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.
NY15-05
PE15-01
PA15-01
PAEX15-01
TO: Health Benefits Administrators
FROM: Employee Benefits Division
SUBJECT: New NYBEAS Transaction "Marriage (to) Domestic Partner"
DATE: March 4, 2015
A new transaction has been made available available on the New York Benefits Eligibility and Accounting System (NYBEAS). The new transaction is designed to replace the previous instructions for handling enrollee marriages to covered domestic partners in Chapter 4 of the HBA Manual https://www.cs.ny.gov/employee-benefits/hba/shared/manuals/ny/2001manual/chap4/4_5.cfm.
This transaction is called Marriage Domestic Partner (DEP/MDP) and is located at Benefits > Transactions > Marriage Domestic Partner.
The processing of the Marriage Domestic Partner (DEP/MDP) transaction, will update NYBEAS as follows:
- the dependent’s relationship status from “Domestic Partner” to “Spouse”,
- the enrollee and the dependent marital status to “Married”,
- the enrollee and the dependent marital status date to the date of marriage,
- removes the assessment of imputed income, effective the date of marriage, for all applicable plan types (Medical, Dental and Vision),
- the dependent federally qualified indicator to “Yes”, if applicable.
Before processing the Marriage Domestic Partner (DEP/MDP) transaction, verify that the enrollee has existing family coverage with an enrolled Domestic Partner. (If the enrollee has individual coverage, you will need to use a Change of Coverage transaction).
It is important to note that Medicare Secondary Payor rules are different for a domestic partner and a spouse. If an actively working enrollee marries their domestic partner who is 65 or older, the dependent should no longer be treated as Medicare primary, but instead should be treated as NYSHIP primary. Refer to our publication Medicare & NYSHIP for additional information.
For step-by-step instructions on how to process this transaction, please review the attached instructions. Additionally, EBD is working on developing a training video for HBAs for this transaction. A System Announcement will be sent once the training video has been completed and added to the E-learning section of HBA Online.
For NYS and PE enrollees, a transaction notification letter will be auto-generated and mailed to the enrollee’s NYBEAS address of record. Please see attached example. NOTE: Participating Agencies are responsible for advising their enrollees of changes to their NYBEAS enrollment record and any applicable tax implications.
If you have questions, please contact the HBA Help Line at 518-474-2780 from 9:00 a.m. to 4:00 p.m. EST, Monday through Friday.