Empire Plan supplement - 2022 Administrative Guide

Applicability of this supplement

The Empire Plan is a health insurance program developed by New York State and its employee unions especially for employees of New York State and their families. It is the most selected group health insurance option under the New York State Health Insurance Program (NYSHIP), covering more than 1 million employees, retirees and eligible dependents from more than 740 participating employers and agencies. There are member populations nationwide with larger concentrations outside New York in Arizona, California, Connecticut, Delaware, Florida, Georgia, Massachusetts, Maryland, North Carolina, New Jersey, Nevada, Pennsylvania, South Carolina, Tennessee, Texas and Virginia.

Multiple carriers/vendors are involved in plan administration:

• Medical/Surgical Program is administered by UnitedHealthcare. It includes a PPO network for its Participating Provider Program. Certain hospital services are included in this coverage.
• Hospitalization and Related Expense coverage is administered by Empire BlueCross.
• Mental Health and Substance Abuse Program is administered by Beacon Health Options, Inc.
• Prescription Drug Program is administered by CVS Caremark.