Department of Civil Service

NY01-59

TO: SUNY Health Benefits Administrators
FROM: Employee Benefits Division
SUBJECT: GSEU Enrollment Form
DATE: December 4, 2001

Medical and Vision benefits for GSEU students enrolled in the State Employee Health Plan (SEHP) will be administered by the Department of Civil Service effective January 1, 2002. Dental benefits under SEHP are already administered by the Department of Civil Service (as of July 1, 2001).

Students currently enrolled in Dental benefits on NYBEAS will automatically be enrolled in Medical and Vision benefits on NYBEAS by January 1st. No further documentation is required from these enrollees.

For new enrollees, you must:

• Have the enrollee complete an enrollment form (PS-404G) and submit to you the completed PS-404G with the required proofs. GSEU students are required to provide the same proofs as other NYSHIP enrollees (see Chapter 1 – Enrollment and Eligibility of your HBA handbook).
• Review the form and proofs and process the enrollment in accordance with guidelines found in Chapter 1 – Enrollment and Eligibility and Chapter 12 - SUNY Student Employee Health Plan (SEHP), of your HBA handbook.
• Chapter 12 will be updated and distributed shortly.

Current enrollees will receive benefit cards to use for the medical benefit by January 1st. Enrollees should continue to use their dental benefit card. New enrollees with be issued a separate dental benefit card. There is no benefit card for the vision benefit.

A NYSHIP SEHP benefit summary and welcome letter will be mailed to enrollees in late December. You will received a small supply of the benefit summary in late December, ID cards and the appropriate Participating Provider Directory (Update or Downstate New York) will be mailed separately to enrollees in late December. Please refer to NY01-57 for information about the summary, welcome letter, directory and ID card mailings.

If you have any questions, please contact your processor directly or the Communications Unit (518) 457-7577 if it relates to enrollee informational material.