COVID-19 Information

1 Empire Plan Report October 2020 NY Active New York State Health Insurance Program (NYSHIP) for Employees of New York State, their enrolled Dependents and for COBRA Enrollees and Young Adult Option Enrollees with their Empire Plan benefits IN THIS REPORT What's New 2 What's New This Empire Plan Report summarizes the changes to your benefits and coverage under the New York State Health Insurance Program (NYSHIP). 2 COVID-19 and The Empire Plan. The Empire Plan Certificate Amendments reflecting Information the changes outlined in this Report will be posted on NYSHIP Online.

2 The Empire Plan Certificate, which describes the coverage provided by 4 Empire Plan The Empire Plan, will be updated on NYSHIP Online to reflect the new Changes Amendments. A new Empire Plan Certificate, containing all Empire Plan benefit changes, will be mailed to your home when complete. 11 NYSHIP Changes This Report includes Information about: The medical provider national network expansion (page 4). 14 Reminders Telehealth coverage (page 5). Disease Management Programs (page 9). Changes to the annual Option Transfer Period (page 13).

3 COVID-19 Information COVID-19 Testing and Diagnosis COVID-19 Mental Health Services COVID-19 diagnostic testing is available to all During COVID-19 , The Empire Plan is offering the individuals who reside or work in New York State. following mental health services: For up-to-date Information on COVID-19 , including Empire Plan enrollees and covered dependents guidance on testing and how to find a test site near who registered for Beacon Health Options you, visit the NYS Department of Health's website myStrength COVID-19 website and app content at You can have continued access at no cost through also call the NYS COVID-19 Hotline at 1-888-364-3065 December 31, 2020.

4 MyStrength has an extensive for questions regarding eligibility and testing. library of articles, videos and eLearning programs In compliance with NYS and federal mandates: that are aimed at helping you navigate new COVID-19 testing is available at no cost to you COVID-19 challenges, such as heightened levels through your medical provider or through a of stress and/or anxiety and parental challenges drive-through test site. Testing is covered under as families work and learn at home. the Medical/Surgical Program administered Recognizing that the emotional and psychological by UnitedHealthcare.

5 Well-being of essential workers is critically All diagnostic tests (including antibody tests), office important in the continuing fight against visits and urgent care or emergency department COVID-19 , the NYS Department of Financial visits related to diagnosing COVID-19 are covered Services (DFS) promulgated an emergency in full under The Empire Plan. regulation in May 2020 to address the mental health needs of this population. In accordance These mandates apply to participating providers and with these requirements, all out-of-pocket costs, non-network providers and are subject to expiration including copayments, deductibles and dependent upon the authorizing law or regulation.

6 Coinsurance, are waived for in-network mental For more Information on COVID-19 testing, or health services for New York State's frontline if you feel you were charged a copayment for essential workers. COVID-19 -related services in error, call The Empire For more Information on mental health services for Plan toll free at 1-877-7-NYSHIP (1-877-769-7447) essential workers and to confirm the waiver is still and select the prompt for the appropriate Program. in effect, see the DFS' guidance at industry_guidance/circular_letters/cl202 0_10.

7 2 NY Active Empire Plan Report - 10/20. COVID-19 -related Changes to registration process or have questions, call LiveHealth Online at 1-888-LiveHealth (1-888-548-3432). Prescription Drug Program LiveHealth Online has representatives available To help ensure that you and your covered 24 hours a day, seven days a week. You may also dependents have access to your medications call The Empire Plan toll free at 1-877-7-NYSHIP. during the pandemic, the Prescription Drug Program (1-877-769-7447) and press or say 2 for the Hospital has issued the following temporary changes:* Program.

8 See Telehealth Coverage on page 5 for Emergency Refills: A maximum of three emergency, Information on telehealth visits with your own doctor 30-day refills per prescription are available, with or therapist. select exceptions. Prior Authorization Extension: Prior Authorizations COVID-19 Telephone Scams (PAs) for most medications are extended through The Department of Civil Service is aware that third December 31, 2020. For example, if a PA is set to party companies, unaffiliated with The Empire Plan, expire on November 1, the expiration date will be are calling enrollees with fraudulent offers, such as extended to December 31.

9 Ninety-day extensions to obtain no-cost medications and to upgrade health do not apply to controlled substances, medications benefits. Do not provide your personal Information that involve a defined duration or use or a maximum to these companies; they are not authorized by duration of therapy. The Empire Plan. If you have questions about your prescription How to Protect Yourself drug benefits, call The Empire Plan toll free at It is important to know the difference between 1-877-7-NYSHIP (1-877-769-7447) and press a phone scam and a legitimate call from The or say 4 for the Prescription Drug Program.

10 Empire Plan. * Please contact the Prescription Drug Program to confirm The Plan will contact you: that these COVID-19 -related changes are still in effect. To follow up on a recent customer experience or Telemedicine Visits Through an inquiry you made about your benefits, eligibility or claim status LiveHealth Online Earlier this year, The Empire Plan began offering About your prescription order status or to remind a new telemedicine benefit to help you and your you to refill a prescription covered dependents access health care services If you are enrolled in a specific program ( , Future remotely.)