Contract College Health Insurance
- NYSHIP General Information Book for Employees enrolled in the Empire Plan
- Empire Plan Participating Providers
- NYSHIP Privacy Notice
- NYSHIP Release of Protected Health Information
- The Empire Plan Prescription Drug through Medco (PDF)
- The Empire Plan Prescription Drug through Medco Mail Service Order Form (PDF)
- The Empire
Plan Prescription Drug through Medco Reimbursement Claim Form (PDF)
- Contract College Health and Dental Forms
- Instructions for completing the PS-404 PS-404 (PDF)
- Documentation to be included with enrollment form for Contract College Health and Dental Plan
- PS-457 (PDF) NYSHIP Statement of Dependence
- Empire Claim Form
- NYSHIP COBRA Request
- ValueOptions Claim Form
- Contract College Dental Plan and Claim Forms Call GHI at (800) 947-0101 to order ID cards
- Contract College Dental Plan Participating Providers
- GHI Claim
Form