Empire Plan Prescription Drug Program Vendor to Change

The state has awarded the contract to manage Empire Plan prescription drug benefits to Empire Blue Cross Blue Shield (BCBS) and Caremark Rx.  The three-year contract will be effective January 1, 2006.  The contract is currently held by CIGNA and Express Scripts, Inc.  This change in vendor does not affect members enrolled in an HMO.  

Empire Plan enrollees will continue to receive the same level of benefits including what prescription drugs and medicines are covered, copayment amounts, and reasonable access to in-network retail pharmacies, as well as a mail service pharmacy.  As more information becomes available, we will notify members immediately of any changes that may affect them. 

Empire BCBS currently has the contract to insure Empire Plan hospital benefits.  Caremark Rx, one of the nation’s largest pharmacy benefit managers, manages prescription drug benefits for over 70 million people.

The Empire BCBS/Caremark Rx bid was selected from four bidders after being evaluated by staff from the NYS Department of Civil Service, the Governor’s Office of Employee Relations, and the Division of the Budget. The PEF Joint Labor/Management Committee on Health Benefits   was involved in the vendor selection process by reviewing the draft Request For Proposals (RFP), evaluating the technical component of each of the bidder’s proposal, and participating in the bidder interviews.  Civil Service will be providing the Committee with an overview of the vendor selection process, including premium cost information, in the near future.

Members with questions and/or concerns should contact Lorraine Simpkins or Deborah Stayman at 1-800-342-4306, ext. 283 or e-mail health_benefit@pef.org