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.
GOVERNOR
DEPARTMENT OF CIVIL SERVICE
ALBANY, NEW YORK 12239
www.cs.ny.gov
NY11-26
PE11-22
TO: Agency Health Benefits Administrators
FROM: Employee Benefits Division
SUBJECT: Changes to Vestee Processing
DATE: September 8, 2011
We have recently updated the process for enrolling a vestee in the New York State Health Insurance Program (NYSHIP). Going forward, enrollees under age 55 who experience a job termination and have a service date (on the NYBEAS Employee Information panel - Personal tab) indicating at least 10 years of service will no longer be placed in a pending status. Instead, when a termination is processed for one of these individuals, the enrollee will not have coverage in effect until he/she makes a positive election to continue coverage. EBD will automatically generate a COBRA application for all applicable benefit programs (medical, dental and vision) as well as a Vestee application and cover letter for medical coverage. The Vestee letter will explain what Vestee coverage is and how the enrollee can apply for the coverage. These two communications will be mailed under separate cover.
Completed Vestee applications should be returned to the Employee Benefits Division. If confirmation of the required 10 years of service is received, the former employee will be re-enrolled in a Vestee benefit program for medical coverage. The enrollee must also execute the COBRA application if he/she wishes to enroll in COBRA coverage for dental and/or vision benefits through NYSHIP. A confirmation letter will automatically be generated confirming enrollment for any Vestee and/or COBRA coverage that is elected.
If you receive calls regarding these Vestee letters, you should inform the enrollee that if they believe they qualify and want the coverage, they should complete the Vestee application. If they need coverage and do NOT have the 10 years of service, or want to apply for the NYSHIP dental and/or vision benefit, they should be advised to fill out the COBRA application which was mailed to them separately.
Any questions regarding this new procedure should be directed to your processor.