Option Transfer: Questions and Answers
See below for some answers to some Frequently Asked Questions about Option Transfer. If you have a question that has not been answered here or elsewhere within the Option Transfer Guide, contact the Employee Benefits Division.
How often am I permitted to change my NYSHIP health plan option?
Once in a 12-month period, you may change to any NYSHIP option for which you are eligible for any reason.
You may change options more than once during a 12-month period only if you experience a qualifying life event. All requests to change options must be made in a timely manner, no later than 30 days after your qualifying life event, to ensure you have continued access to benefits.
You are no longer eligible to continue coverage in your current HMO because you move permanently out of your HMO's service area or your job's location changes and is no longer located in your current HMO's service area. To keep NYSHIP coverage, you must choose The Empire Plan or a different HMO that serves your new area.
You move permanently or your job's location changes and you want to change to an HMO that was not available where you previously lived or worked. You may change to the newly available HMO regardless of the option you had before you moved.
Your dependent moves permanently and is no longer in your HMO's service area. (Note: A student attending college outside your HMO's service area is not considered a change in permanent residence.)
You add a newly eligible dependent to your coverage in a timely manner. The dependent may be acquired through marriage, domestic partnership, birth, adoption or placement for adoption or if your child meets "other" child eligibility criteria.
You retire or vest your health insurance.
Note: An option change made during the June 2023 Special Option Transfer Period (due to the Empire Plan benefit changes that were administratively extended to retirees of New York State and Participating Employers effective July 1st) does not count toward the once-in-a-12-month-period limit for retirees. If you wish to change your option again after reviewing rates and benefit plan information for the 2024 plan year, you will be permitted to do so.
If I change options in the middle of this year and my benefits change or the cost of the coverage I have selected increases for next year, will I be able to change options again effective January 1 of next year?
No. Unless you experience a qualifying event (see list above), you are only permitted to change options once during any twelve-month period. For example: if you change options effective July 1 of the current year, you will not be eligible for another option change until July 1 of next year. Therefore, if a particular benefit or the cost of coverage is an important consideration for you, you may want to postpone a decision about changing options until you know what your benefits and cost will be for the upcoming calendar year.
How soon after I submit my option transfer request will coverage under my new health plan take effect?
You must submit your option transfer request at least 30 days prior to the date you would like your change in coverage to take effect. The effective date of your option transfer will always be the first day of a month.
I currently reside in New York State but have plans to relocate permanently to a different part of the country later this year. I am currently enrolled in a NYSHIP HMO Medicare Advantage Plan. What do I need to do to maintain enrollment in NYSHIP once I move?
While coverage under a particular NYSHIP HMO is only available to enrollees who live or work in that HMO's New York State service area, coverage under The Empire Plan is available nationwide. To maintain your NYSHIP coverage, you will need to change your option to The Empire Plan. Your upcoming move to a location outside of your current HMO's service area is considered a qualifying life event under NYSHIP. Before finalizing your decision, familiarize yourself with The Empire Plan and how to access the services and medications you need as an Empire Plan enrollee. You must submit your option transfer request at least 30 days prior to the date on which you plan to move out of state. The effective date of your option transfer will always be the first day of a month.
I just submitted my option transfer request. When will I receive my new benefit card(s)?
Enrollees typically receive their new benefit card(s) 3-4 weeks after an option request is submitted.