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My Plan Type: PEF | HMO

Using Coverage

Find a Provider Search our provider directories to locate a provider near you Eligibility Review the eligibility rules to see if you qualify for coverage Enrollment Learn important information about enrolling in a plan Claims and Forms Download fillable claims or administrative forms for each NYSHIP program Prescription Drug Information Access a selection of Empire Plan drug formularies Changing Plans Learn how to change plans or coverage types during Open Enrollment

What’s covered

The Empire Plan vs. HMO Compare the benefits, costs and service areas for each plan option Dental/Vision Review plan documents, benefits, forms and other resources Medicare and NYSHIP Learn how NYSHIP supplements Medicare and about enrollment deadlines Young Adult Coverage Explore health plan choices and rates for young adults

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With over one million providers at your fingertips, the Empire Plan offers a national network of participating providers, hospitals, and pharmacies to choose from.

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Life Events

When You Retire What you need to know to keep your NYSHIP coverage after you stop working Spouse, Domestic Partner and Divorce Coverage Family coverage options for your spouse or domsetic partner Dependent Children Coverage Eligibility and coverage options for children under 26 Relocation Keep your NYSHIP information up-to-date when you move

Special Circumstances

Losing Coverage Understanding your options if you lose NYSHIP coverage and eligibility Disability Retirement Accessing coverage with a disability certification Early Medicare Eligibility How NYSHIP coverage works with Medicare when you qualify early Leave Without Pay Understanding continued coverage while on leave without pay Dependent Survivor Coverage Coverage information when the primary holder has passed

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Everything you need to know about your options for health insurance coverage and the Open Enrollment period.

Coverage Options

Resource Library

Documents & Publications View a complete library of all NYSHIP documents and publications Video Library Watch helpful videos and learn more about NYSHIP Articles Read about specialized topics, news and updates about your plan

Tools and Support

Frequently Asked Questions Answers to common questions about NYSHIP and your coverage options Contact EBD Contact information for the Employee Benefits Division Digital Communication Preferences Everything you need to know about digital communications Finding Your HBA Information about the roles of a HBA and how to contact them.

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New to NYSHIP? Read our latest article to understand the basics of NYSHIP and what you need to choose.

Getting Started with NYSHIP

Home / Homepage / Publications

Empire Plan Report

Empire Plan Benefits NY1586

Publication Description

Learn what's changing in 2026, including copays, coverage and virtual care updates.

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