Department of Civil Service

NY00-46

TO: State Agency Health Benefits Administrators
FROM: Employee Benefits Division
SUBJECT: 2000 Option Transfer, Pretax Selection and Domestic Partner Federal Qualification Periods
DATE: October 31, 2000

The purpose of this memo is to distribute information about the annual Option Transfer, Pretax Selection and Domestic Partner Federal Qualification Periods. Included with this memo are several attachments; a summary of HMO changes, an option code listing, an informational memo for posting at your agency and copies of letters sent to certain HMO enrollees.

NYSHIP HMO Changes for 2001
Benefit Plan Codes
Pre-Tax Contribution Program (PTCP)
Letters to Enrollees and Retirees

Health Insurance Option Transfer Period

The annual Option Transfer Period begins on November 1, 2000. Employees are entitled to 30 days from the date rates are delivered to the agencies to make decisions on health insurance coverage for 2001. We will send notification of this year's Option Transfer Period end date by separate HBA memo when rates are established and approved. Please do not process benefit plan changes until notified to do so.

Pretax Contribution Program Selection Period

The annual Pretax Contribution Program Selection period runs from November 1 through November 30, 2000. Enrollees who want to change their Pretax status must do so during this period. Further, Pretax enrollees who want to voluntarily cancel their coverage or change to individual coverage without a qualifying event must request the change during this period. The Pretax Contribution Program Selection period will not be extended beyond November 30.

Domestic Partner Qualification Reporting Period

The annual Domestic Partner Federal Qualification reporting period also runs from November 1 through November 30. Enrollees who want to change the federally qualified status of their domestic partner must submit a PS425.3 - Dependent Tax Affidavit, to their HBA requesting the change in federally qualified status. This period will not be extended.

HOP and SLEP Enrollment Period

The annual enrollment period for the Health Option Program (HOP) and the Sick Leave Exchange Program (SLEP) runs from November 1 through November 30, 2000. Enrollees who are eligible to participate in either of these programs must enroll during this period. The HOP and SLEP enrollment period will not be extended beyond November 30. Additional information regarding these programs will be issued in separate HBA memos.

HEALTH MAINTENANCE ORGANIZATIONS - CODES AND SERVICE AREAS

HMO Codes

To be eligible for enrollment in an HMO, an enrollee must live or work in the HMO's approved service area. Enrollees are not eligible to join every HMO participating in the New York State Health Insurance Program (NYSHIP). For questions regarding an HMO's approved service area consult the 2001 Health Insurance Choices.

NOTE: Several HMOs with similar or duplicate names cover different regions. Enrollees may become confused about the correct Benefit Plan code, so make sure to verify that the enrollee's service area and HMO Benefit Plan code match before processing a Benefit Plan change.

HMO Changes for 2001

Refer to Attachment A for a summary of HMO changes.

HMO Enrollment

An enrollee who wishes to enroll in an HMO must fill out both a PS-404 - NYS Health Insurance Transaction Form and an HMO enrollment form. The completed PS-404 should be retained in the employee's file. Send the HMO enrollment form to the HMO, keep a copy for your file and give a copy to the enrollee to serve as identification until the enrollee receives his/her identification cards. Do not send the HMO enrollment form to the New York Health Plan Association (formerly the HMO Council of New York) or to Civil Service. Within six weeks of receipt of the HMO enrollment form, each HMO will verify enrollment through the weekly transaction recaps.

The HMO enrollment form is unchanged. Additional copies of this form can be ordered through EBD by using the NY STATE AGENCY PUBLICATIONS SUPPLY REQUEST FORM.

