The Empire Plan is a unique health insurance plan designed especially for public employees in New York State. Empire Plan benefits include inpatient and outpatient hospital coverage, medical/surgical coverage, Centers of Excellence for transplants, infertility and cancer, home care services, equipment and supplies, mental health and substance abuse coverage and prescription drug coverage.
DAVID A. PATERSON
GOVERNOR
DEPARTMENT OF CIVIL SERVICE
ALBANY, NEW YORK 12239
www.cs.ny.gov
NANCY G. GROENWEGEN
COMMISSIONER
PE10-28
PA10-27
PAEX10-22
TO: Agency Health Benefits Administrators
FROM: Employee Benefits Division
SUBJECT: Changes in Procedures for Dependent Eligibility Audit (DEAS)
DATE: August 23, 2010
Effective August 28, 2010, the Department of Civil Service will no longer handle reinstatements related to the Dependent Eligibility Verification Project. The toll free telephone line established for this project will no longer be in service after 5:00PM on August 27, 2010. Enrollees who request reinstatement of dependents removed during the project after this time will be instructed to submit the required documentation directly to their agency Health Benefits Administrator (HBA).
Enrollees requesting reinstatement for dependents removed effective February 1, 2009 must submit the documentation that was required during the Dependent Eligibility Verification Project. You are required to review the documentation to determine the dependent’s eligibility as of February 1, 2009. If you have questions regarding the documents that must be submitted to establish eligibility, visit our website at http://www.cs.state.ny.us/nyshipeligibilityproject/.
Once you’ve verified the enrollee has submitted the proper documentation, you may process the appropriate transaction to re-add the dependent(s). HBAs may process a DEP/ADD; however, a CCO/PCT to re-add an eligible dependent must be done through the Correction Request Panel in NYBEAS. Upon completing the transaction or Correction Request Panel, you must place a comment in NYBEAS. In your comments, you will need to specify the date and type of documents on file for each dependent. Below are a few examples of what you will need to include:
Re-adding Spouse
"Dependent #02, Jane (spouse) re-added effective 2/1/09 upon Enrollee supplying copy of 2008 tax returns, "married filing jointly" showing both Enrollee and Spouse’s name."
"Dependent #02 Jane (spouse) re-added effective 2/1/09 upon Enrollee supplying marriage certificate and mortgage statement dated 12/1/08."
Re-adding Children Under Age 19
"Dependent #04 John (son) re-added effective 2/1/09 upon Enrollee supplying birth certificate listing enrollee as parent"
"Dependent #04 John (son) re-added effective 2/1/09 upon Enrollee supplying birth certificate listing enrollee’s approved spouse as parent."
Re-adding Children over Age 19
"Dependent #04 John (son) re-added effective 2/1/09 upon Enrollee supplying birth certificate listing enrollee as parent and proof of full time student status dated 1/1/09."
Re-adding Domestic Partner
"Domestic Partner Packet and proofs submitted to EBD to process addition of Dependent #06 Sue (domestic partner) effective 2/1/09."
Please allow ten business days from the time you enter your request on the Correction Request Panel for the dependent’s reinstatement to be fully updated by EBD and the NYSHIP carriers.
Important: After you have verified that an enrollee has submitted the proper documentation to re-add a dependent removed during the verification project, please submit copies of the required documentation to our office. Documentation must be mailed to:
New York State Department of Civil Service
Employee Benefits Division
Attn: Dependent Eligibility Verification Project
Alfred E. Smith State Office Building
Albany, NY 12239
Please note this process should not be used to reinstate coverage for dependents after February 1, 2009. Refer to memo PA 10-15, PAEX 10-11 and PE 10-13 dated June 22, 2010 for more details.
Your continued compliance with NYSHIP rules and regulations in maintaining accurate enrollment records is very important. If you have questions regarding this memo you may contact your processor at 518-474-2780.