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
NY14-21
PE14-18
TO: New York State Agency Benefits Administrators
FROM: Employee Benefits Division (EBD)
SUBJECT: Management/Confidential Group Life Insurance Plan Annual Update
DATE: August 14, 2014
EBD is preparing for the 2014 Annual Update of the Management/Confidential (M/C) Group Life Insurance Plan enrollment records.
Post the attached notice to inform your M/C enrollees of the 2014 M/C Group Life Insurance Plan Annual Update.
RATE SCHEDULE
Premium rates will remain the same for the plan year September 1, 2014 through August 31, 2015 for personal Life insurance, Accidental Death and Dismemberment, and Accident and Sickness. Additionally, there has been no change to the administrative charges for the plan.
AUTOMATIC CHANGES
The annual update will automatically produce a change in payroll deductions for:
- Any enrollee who has reached a higher five-year premium age bracket as of September 1, 2014,
- Any enrollee whose age as of September 1, 2014, requires a reduction in coverage, and
- Any enrollee covered at a multiple of annual salary whose salary has changed by an amount sufficient to affect the total amount of coverage.
SALARY/COMPENSATION USED IN CALCULATIONS
Updated life insurance coverage for NYS enrollees who have chosen a multiple of salary option for their coverage amount is based upon the annual salaries as reported by the Office of the State Comptroller (OSC) on the following payrolls:
Administration Payroll checks dated July 30, 2014
Institution Payroll checks dated August 7, 2014
Updated life insurance coverage for PE enrollees or NYS enrollees whose salary is not captured by OSC is based upon the annual salaries reported by the agency Benefits Administrators.
Enrollees whose salaries change between the dates above and September 1, 2014 should request an adjustment in their coverage to reflect the salary change. Once the agency listing has been received, Benefits Administrators should review the complete listing and report any incorrect salaries to the Employee Benefits Division ATTN: M/C Life Insurance Unit, no later than October 31, 2014.
Additional compensation paid on a permanent basis, such as location pay, geographic differential, or special allowance, will be included in the annual salary. However, items such as shift differential, overtime pay and maintenance adjustments may not be considered salary for life insurance purposes.
Note: Enrollees requesting to increase or decrease their multiple of salary option must fill out a PS-934, M/C Life Insurance Transaction Form, check the "Change in Coverage" box in item 14 and select one of the options in item 15 that is either greater or less than their current option choice. (The maximum allowable coverage option is five times salary, with a maximum of $500,000). Any increase in coverage request requires that the enrollee mail a completed Statement of Health form to MetLife.
AGE-RELATED REDUCTIONS IN COVERAGE FOR ACTIVE EMPLOYEES
For active employees who are insured for a multiple of salary:
- At age 65-69, the coverage available will be 65% of the coverage available to the enrollee if the enrollee were under 65,
- At age 70-74, the coverage available will be 45% of the coverage available to the enrollee if the enrollee were under 65,
- At age 75-79, the coverage available will be 30% of the coverage available to the enrollee if the enrollee were under 65, and
- At age 80 and over, the coverage available will be 20% of the coverage available to the enrollee if the enrollee were under 65.
- However, in no case will the coverage be reduced below $15,000.
AGE-RELATED REDUCTIONS IN COVERAGE FOR RETIREES
For retired enrollees who are insured for a multiple of salary:
- At age 65-69, the coverage available will be 65% of the coverage available to the enrollee if the enrollee were under age 65 (but not less than $15,000).
- At age 70 and over, the coverage will be reduced to $15,000.
ACCIDENTAL DEATH AND DISMEMBERMENT COVERAGE
All active employees, regardless of age, as well as retirees under age 70 will be covered for Accidental Death and Dismemberment (AD&D) benefits equal to their life insurance coverage but not above $250,000. Retired enrollees, age 70 and over, are not eligible for AD&D.
SMOKER/NON-SMOKER CHANGES
Individuals previously enrolled as "smokers" who have not smoked since September 1, 2013, may now apply for the special non-smoker premium discount. To apply for non-smoker status, enrollees must complete a PS-934 "Management/Confidential Group Life Insurance Transaction" form, including checking "Other" in block 14 and then submitting the completed form to their agency Benefits Administrator. These forms must be returned to you by September 30, 2014, and forwarded to and received by the M/C Life Insurance Unit by October 31, 2014.
EFFECTVE DATES OF PREMIUM CHANGES/COVERAGE AMOUNTS
Effective dates of new payroll deductions and changes in the amount of life insurance coverage for NYS employees on the OSC payroll system will change automatically on the Institution and Administration paychecks dated as follows:
Institution Lag Payroll checks dated September 4, 2014; coverage will become effective at 12:01 a.m. September 4, 2014;
Administration Lag Payroll checks dated September 10, 2014; coverage will become effective at 12:01 a.m. September 11, 2014; and
Administration Current Payroll checks dated August 27, 2014; coverage will become effective at 12:01 a.m. September 11, 2014.
Effective dates of new payroll deductions and changes in the amount of life insurance coverage for PE enrollees will be September 1, 2014.
AGENCY AND INDIVIDUAL UPDATE NOTICES
In mid-August 2014, agencies will receive a printout showing the updated status for each enrollee. If you have any questions please call the M/C Life Insurance Unit at (518) 473-3496 and select the life insurance option.