BENEFIT PLAN TRANSFER PROCEDURES

Changing Benefit Plans

We will provide the dates you will be able to enter benefit plan changes on NYBEAS via a Broadcast Message and in the next Option Transfer Period HBA memo. Refer to pages 99 and 100 of the HBA Handbook for instructions on changing benefit plans (PLN/CHG). The PLN/CHG transaction will be available when rates are approved and the Option Transfer Period is defined. Please remember the following:

• Make sure the benefit plan number for the benefit plan selected by the enrollee is correct - that the code is the same as that indicated on the enclosed benefit plan code sheet. (EXAMPLE: EMPIRE - 001, COMMUNITY BLUE - 067.) Also, verify that the enrollee is eligible for the chosen benefit plan, that is, he/she lives or works in an HMO's service area.
• Beginning with the Option Transfer Period for 2001, each COBRA dependent may elect to change to Individual coverage in a plan different from that of the enrollee's family coverage.
• Transactions which do not have a transaction date equal to, or later than, the most recent date on the NYBEAS Benefit Panel will not process. Therefore, to avoid enrollment, claim status and deduction-adjustment problems, multiple transactions must be submitted in transaction date sequence (chronological order). Note: NYBEAS allows you to process multiple transactions on the same day.
• A PS-404 MUST BE SIGNED AND DATED BY THE ENROLLEE FOR EACH TRANSACTION. Health Benefits Administrators cannot sign for the enrollee or process transactions indicating "signature on file."
• Once a benefit plan change has been entered on NYBEAS, a subsequent benefit plan change can be made as long as it occurs during the Option Transfer Period.

Year 2001 Benefit Plan Effective Dates

The effective date of the Benefit Plan change is 1/4/01 for Administration payroll employees and 12/28/00 for Institution payroll employees. In order to avoid retroactive premium adjustments, Benefit Plan Change transactions must be entered by agencies on Administration Lag payrolls no later than 12/19/00. Institution agencies must enter Benefit Plan Change transactions no later than 12/12/00 to avoid retroactive premium adjustments.

PRE-TAX CONTRIBUTION PROGRAM (PTCP) PROCEDURES

Below are agency operating procedures for your use. A designated fact sheet for employees is included as Attachment C and should be posted at work sites.

IMPORTANT! IRS REGULATIONS ARE VERY SPECIFIC FOR CHANGES IN PTCP STATUS. ARBITRARY CHANGES IN PTCP STATUS CAN ONLY BE MADE DURING THE ANNUAL ELECTION PERIOD NOVEMBER 1ST - NOVEMBER 30TH.

See Submitting Changes in Tax Status below.

Submitting Changes in Tax Status Election

• If the NYSHIP enrollee is currently enrolled in PTCP for the 2000 Plan Year and wishes to opt out of PTCP for the 2001 Plan Year, or is not enrolled in PTCP and wishes to opt in for Plan Year 2001, the enrollee must complete a PS-404 and return it to his/her HBA, postmarked no later than November 30, 2000. Hand-delivered PS-404s should be date-stamped upon receipt.
• Send a copy of the PS-404 to your EBD processor by November 30, 2000. If you send forms to EBD after November 30, 2000, you must include proof of timely request by the enrollee (e.g. an envelope postmarked on or before November 30, 2000). Submission of this form will effect a change in the PTCP status for the Plan Year of January 1, 2001 through December 31, 2001.
• The requested changes in PTCP status (pretax or post tax) will impact the first payroll check of 2001 (1/3/01 for Administration payrolls and 12/28/00 for Institution payrolls).

Change in Health Insurance Coverage For PTCP Enrollees

To make a health insurance coverage change for the PTCP 2001 Plan Year, the enrollee currently in PTCP must complete a PS-404 and submit it to you prior to November 30, 2000. You must enter the CCO/VOL or CAN/VOL on NYBEAS using the date below as the date of request. Do not enter these transactions with any other dates of request. Remember- If coverage is being changed between spouses, coordinate the dates with the other spouse's HBA before submitting transactions.

Transaction Type	Date to be used on NYBEAS as Date of Request	Transaction Effective Date
CCO to Individual (CCO/VOL) or Voluntary CAN (CAN/VOL)	For Administration: December 21, 2000	January 4, 2001
CCO to Individual (CCO/VOL) or Voluntary CAN (CAN/VOL)	For Institution: December 14, 2000	December 28, 2001

Effect of HOP or SLEP Selection on PTCP

Enrollees and HBAs are reminded that even though the enrollee's participation in the HOP or SLEP program results in a lower or no enrollee premium deduction, enrollees are still subject to the IRS125 rules on arbitrary changes outside of the annual election period.

