ID cards, Empire Plan supplement - 2022 UnitedHealthcare Administrative Guide

Empire Plan participants are given NYSHIP ID cards by the State of New York Department of Civil Service, the Empire Plan policyholder. Current versions of NYSHIP ID cards are displayed on the following page. Prior versions also remain in circulation. Some list the Empire Plan name and/or carriers involved in coverage; others do not. All are valid Empire Plan ID cards.

Front of card, showing member information, including: OOP limits and deductibles.
Empire Plan ID card back
Front side of the New York State Health Insurance Program (NYSHIP) - sample ID Card, showing sample member information, including: hospital, medical/surgical, mental health/substance use, and RX benefits.
Back side of the New York State Health Insurance Program (NYSHIP) - sample ID Card, showing precertification requirements and where to submit hospital and hospice claims to your local BlueCross and/or BlueShield Plan.
 Front of card, showing member information, including: OOP limits and deductibles.