Department of Civil Service

NY15-17

TO: New York State Health Benefits Administrators for Troopers of the New York State Police represented by Police Benevolent Association (PBA)
FROM: Employee Benefits Division
SUBJECT: NYSHIP Contribution Rate Changes and Special Option Transfer Period for Troopers of the New York State Police represented by Police Benevolent Association (PBA)
DATE: August 18, 2015

The collective bargaining agreement between New York State (the State) and the Police Benevolent Association (PBA) will result in changes to the New York State Health Insurance Program (NYSHIP) benefits and premium contributions for Troopers of the New York State Police (PBA-T) effective October 1, 2015. As a result, a Special Option Transfer Period for PBA-T employees will be held from September 1 through September 30, 2015.

The following changes will impact PBA-T employees’ NYSHIP premium and their corresponding health insurance deductions beginning with the paycheck dated September 23, 2015:

• Employee Biweekly Premium Contribution: PBA-T employees’ premium contribution will be 16% of the cost of individual coverage and 31% of the cost of dependent coverage.
• Change in Premium Due to NYSHIP Benefit Changes: NYSHIP benefit changes also contribute to a change in NYSHIP premium. Employees should refer to the July 2015 NYSHIP HMO and Empire Plan Special Reports publications for specific information regarding these benefit changes.
• 33 Pay Period Biweekly Premium Adjustment: Per the agreement, there is an adjustment to the PBA-T employees’ premium for 33 pay periods (September 23, 2015 through December 14, 2016). Each enrollee adjustment amount will depend upon the plan the enrollee is in (Empire Plan or NYSHIP HMO) and the coverage type (Individual or Family) elected.

The attached rate chart presents the PBA-T rates effective October 1, 2015. This chart lists the employee contribution rate and the rate an employee is responsible for when on a full share leave of absence.

Special Option Transfer Period (September 1 – September 30, 2015)
There will be a Special Option Transfer Period from September 1, 2015 through September 30, 2015 for PBA-T employees. Enrollees that participate in the Pre-Tax Contribution Program (PTCP) will be able to make changes in their pre-tax contributions as the Special Option Transfer Period is considered to be a PTCP qualifying event. Therefore, the enrollee may change options, change coverage from family to individual or individual to family or cancel coverage.  Previously eligible employees, who are not currently enrolled in NYSHIP, may enroll in NYSHIP coverage during the Special Option Transfer Period.  However, the employee may not elect to have pre-tax deductions taken until the PTCP annual election period, November 1 through November 30. In all cases of enrollment of previously eligible employees or dependents, a late enrollment period will be applied.

Please contact the HBA Help Line (518-474-2780) if you have any questions about Special Option Transfer, PTCP or late enrollment. 

Enrollees should be encouraged to carefully review the settled version of Health Insurance Choices for 2015 booklet [AL1288], the July 2015 Empire Plan Special Report or HMO Special Report that describes benefit changes, and the NYSHIP Rate Changes Effective October 1, 2015 flyer. The latter three publications were mailed to enrollee homes in late July. Enrollees may request a 2015 Choices booklet from you or access the online version on NYSHIP Online, to assist in the decision-making process.

Employees requesting coverage or enrollees requesting a change should be provided with a Health Insurance Transaction Form - PS-404. Forms must be completed and returned to you by September 30, 2015. Online option changes using MyNYSHIP will not be available to enrollees during the Special Option Transfer Period.

NOTE: No action is required for enrollees who wish to keep their current health insurance coverage and option.

Updated Life Expectancy Table
The most recently implemented Actuarial Table of Life Expectancy for PBA-T employees will impact the sick leave calculation for PBA-T enrollees with a retirement date after September 30, 2015 (October 1, 2015 or later on the NYBEAS Job Panel). The Online Sick Leave Credit Calculator now includes both the current table and the newly applicable table. Dropdowns are available for the selection of the appropriate chart based upon retirement date; prior to October 1 and On October 1 and after.  The Actuarial Table of Life Expectancy is used to calculate the value of unused sick leave credits that can be applied to reduce health insurance premiums in retirement.

Opt-Out Program for the remainder of 2015 Plan Year
The Opt-Out Program will be available to PBA-T employees during the Special Option Transfer Period.

To be eligible for the Opt-out Program beginning October 1, 2015, PBA-T employees must have been enrolled in NYSHIP as of April 1, 2014 (or their first date of NYSHIP eligibility if that date is later than April 1, 2014) and remain enrolled through September 30, 2015. An enrollee who did not maintain continuous coverage may be eligible to elect enrollment in the Opt-out Program if he/she was cancelled from coverage during a full share leave without pay.

Please contact the HBA Help Line (518-474-2780) for assistance in determining eligibility if the enrollee had a break in coverage.

To qualify for the Opt-out Program, PBA-T employees must also be covered under an employer-sponsored group health insurance plan through other employment of their own or a plan that their spouse, domestic partner or parent has as the result of his or her employment. A PBA-T employee is not eligible for an incentive payment if the other coverage is provided via a NYSHIP policy as a result of the employee’s, spouse’s, domestic partner’s or parent’s employment relationship with New York State, or is the result of his or her own employment with a NYSHIP Participating Agency (PA) or Participating Employer (PE). If a PBA-T employee is covered as a dependent on another person’s NYSHIP policy through a PA or PE, the PBA-T employee is only eligible to receive the individual incentive payment.

Please refer your employees to the July 2015 NYSHIP HMO or Empire Plan Special Reports for specific information regarding Opt-out Program Incentive payment amounts, how employees are reimbursed, the eligibility requirements to elect the Opt-out Program and other coverage requirements, as well as answers to Frequently Asked Questions regarding the Opt-out Program.

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 PLN/CHG transaction will be available on NYBEAS between September 1 and October 9, 2015. Please see the chart below for more details, and for the date that transactions must be processed in order to avoid retroactive health insurance deductions.

*Please note that any option change transactions processed by Health Benefits Administrators after the retroactivity cutoff date will NOT be reflected in the September 23, 2015 paycheck.

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