Arbitrary Health Insurance Coverage Changes Ouside of Annual PCTP Election Period

• The Internal Revenue Service (IRS) defines arbitrary Health Insurance Coverage changes. When a change is defined as arbitrary, it cannot change an employee's Pretax contribution.
• IRS rules require an employer to comply with an employee's annual election of a Pretax premium contribution and to continue the Pretax contribution toward the employee's health insurance coverage during the PTCP Plan year unless a qualifying event occurs.
• Paycheck deductions must be used to provide the benefit the employee has elected and the election cannot be revoked during a PTCP Plan Year (except in circumstances permittd under IRS rules and outlined in the attached information). Therefore, the following health changes will not be accepted from persons enrolled in the PTCP outside of the Pretax Selection Period:

• Change from Family to Individual coverage while an employee's dependents are still eligible for coverage.
• Voluntary cancellation of coverage while the employee is still eligible for coverage.

NOTE: Under PTCP rules, a State employee with eligible dependents is entitled to provide coverage for those dependents, subject to an applicable waiting period even though the change from Individual to Family coverage is not the result of a qualifying event.

Newly Eligible Employees and Eligible Employees Not Currently Enrolled

Newly eligible employees and eligible employees who previously did not have coverage now applying for coverage in NYSHIP are entitled to elect the PTCP outside of annual PCTP election period.

• the enrollee wants to participate in the PTCP, enrollment is automatic
• the enrollee does not want to participate in the PTCP, enter the "NEW" transaction on NYBEAS, and fax the PS-404 with the "NEW" transaction, indicating declination of the PTCP in the "Authorization" section, to the attention of your processor at (518) 485-5590.

Employees on Leave Without Pay (LWOP) Who Return to the Payroll in 2001

• An employee who goes on LWOP or terminates after the beginning of the PTCP Plan year (January 1, 2001) and subsequently returns to the payroll during the same Plan year (prior to December 31, 2001) is not entitled to a new election. The election (i.e. pretax or post tax) in effect at the beginning of the Plan year will continue until the next Plan year.
• An employee who enters LWOP status during a plan year prior to the annual Pretax Selection Period, and subsequently returns to the payroll in the next plan year is entitled to a new PTCP election upon returning to the payroll.

Employees With Domestic Partner Coverage

Employees with Domestic Partner Coverage may elect to participate in the PTCP. However, PTCP enrollees covering a non-federally qualified domestic partner can only have the Individual premium amount taken on a pretax basis. An enrollee with a non-federally qualified domestic partner must pay the additional contribution for Family coverage on a post-tax basis as required by the Internal Revenue Code.

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ATTACHMENT A

NYSHIP HMO CHANGES FOR 2001

HMO Process Overview

Each year, a Request for Proposals entitled Specifications for Health Maintenance Organizations Participation in NYSHIP (RFP) is released soliciting proposals from HMOs to provide health insurance benefits to NYS employees and retirees. The content of the RFP, the review of submitted proposals and decisions relating to benefits for the ensuing year are the responsibility of the Joint Labor Management Committees on Health Benefits (JLMC). This committee is comprised of individuals representing the State's eight employee unions, the Governor's Office of Employee Relations and the Department of Civil Service.

