The benefits for which you're entitled are determined by your bargaining unit.
For more detailed benefit questions, please go to the Benefits FAQ'S page and click on your bargaining unit.
You must provide the following document(s) as applicable:
• Yourself - proof of social security number
• Spouse - marriage certificate, proof of social security number, proof of financial obligation if married more than one year, AND proof of date of birth.
• Other dependents - proof of social security number AND proof of date of birth.
• Dependent children over age 19 also need to provide proof of full time student status.
Additional information is required to enroll a domestic partner, please ask for a special packet of information from Employee Benefits or go to the Forms page, then select the Domestic Partnership forms.
Eligible dependents include your spouse (including your same sex spouse if you have a marriage certificate from a jurisdiction in which same sex marriage is legal - ask for more details); same or opposite sex domestic partner; your unmarried children under age 19, which includes your natural children, legally adopted children and dependent step children; and your unmarried children between the ages of 19 and 25 if registered as a full-time student. Please contact Employee Benefits (777-4850) to ask about eligibility for ‘other' dependents.
Your same or opposite sex domestic partner who must be 18 years of age or older, unmarried and not related in a way that would bar marriage. You must be co-residing and financially interdependent. At the time of application, you must have been in this partnership for 6 months. You must be able to prove both residential and financial interdependence.
Please note that there are tax implications, referred to as "imputed income", when adding a domestic partner. For further information please go to the Forms page, then select the Domestic Partnership forms.
There are several different ways to find a participating provider. You can access an online listing at www.empireplanproviders.com; or through the Department of Civil Service website at http://www.cs.ny.gov.
You can call the Empire Plan toll free phone number directly at 1-877-769-7447. There is a printed book of participating providers available in the Human Resources Office. You should use caution when using this book as it is only as current as the day it was printed. Also, please note, it is very important that you ask the physicians office directly if they "participate with the New York State Employees Empire Plan".
Depending upon your affiliation with the university, where you access this information
will vary, as the carriers are different. For all state sponsored dental and vision
units (GSEU, PEF, MC, NYSCOPBA and C82), you can access this information at the Department
of Civil Service website http://www.cs.ny.gov. For those employees represented by UUP, you can access this information at www.uupinfo.org or by calling the benefit fund at 1-800-887-3863. For CSEA represented employees,
you can access this information at www.cseaebf.com or by calling 1-800-323-2732.
For all state sponsored dental and vision units (GSEU, PEF, MC, NYSCOPBA and C82),
you will received two separate cards for these programs. Dental is provided by GHI
and vision by EyeMed. For employees represented by UUP and CSEA benefit funds, you
will not receive a separate ID card.
You can enroll for insurance or change from individual to family at anytime; however, the effective date is dependent upon the reason for the change.
- With prompt notification of a qualifying event, the change could be effective as of the date of the event or shortly thereafter.
- Without prompt notification or without a qualifying event, the effective date may be as long as 10 weeks from the request date.
- If your premiums are deducted on a pre-tax basis, you may change coverage with prompt notice of a qualifying event. Without a qualifying event, you may change coverage during the annual option transfer period only.
- If post-tax, you may change or cancel coverage at anytime.
A change in family status (e.g. marriage, birth, death, divorce, or only dependent
child's attaining the maximum age for coverage).
If you are enrolled in an HMO and you no longer live or work in the HMO's service area, you must choose another HMO or the Empire Plan. Other qualifying events can include:
- Your spouse loses coverage due to termination of employment
- You first become eligible for health insurance coverage
- Your employment with the State terminates
- Your spouse has a change in employment status which results in either acquiring or losing eligibility for health insurance coverage
- You receive a divorce/legal separation and are required under court order to provide insurance for your eligible dependent children and/or legally separated spouse.
It is a routine out-of pocket expense that the enrollee/patient pays when using a participating provider.
The amount of out of pocket expenses you must pay before your insurance will begin to pay. This is only applicable when using an out of network provider under the Empire Plan.
There is a 366 day vesting period for new employees enrolling in the Optional Retirement Program (ORP). During this vesting period, your 3% contribution is held in an escrow type account and is not invested with TIAA-CREF. Once you have satisfied your 366 day vesting period, the accumulations of your 3%, plus the state's contributions, going back to the first day, are then sent to TIAA-CREF and are invested into your allocation choices. From that point forward, every 2 weeks your money plus the state's money is sent directly to TIAA-CREF to be invested.
If you separate from service prior to vesting, you are entitled for a refund of your
own contributions, plus any interest accumulated, but you would not be entitled to
any state contributions
As long as an employee is actively working in a benefits eligible position, no matter your age, NYSHIP will be your primary insurance carrier. Once you are age 65 and eligible for Medicare, we suggest that while you are still working, that you enroll in Medicare Part A only. Part A is the hospitalization portion and is a free benefit to you. Keep in mind that in this scenario, Medicare Part A would be secondary coverage for you as long as you are working and eligible for NYSHIP. Most people do not take Medicare Part B until they are no longer working (retired), as this would be secondary insurance to your NYSHIP coverage and there is a monthly premium for Part B, which is the major medical portion of Medicare.
Please keep in mind that once you are retired or no longer working and reach age 65, you MUST be enrolled in Medicare Parts A and B.
- If you are a member of one of the New York State Retirement Systems' (ERS or TRS), you will need to file an application for service retirement with the appropriate retirement system. Please keep in mind that retirement applications must be filed and received by the applicable retirement system at least 30 days prior to retirement, but not more than 90 days prior. For employees in the Optional Retirement Program, you should contact the appropriate carrier when you are ready to discuss your options.
- You must notify your department, in writing, at least 30 days prior to your retirement date.
- You will need to meet with a Human Resources representative to finalize health insurance
paperwork prior to your retirement date.