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.
ANDREW M. CUOMO
GOVERNOR
DEPARTMENT OF CIVIL SERVICE
ALBANY, NEW YORK 12239
www.cs.ny.gov
JERRY BOONE
COMMISSIONER
NY14-23
TO: New York State Health Benefits Administrators of Employees represented by District Council 37 (DC-37)
FROM: Employee Benefits Division
SUBJECT: NYSHIP Contribution Rate Changes and Special Option Transfer Period for Employees represented by DC-37
DATE: June 27, 2014
The collective bargaining agreement between New York State and DC-37 will result in New York State Health Insurance Program (NYSHIP) rate and premium contribution changes effective September 1, 2014. A Special Option Transfer Period for DC-37 employees will be held from July 31 through August 29, 2014.
For employees in titles allocated or equated to SG-9 and below, the State’s contribution is 88% of the cost of enrollee coverage and 73% of the cost of dependent coverage. For employees in titles allocated or equated to SG-10 and above, the State’s contribution is 84% of the cost of enrollee coverage and 69% of the cost of dependent coverage. The State’s contribution to the cost of HMO coverage continues to be capped based on the dollar amount of its contribution to the cost of Empire Plan coverage.
In addition to the change in an employee’s premium contribution due to the impact of benefit changes and the new premium contribution rate, there is an adjustment to the biweekly health insurance contribution as a result of the collective bargaining agreement. The adjustment will be included in affected employees’ health insurance deductions for 35 pay periods from August 2014 through December 2015, beginning with the paycheck dated August 27, 2014 for Administration Lag. The adjustment amount will depend on the plan the enrollee is in, the coverage type (Individual or Family) and the salary grade level.
The attached rate charts reflect NYSHIP rates for the affected employees for the remainder of 2014 and are categorized as follows:
- Employees represented by DC-37 in titles allocated or equated to SG-9 and below
- Active Employee Share for Individual and Family Coverage
- Full Share (Net Leave Without Pay) for Individual and Family Coverage
- Employees represented by DC-37 in titles allocated or equated to SG-10 an above
- Active Employee Share for Individual and Family Coverage
- Full Share (Net Leave Without Pay) for Individual and Family Coverage
Special Option Transfer Period (July 31 – August 29)
As a result of these changes, there will be a Special Option Transfer Period from July 31, 2014 through August 29, 2014 for employees represented by DC-37. Enrollees that participate in the Pre-Tax Contribution Program (PTCP) will be able to make changes in their pre-tax contributions since the Special Option Transfer Period is considered to be a PTCP qualifying event (significant change in cost and/or coverage). Therefore, the enrollee may change option, change coverage from family to individual or from individual to family, or cancel coverage. Previously eligible employees who wish to enroll must satisfy a late enrollment period. If they enroll during the Special Option Transfer Period, they are also eligible to enroll in the PTCP.
To assist affected employees in making a decision about changing options, please refer to NYSHIP Rate Changes Effective September 1, 2014 for employees represented by DC-37, which shows the enrollee contribution rates in effect September 1, 2014. This chart is available on HBA Online under Health Plan Choices > Rates and Option Transfer Information > Special Option Transfer Period for DC-37.
Please contact the HBA Help Line if you have any questions about whether an enrollee’s requested option change is permissible, or if an enrollee has requested to make a change to Individual coverage or to cancel coverage, due to an increase in premium.
Enrollees who are considering changing their health insurance plans should be encouraged to carefully review the 2014 NYSHIP Choices booklet, the July 2014 Empire Plan Special Report and HMO Special Report that describe benefit changes, and the NYSHIP Rate Changes Effective September 1, 2014 flyer. The latter three publications will be mailed to enrollee homes in June. Enrollees may request 2014 Choices booklets from you to assist in the decision- making process.
Please provide the Health Insurance Transaction Form PS-404 to those enrollees requesting an option change. Forms must be completed and returned to you by August 29, 2014. Online option changes using MyNYSHIP will NOT be available to enrollees during the Special Option Transfer Period.
No action is required for enrollees who wish to keep their current health insurance option.
Updated Life Expectancy Table
Effective September 1, 2014, the Actuarial Table of Life Expectancy for employees represented by DC-37 has been updated to reflect the fact that Americans are living longer. The Actuarial Table of Life Expectancy is used to calculate the value of unused sick leave credits that can be applied to health insurance premiums in retirement. The new table will impact the sick leave calculation used to offset NYSHIP health insurance premiums for DC-37 enrollees with a retirement date after August 31, 2014.
Opt-out Program for 2015
The Opt-out Program will be available to employees represented by DC-37 during the Annual Option Transfer Period. Please refer to the Annual Option Transfer Memo, usually released in December, for additional information.
NYBEAS Processing and Important Dates for Benefit Plan Changes
To process a Benefit Plan Change during this Special Option Transfer period, the PLN/CHG transaction should be used. The effective dates for Benefit Plan changes during this Special Option Transfer period are as follows:
- August 27, 2014 for Administration Lag payroll employees
The PLN/CHG transaction will be available on NYBEAS between July 31 and September 5. Please see the charts below for more details, and for the dates that transactions must be processed by in order to avoid retroactivity in health insurance deductions.
| Payroll | Paycheck | Transaction Effective Date | Keying Window | To avoid retroactivity key by* |
|---|---|---|---|---|
| Admin Lag | 8/27/2014 | 8/28/2014 | 7/31/2014 – 9/5/2014 | 8/12/2014 |
*Please note that any option change transactions processed by health benefits administrators after the retroactivity cutoff dates will NOT be reflected in the August 27, 2014 paycheck.