What's new for 2001

• Independent Health Hudson Valley's Departure from NYSHIP
• HIP's Pilot Program in Florida is discontinued
• Medicare + Choice issues
• HMO Service Area Expansions

Independent Health Hudson Valley's Departure from NYSHIP

A corporate decision was made by Independent Health Hudson Valley (IH) not to seek participation in NYSHIP for 2001 primarily due to the lack of enrollment gains over the years and an inability to compete with larger HMOs in their service area. Individuals enrolled in IH will be afforded an opportunity to switch to another health insurance plan during the annual option transfer period. If no option change is made, the subscriber will be enrolled in the Empire Plan effective January 1st 2001.¹

Pilot Program in Florida

The pilot program providing health insurance benefits to retirees in Florida through HIP is being terminated. This decision was prompted by HIP's plans to sell its Florida plan and the uncertainty of the intended buyer's commitment to maintain current benefit levels and services. Impacted retirees will be automatically enrolled in the Empire Plan effective January 1st 2001.¹

Medicare + Choice issues: HIP and Aetna US Healthcare

HIP has decided to discontinue its Medicare + Choice option in Suffolk County. Interestingly, Aetna US Healthcare has also decided to follow HIP's lead by discontinuing its Medicare + Choice product in Nassau, Suffolk, Dutchess, Orange and Putnam Counties. Both HMOs note that the reimbursement levels provided by the Health Care Financing Administration do not keep up with escalating claims costs. Both HMOs will provide benefits in these counties that mirror the benefits afforded to active enrollees. The Medicare + Choice benefits will continue to be available in the remainder of their service area.

Letters being sent to enrollees affected by the above HMO changes.

HMO Service Area Expansions

Several NYSHIP HMOs service area expansion requests have been approved by the JLMC. Two HMOs, Blue Choice HMO and CDPHP have also requested additional option codes to accommodate premium rate differences needed to cover the regional variance in claims expenses. For example, a physician's services in the New York City area typically cost more than the same service in Albany. The newly approved service area counties and option codes are indicated in bold below. MVP has asked to consolidate its option codes from two (060 and 100) to one code (060).

Elderplan

Option Code #068

Brooklyn, New York, Queens and Richmond Counties

BlueChoice HMO

Option Code #280 Upstate Region

Albany, Clinton, Columbia, Essex, Fulton, Greene, Montgomery, Rensselaer, Saratoga, Schenectady, Schoharie, Warren and Washington Counties.

Option Code #290 Downstate Region

Bronx, Delaware, Dutchess, Kings, Nassau, New York, Orange, Putnam, Queens, Richmond, Rockland, Suffolk, Sullivan, Ulster, and Westchester Counties

Capital District Physicians' Health Plan (CDPHP)

Option Code #063 Capital Region

Albany, Columbia, Essex, Fulton, Greene, Hamilton, Montgomery, Rensselaer, Saratoga, Schenectady, Schoharie, Warren and Washington Counties

Option Code #300 Central Region

Broome, Chenango, Delaware, Herkimer, Madison, Oneida, Otsego and Tioga Counties

Option Code #310 Western Hudson Valley Region

Orange and Ulster Counties

Mohawk Valley Physicians' Health Plan (MVP)

Option Code #060

Albany, Broome, Chenango, Columbia, Delaware, Dutchess, Fulton, Green, Hamilton, Herkimer, Lewis, Madison, Montgomery, Oneida, Onondaga, Orange, Otsego, Putnam, Rensselaer, Saratoga, Schenectady, Schoharie, Tioga Ulster, Warren and Washington Counties

UnitedHealthcare

Option Code #260

Cayuga, Herkimer, Madison, Oneida, Onondaga and Oswego Counties

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ATTACHMENT B

BENEFIT PLAN CODES

Consult the 2001 Health Insurance CHOICES guide for further information on the specific service area for each HMO.

*For HMOs with more than one code, please verify the correct service area.

Aetna US Healthcare - 210

Blue Choice - 066

BlueChoice HMO - 280 & 290

Capital District Physicians' Health Plan (CDPHP) - 063, 300 & 310

Community Blue - 067

Elderplan - 068

Empire Plan - 001

GHI HMO Select - 220

HIP Health Plan of New York - 050

HMOBlue - 160

HMO-CNY - 072

Independent Health - Western New York - 059

MVP Health Plan - 060

Preferred Care - 058

UnitedHealthcare - 260

Univera Healthcare - CNY - 055

Univera Healthcare - WNY - 057

Vytra Health Plans - 070

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ATTACHMENT C

PRE-TAX CONTRIBUTION PROGRAM (PTCP)

(Please Post This Information Prominently)

Under the Pre-Tax Contribution Program (PTCP), you may have your share of your health insurance premium deducted from your gross wages before taxes are withheld. This program may lower your taxes.

