browser only with your consent. A mental health diagnosis can prevent people from qualifying for life insurance or increasing their existing plan. The Empire Plan is NYSHIPs unique health insurance plan designed exclusively for New York States public employees and employers. Click here for a table of the counties each HMO serves in 2023. This cookie is set by GDPR Cookie Consent plugin. to retain NYSHIP coverage provided the employee has at least 10 years of benefits eligible service, and are within 10 years of retirement. The second set reflects 2023 biweekly rates for CSEA-represented state employees who are Grade 10 and above. 0000001372 00000 n This program offers a PPO, known as the Empire Plan, and several different HMOs, varying by geographic region around the State. 0000008482 00000 n The 2023 NYSHIP Option Transfer and Pre-Tax Contribution Program (PTCP) Election Period runs from Thursday, December 1, 2022 through Friday, December 30, 2022. 35 East 84th Street, New York, NY 10028. :2ceuzF3rAEb Empire Plan Health Insurance Certificate - Detailed description of the benefits and plan requirements. 1 Sep 2022. Bethzayda Matos, Pre-Licensed Professional, Bronx, NY, 10451, (347) 754-3657, My goal as a therapist is to provide guidance and support to individuals and families to help them strengthen their . In most areas of the country, a person can expect to pay $100-$200 per session. Hv\MzYGc{?6{3*1.~l}~`8-r&dx@Nf B$0`8&D`2p-

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