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The Joint Committee on Health Benefits will work with the State and

Empire Plan carriers on the ongoing oversight of this benefit. Additionally,

ongoing Program oversight and evaluation of the lifetime coverage limit
will enable future modification if warranted.

§9.11 Empire Plan Voluntary Nurse Line
The medical component of the Empire Plan shall include a voluntary 24-

hour/7-days a week nurse-line feature to provide both clinical and benefit
information through a toll-free phone number.

The Joint Committee on Health Benefits will work with the State and
Empire Plan carriers on the ongoing oversight of this benefit.

§9.12 Empire Plan Disease Management Program
The Empire Plan medical component shall include a voluntary disease

management program. Disease Management covers those illnesses
identified to be chronic, high cost, impact quality of life, and rely

considerably on the patient's compliance with treatment protocols. The
current Integrated Disease Management Program includes, but is not limited

to: Chronic Obstructive Pulmonary Disease, Coronary Artery Disease,
Heart Failure, Asthma, Diabetes and Chronic Kidney Disease. Nutritional

services will be covered for those programs identified when clinically
appropriate.

The Joint Committee on Health Benefits will work with the State and
Empire Plan carriers on the selection, design, implementation and ongoing

oversight of the new and existing Disease Management Programs.
§9.13 Health Maintenance Organizations

Eligible employees in the State Health Insurance Plan may elect to

participate in a federally qualified or state certified Health Maintenance
Organization which has been approved to participate in the State Health
Insurance Program by the Joint Committee on Health Benefits. If more than

one HMO services the same geographic area, the Joint Committee on Health

Benefits reserves the right to approve a contract with only such
organization(s) deemed to be a quality, cost effective option(s). The Joint

Committee on Health Benefits will work with the State through the HMO
Workgroup to identify and mutually agree upon appropriate incentives for

HMO alternatives to become more competitive in quality of care provided
and efficient in cost to payers. Employees may change their health

insurance option each year during the month of November, unless another

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