Who is Eligible

If you are an active State employee who receives regular payroll checks and has Health Insurance premiums withheld from your paycheck, you are eligible to participate in the PTCP. You will not be eligible to participate in the PTCP if you pay for your health insurance directly instead of by payroll deduction (for example, if you are on Leave Without Pay (LWOP)).

Tax Savings

Making your contributions to your health insurance premium on a before tax basis (contributions are made before taxes are withheld) effectively reduces your salary by the amount of your contribution. Therefore, you pay taxes based on a lower salary. These salary-based taxes include Federal income taxes, Social Security taxes, and most State and local income taxes. (If you live in New Jersey or in Erie, Philadelphia or Pittsburgh Pennsylvania, you are not allowed to reduce your State or Local taxable income by the amount of your health plan contribution. If you live in these areas, only your Federal income taxes and Social Security taxes will be affected.) The amount you save in taxes will depend on the amount of your income, your premium and the number of withholding allowances that you claim on your taxes. Contact your tax professional for advice on how participation in the PTCP will affect you.

Automatic Deductions and Opt-Out Period

If you are eligible for PTCP, you will be enrolled automatically in the Program unless you file a PS-404 Form with your agency Health Benefits Administrator indicating that you decline to participate. New employees who want to opt out must do so at the time they enroll for health insurance coverage. Once enrolled in NYSHIP, if you want to opt out, you must do so for each tax year by the designated Pre-Tax Selection Period deadline. For example, to opt out of the PTCP for the 2001 Plan Year, you must complete the PS-404 and return it to your HBA, no later than November 30, 2000.

Domestic Partners: Not Eligible for Pre-Tax

Under IRS pre-tax rules, unless a domestic partner qualifies under Section 152 of the Internal Revenue Code, a domestic partner is not an eligible dependent. Therefore, if you cover your non-federally qualified partner, the portion of the premium you pay for Family health insurance coverage must be taken on a post-tax basis.

Changes Permitted for PTCP Enrollees Outside of November Election Period

Under Internal Revenue Service (IRS) regulations, if you participate in the PTCP, you may change your health insurance deduction only when one of the following PTCP qualifying events occurs:

• You have a change in family status (e.g. marriage, birth, death, legal separation, divorce, attainment of the maximum coverage age in the case of a dependent child, or other loss of dependent eligibility).
• You are enrolled in an HMO and move out of that HMO's service area and you must choose another HMO or the Empire Plan.
• Your spouse loses his/her coverage due to termination of employment and you apply for coverage for your spouse under NYSHIP.
• You first become eligible for health coverage on or after January 1, 2001.
• Your employment with the State terminates, or you retire.
• Your spouse has a change in employment status, which results in either acquiring or losing eligibility for health insurance coverage.
• You receive a divorce/legal separation and are required under a court order to provide health insurance coverage for your eligible dependent children.
• There is a significant change in your or your spouse's health coverage, which is attributable to your spouse's employment.
• You or your spouse goes on LWOP during the plan year. You may request a change of coverage during your LWOP or upon return from LWOP. This request must be made within 28 days of your return.

IRS Regulations: Arbitrary Changes Not Permitted During the Year

Internal Revenue Service (IRS) regulations require an employer to take a fixed pre-tax contribution toward an employee's coverage throughout the PTCP year unless a qualifying event or a significant change in your spouse's employment occurs. Changes that do not stem from a qualifying event are defined by the IRS as arbitrary health insurance coverage changes. These arbitrary changes in health insurance coverage cannot change the amount of your health insurance deduction.

