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Quick Facts
- Voluntary for eligible staff, retirees and dependants at headquarters as well as internationally recruited eligible staff, retirees and dependants away from headquarters who plan to seek care in the US
- Covers medically necessary care at reasonable & customary (R&C) cost
- Area of coverage is worldwide
- No co-insurance for services provided by an in-network provider
- Annual deductible and coinsurance of 20% to 30% for services received from an out-of-network provider
- Teleconsultations available through “LiveHealth Online”
- Health and wellness support available through ActiveHealth
- Emergency medical assistance management through UnitedHealthcare Global Assistance and Risk
- Premium is a percentage on salary. 66% of total premium is subsidized by Member States
Plan Summary
The Empire Blue Cross PPO provides worldwide coverage for hospitalization and surgical, medical, vision and prescription drug expenses. Under this plan, medically necessary treatment for a covered illness or injury may be obtained at a hospital or from a physician of one’s own choosing, whether an in-network or out-of-network provider. In addition, members of the Empire Blue Cross plan have access to ActiveHealth as part of participation in this plan. Coverage when travelling or living outside of the US is handled by Blue Cross Blue Shield Global Core.
Information Material - All about Your Plan
Description of Benefits - Empire Blue Cross PPO
The below resources are official outlines of the available Empire PPO. We kindly advise you to carefully review the plan details before making a decision on which plan is best suited for your needs.
Description of Benefits - Empire Blue Cross PPO
Specific Benefits available through the Empire Blue Cross PPO
The below resources are related to additional benefits available through the Empire Blue Cross PPO, such as special programmes, telehealth, international care and the Sydney Health App.
Empire Home Delivery Programme
Care outside the US through Empire Global Core
LiveHealth Online - Telehealth Guide
Sydney App
ActiveHealth
Both Aetna and Empire Blue Cross offer access to ActiveHealth that provides you with various resources intended to help you take better care of yourself, including coaching and health assessments.
ActiveHealth Overview
ActiveHealth Flyer
ActiveHealth Flyer 2
UnitedHealthcare Global Assistance & Risk
UnitedHealthcare Global Assistance & Risk is a facility available to Aetna and Empire Blue Cross subscribers when they are 100 or more miles away from home. UnitedHealthcare Global Assistance & Risk is a programme providing emergency medical assistance management — including coordinating emergency evacuation and repatriation — and other travel assistance services.
FAQs
What is the time limit to submit medical claims?
All claims must reach Empire Blue Cross within two years after the date on which the expenses were incurred.
How can I access care outside the US?
The Blue Cross Blue Shield Global Core Program gives UN participants benefits when living or traveling outside the US. More information can be found on www.bcbsglobalcore.com.
Are Assisted reproductive technologies covered under Empire Blue Cross PPO?
Assisted reproductive technologies including but not limited to In-vitro fertilization, Artificial insemination,Gamete and zygote intrafallopian tube transfer and Intracytoplasmic sperm injection are not covered under the Empire Blue Cross PPO plan.
How can I submit a claim for care rendered in the United States?
Once you have registered to the Empire member pages (www.empireblue.com/login), you can access the claim form section through this weblink: //membersecure.empireblue.com/member/claim-form. This secure webpage will guide you through the claiming process.
How can I submit a claim for care rendered outside the United States?
Once you have registered to the Empire Global Core member pages (www.bcbsglobalcore.com), you can access the claim form section through this weblink: //www.bcbsglobalcore.com/Claims/. This secure webspage will guide you through the claiming process.
Last modified: October 28, 2020
The Empire Plan members have nationwide network access, starting Jan. 1, 2021.
Starting Jan. 1, 2021, members of The Empire Plan will have in-network access to the UnitedHealthcare Options preferred provider organization (PPO) network for all states and U.S. territories outside of New York.
The Empire Plan Supplement will be included with the 2021 UnitedHealthcare Care Provider Administrative Guide. When the guide is posted, the supplement will apply to care providers in all markets outside New York, as well as national care providers and a limited number of providers in New York with The Empire Plan specifically added to their UnitedHealthcare Participation Agreement.
Identifying members of The Empire Plan
Members are New York State government employees, local government employees with Empire Plan or Excelsior Plan benefits, graduate student employees in the Student Employee Health Plan (SEHP), retirees and their dependents. Empire Plan benefit ID cards have “New York State Health Insurance Program (NYSHIP)” and “The Empire Plan” on the front of the card. Recent cards also have the UnitedHealthcare logo. Cards aren’t replaced each year and some valid cards may look different.
You’ll be able use UHCprovider.com tools to verify member eligibility and coverage, submit prior authorization requests and advance notification, submit claims and check claim status.
Different carriers manage coverage for The Empire Plan
- UnitedHealthcare administers the Medical/Surgical Program, including the PPO network.
- Empire BlueCross administers the Hospital Program.
- Beacon Health Options, Inc., administers the Mental Health and Substance Abuse Program and behavioral health services benefit.
- CVS Caremark administers the Prescription Drug Program and pharmacy benefit.
Learn more
- The 2021 Administrative Guide Empire Plan Supplement will include the services, such as advanced radiology procedures, which will require prior notification. UHCprovider.com tools already identify these services.
- Referrals won’t be required.
- Empire Plan participating care providers will be listed in the online directory at empireplanproviders.com.
- At UHCprovider.com/news, you’ll find The Empire Plan Copay Guide and formularies.
We’re here to help
There is one consolidated phone number for The Empire Plan, 877-7-NYSHIP (877-769-7447) that you can call to contact the different programs and carriers.
If you have other questions, please contact your UnitedHealthcare provider advocate or network contact. Thank you.