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ATTACHMENT D

TOPIC: Independent Health - Hudson Valley Region out of NYSHIP - Actives

October 27, 2000

Dear Enrollee,

The HMO you are currently enrolled in, Independent Health - Hudson Valley Region, will not be offered as an option in the New York State Health Insurance Program (NYSHIP) in 2001. You are eligible to continue your coverage in NYSHIP by choosing a new health insurance option for next year. Please read the information below and note the deadlines for choosing your new health insurance plan.

Plans available: Choices for 2001 (Choices) describes the health insurance plans available to you in 2001 under NYSHIP. These plans include the Empire Plan and the HMOs in the area where you live or work. We will send a copy of Choices to your home in November.

Rates and deadline for choosing: In November, we will send a flyer to your home address with plan rates and Option Transfer deadlines. If you wish to enroll in an HMO, you must choose a new option by the deadline. This flyer will also give you the effective date of your new coverage.

If you do not choose a new option before the deadline, you will be automatically enrolled in the Empire Plan.

See your agency Health Benefits Administrator: To choose your new option, see your agency Health Benefits Administrator (HBA) in your personnel office before the Option Transfer deadline. Complete a health insurance transaction form PS 404 enrolling you and your family in a new plan. If you choose an HMO you must also complete an HMO Enrollment Form. Your HBA will have these forms.

If you need more information about specific plan benefits, call the Empire Plan carriers or HMO directly. (See Choices for telephone numbers.) If you have any questions about your health insurance coverage after you have reviewed Choices, please see your agency Health Benefits Administrator.

Employee Benefits Division
NYS Department of Civil Service
The State Campus
Albany, New York 12239

Albany area: (518) 457-5754
All other areas: 1-800-833-4344
Web site: http://www.cs.state.ny.us

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TOPIC: Independent Health - Hudson Valley Region out of NYSHIP - Retirees & COBRA

October 27, 2000

Dear Enrollee,

The Health Maintenance Organization (HMO) you are currently enrolled in, Independent Health - Hudson Valley Region, will not be offered as an option in the New York State Health Insurance Program (NYSHIP) in 2001. You are eligible to continue your coverage in NYSHIP by choosing a new health insurance option for next year. Please read the information below and note the deadlines for choosing your new health insurance plan.

Plans available, rates and deadline for choosing: In December, we will mail a copy of Health Insurance Choices and 2001 Rates (Choices) to your home. Choices describes the health insurance plans available to you in 2001 under NYSHIP. These plans include the Empire Plan and the HMOs serving the area in which you live. Choices also includes plan rates, Option Transfer deadlines and the forms you need to change your option. If you wish to enroll in an HMO, you must choose a new option by the deadline.

If you do not choose a new option before December 22, 2000, you will be automatically enrolled in the Empire Plan.

To change your option: Complete the "2001 NYSHIP Option Transfer Request" form when you receive Choices. Send it to the Operations Unit in the Employee Benefits Division at the address below. If you are enrolling in an HMO, also complete the "Notice of Intent to Enroll in an HMO for 2001" and send it to the HMO you have chosen. You can find these forms at the back of Choices. They are also attached for your convenience.

You may receive calls asking you to join another Medicare HMO in your area. These HMOs may not be part of NYSHIP. Please know your risk. If you are in NYSHIP and you join a Medicare HMO that does not participate in NYSHIP, you may drastically reduce or eliminate your NYSHIP benefits. If you cancel your NYSHIP coverage, New York State will no longer reimburse you for your Medicare Part B premium. If you wish to later re-enroll in NYSHIP there is a three-month waiting period. If you die while you are not enrolled in NYSHIP, your dependents are not eligible for Dependent Survivor coverage.

If you need more information about specific plan benefits, call the Empire Plan carriers or HMOs directly. (See Choices for telephone numbers.) If you have any questions about your health insurance coverage after you have reviewed Choices, please call the Employee Benefits Division at the number below.

Employee Benefits Division
NYS Department of Civil Service
The State Campus
Albany, New York 12239

Albany area: (518) 457-5754
All other areas: 1-800-833-4344
Web site: http://www.cs.state.ny.us

Enclosures:
2001 NYSHIP Option Transfer Request form and instructions
Notice of Intent to Enroll in an HMO for 2001 form and instructions

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TOPIC: HIP out of Florida - Retirees

October 27, 2000

Dear Retiree,

The Health Maintenance Organization (HMO) you are currently enrolled in, Health Insurance Plan of New York (HIP), will no longer be available in Florida in 2001. However, HIP will continue to provide coverage to you through December 31, 2000.

Since there are no other HMOs approved by the New York State Health Insurance Program (NYSHIP) that serve the area where you live, you will automatically be enrolled in the Empire Plan. Your Empire Plan coverage will begin on January 1, 2001.

You may receive calls asking you to join another Medicare HMO in your area. These HMOs are not part of NYSHIP. Please know your risk. If you are in NYSHIP and you join a Medicare HMO that does not participate in NYSHIP, you may drastically reduce or eliminate your NYSHIP benefits. If you cancel your NYSHIP coverage, New York State will no longer reimburse you for your Medicare Part B premium. If you wish to later re-enroll in NYSHIP there is a three-month waiting period. If you die while you are not enrolled in NYSHIP, your dependents are not eligible for Dependent Survivor coverage.

In December we will send you a participating provider directory for Florida and Health Insurance Choices for 2001 (Choices), which includes a summary of your Empire Plan benefits and premium rates for the year. You will also find benefit information and an up-to-date list of providers on our Web site: http://www.cs.state.ny.us. Click on "Employee Benefits & Services" and then "Option Transfer."

If you or your enrolled dependent(s) are Medicare-Primary and enrolled in a HIP Medicare + Choice plan (HIP VIP), then complete the attached disenrollment form by December 10 and send it to:

HIP Health Plan of New York
Enrollment Department
7 West 34th Street
New York, NY 10001

HIP must receive this completed form by December 8, 2000, so the Empire Plan can properly coordinate your benefits effective January 1, 2001.

If you have any questions about the termination of your coverage with HIP, call 1-800-HIP-TALK (1-800-447-8255). If you have any questions about your Empire Plan benefits call the Empire Plan carriers. The telephone numbers are in Choices. If you have any questions about your health insurance coverage, please call the Employee Benefits Division at the numbers below.

Employee Benefits Division
NYS Department of Civil Service
The State Campus
Albany, New York 12239

Albany area: (518) 457-5754
All other areas: 1-800-833-4344
Web site: http://www.cs.state.ny.us

Enclosures:
Enrollment Cancellation form
Florida Participating Provider Directory
2001 At A Glance

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TOPIC: HIP - Suffolk County Retirees

October 27, 2000

Dear Retiree,

The Health Maintenance Organization (HMO) you are currently enrolled in, Health Insurance Plan of New York (HIP), will no longer offer its Medicare + Choice product in Suffolk County for 2001. HIP will continue to provide benefits to Medicare-Primary retirees in Suffolk County, and will coordinate with Medicare. These benefits will be listed in the column marked "Your Cost NYSHIP Primary" on the HIP page in Health Insurance Choices & 2001 Rates (Choices) that you will receive in the mail in December.

Plans available, rates and deadline for choosing: Choices describes the health insurance plans available to you in 2001 under NYSHIP. These plans include the Empire Plan and the HMOs serving the area in which you live. Choices also includes plan rates, Option Transfer deadlines and the forms you need to change your option. If you wish to enroll in another health insurance plan, you must choose a new option by the deadline.

No action is necessary if you wish to remain in HIP. If you do not choose a new option before the deadline, HIP will automatically transition you from Medicare + Choice benefits to those provided under Medicare supplement as noted above.

If you wish to change your option: When you receive Choices, review the instructions on how to enroll in an HMO and the deadlines. Complete the "2001 NYSHIP Option Transfer Request" form when you receive Choices. Send it to the Operations Unit in the Employee Benefits Division at the address below. If you are enrolling in an HMO, also complete the "Notice of Intent to Enroll in an HMO for 2001" form and send it to the HMO you have chosen. You can find these forms at the back of Choices. These forms are also attached for your convenience.

You may receive calls asking you to join another Medicare HMO in your area. These HMOs may not be part of NYSHIP. Please know your risk. If you are in NYSHIP and you join a Medicare HMO that does not participate in NYSHIP, you may drastically reduce or eliminate your NYSHIP benefits. If you cancel your NYSHIP coverage, New York State will no longer reimburse you for your Medicare Part B premium. If you wish to later re-enroll in NYSHIP there is a three-month waiting period. If you die while you are not enrolled in NYSHIP, your dependents are not eligible for Dependent Survivor coverage.

If you need more information about specific plan benefits, call the Empire Plan carriers or HMOs directly. (See Choices for telephone numbers.) If you have any questions about your health insurance coverage after you have reviewed Choices, please call the Employee Benefits Division at the number below.

Employee Benefits Division
NYS Department of Civil Service
The State Campus
Albany, New York 12239

Albany area: (518) 457-5754
All other areas: 1-800-833-4344
Web site: http://www.cs.state.ny.us

Enclosures:
2001 NYSHIP Option Transfer Request form and instructions
Notice of Intent to Enroll in an HMO for 2001 and instructions

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TOPIC: Aetna - Dutchess, Nassau, Orange, Putnam and Suffolk Retirees

October 27, 2000

Dear Retiree,

The Health Maintenance Organization (HMO) you are currently enrolled in, Aetna U.S. Healthcare (Aetna), will no longer offer its Medicare + Choice product in Dutchess, Nassau, Orange, Putnam and Suffolk Counties for 2001. Aetna will continue to provide benefits to Medicare-Primary retirees in these counties, and will coordinate with Medicare. These benefits will be listed in the column marked "Your Cost NYSHIP Primary" on the Aetna page in Health Insurance Choices & 2001 Rates (Choices) that you will receive in the mail in December.

Plans available, rates and deadline for choosing: Choices describes the health insurance plans available to you in 2001 under NYSHIP. These plans include the Empire Plan and the HMOs serving the area in which you live. Choices also includes plan rates, Option Transfer deadlines and the forms you need to change your option. If you wish to enroll in another health insurance plan, you must choose a new option by the deadline.

No action is necessary if you wish to remain in Aetna. If you do not choose a new option before the deadline, Aetna will automatically transition you from Medicare + Choice benefits to those provided under Medicare supplement as noted above.

If you wish to change your option: When you receive Choices, review the instructions on how to enroll in an HMO and the deadlines. Complete the "2001 NYSHIP Option Transfer Request" form when you receive Choices. Send it to the Operations Unit in the Employee Benefits Division at the address below. If you are enrolling in an HMO, also complete the "Notice of Intent to Enroll in an HMO for 2001" form and send it to the HMO you have chosen. You can find these forms at the back of Choices. They are also attached for your convenience.

You may receive calls asking you to join another Medicare HMO in your area. These HMOs may not be part of NYSHIP. Please know your risk. If you are in NYSHIP and you join a Medicare HMO that does not participate in NYSHIP, you may drastically reduce or eliminate your NYSHIP benefits. If you cancel your NYSHIP coverage, New York State will no longer reimburse you for your Medicare Part B premium. If you wish to later re-enroll in NYSHIP there is a three-month waiting period. If you die while you are not enrolled in NYSHIP, your dependents are not eligible for Dependent Survivor coverage.

If you need more information about specific plan benefits, call the Empire Plan carriers or HMOs directly. (See Choices for telephone numbers.) If you have any questions about your health insurance coverage after you have reviewed Choices, please call the Employee Benefits Division at the number below.

Employee Benefits Division
NYS Department of Civil Service
The State Campus
Albany, New York 12239

Albany area: (518) 457-5754
All other areas: 1-800-833-4344
Web site: http://www.cs.state.ny.us

Enclosures:
2001 NYSHIP Option Transfer Request
Notice of Intent to Enroll in an HMO for 2001

 

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