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.
KATHY HOCHUL
Governor
TIMOTHY R. HOGUES
Commissioner
NY22-32
TO: New York State Agency Health Benefits Administrators
FROM: Employee Benefits Division
SUBJECT: 2023 Annual Option Transfer and Pre-Tax Contribution Program Election Period
DATE: November 21, 2022
Annual Option Transfer Period and Pre-Tax Contribution Program Dates
The 2023 Option Transfer and Pre-Tax Contribution Program (PTCP) Election Period for New York State employees is December 1, 2022, through December 30, 2022. Employees who wish to request a change during the annual Option Transfer Period can do so by submitting a completed Health Insurance Transaction Form (PS-404) or though MyNYSHIP by December 30, 2022. Do NOT accept changes prior to or after the Option Transfer Period.
PTCP Election Period
Please refer to The Pre-Tax Contribution Program section of the HBA Manual regarding the PTCP and Annual Election Period. Note that changes to an enrollee’s tax election takes place with the first paycheck of the upcoming “Tax Year”, which can differ from the “Plan Year” effective date.
Opt-Out Program
Please refer to the Opt-Out section of the HBA Manual regarding the requirements for the Opt-out Program. Note that enrollees who signed the PS-409 Opt-out Program Attestation form have attested to their eligibility and must notify their HBA when no longer eligible for coverage through other employer-sponsored health plan. Delays in notification of loss of other employer-sponsored coverage will result in a late enrollment waiting period when requesting NYSHIP coverage. Additionally, enrollees will be required to repay Opt-out incentive payments provided to them after the date of cancellation of their other employer-sponsored coverage.
2022/2023 Opt-out Incentive Payment Dates
Please refer to the chart below for the dates of the final 2022 incentive payment and first 2023 incentive payment, in accordance with each payroll cycle.
| Employee’s Payroll Cycle | Last Paycheck with 2022 Opt-out Payment |
First Paycheck with 2023 Opt-out Payment |
| Administration Lag | 12/21/22 | 1/4/23 |
| Administration Current | 12/07/22 | 12/21/2022 |
| Institution Lag | 12/15/22 | 12/29/2022 |
| Institution Current | 12/1/22 | 12/15/22 |
| Triple Lag | 12/29/22 | 1/12/23 |
2022 Effective Dates for Requested Changes
During the annual Option Transfer Period, employees may make changes to their NYSHIP Option, including electing the Opt-out Program, if eligible. For employees enrolled in the PTCP, the annual Option Transfer Period is the time when they may request changes that will affect their biweekly premium deduction for the new plan year (for example, request to change from family coverage to individual coverage or cancel coverage altogether).
The NYBEAS benefit plan effective dates for Plan Year 2023 are:
- January 5, 2023 for employees on the Administration Payroll
- December 29, 2022 for employees on the Institution Payroll
Employees who request to enroll in NYSHIP coverage or add previously eligible dependents to existing coverage are still subject to NYSHIP’s late enrollment rules. This means that employees who request enrollment without a qualifying life event and after their 42- or 56-day waiting period will be considered late enrollees. Refer to the NYSHIP General Information Book for NY active employees for more information.
Note: Effective dates of enrollments, cancellations, and changes in coverage between 2 NYSHIP eligible employees who are married or in a domestic partnership, will be coordinated when requested by both employees within the Option Transfer Period. To ensure uninterrupted coverage, HBAs should coordinate this process by consulting with fellow HBAs and/or EBD.
NYBEAS Keying Window for Annual Option Transfer Period
During the HBA keying window that is open from December 1, 2022 through January 31, 2023, you will be able to process the following annual Option Transfer Period transactions.
NYBEAS Transactions Only Available During Annual Option Transfer Period[1]
| Action / Reason | Description | Reason to Use Transaction |
| PLN / CHG |
Benefit Plan Change during the Option Transfer Period |
Used to process an employee’s request who is already enrolled in NYSHIP and wishes to change their NYSHIP Option (to Empire Plan, a NYSHIP HMO, or the Opt-out Program). |
| CCO / OPN | Change to Individual Coverage during the Option Transfer Period | Used to process an employee’s request to change from Family coverage to Individual coverage. |
| CAN / OPN | Cancel Coverage during the Option Transfer Period | Used to process an employee’s request to voluntarily cancel their coverage. |
| TAX/CHG | Changing Enrollee’s Tax Election | Used to process an employee’s request to change their health insurance deductions to either “Pre-Tax” or “Post-Tax”. |
NYBEAS ANNUAL OPTION TRANSFER PERIOD KEYING WINDOW AND RETROACTIVITY DATES
The keying window in NYBEAS will be open to HBAs through January 31, 2023. Since the Option Transfer Period begins in December, more enrollees may experience retroactivity, with many transactions impacting pay checks in January and perhaps into February. To avoid retroactive premium adjustments, when possible, transactions must be entered by HBAs according to the schedule below:
| Payroll Cycle | Effective Date on NYBEAS | Retroactivity Cutoff Dates | First Paycheck Date | NYBEAS Annual Option Transfer Keying Window |
| Administration Lag | 1/5/23 | 12/20/22 | 1/4/23 | 12/1/22 –1/31/23 |
| Administration Current | 12/6/22 | 12/21/22 | ||
| Administration Triple Lag | 12/13/22 | 12/29/22 | ||
| Institution Lag* | 12/29/22 | 12/13/22 | 12/29/22 | |
| Institution Current* | 11/29/22 | 12/15/22 |
*Institution Payroll Cycle benefit change transactions which are effective 12/29/22 MUST be entered prior to any PTCP Election changes, which are effective 1/12/22. To avoid the need for a correction request or sending transactions to EBD, NYBEAS transactions must be processed in effective date order.
Processing NYBEAS transactions after the dates shown in the Retroactivity Cutoff Dates column will result in the enrollee having retroactive premium adjustments to their NYSHIP account. Please note all enrollees on the Institution Current payroll will be subject to retroactivity as their cutoff date is prior to Option Transfer Period beginning.
If an employee’s annual Option Transfer request results in an increase in the employee’s NYSHIP premium (for example a change to a more expensive NYSHIP Option), and the transaction is processed after the Retroactivity Cutoff Date, the employee will owe retroactive NYSHIP premiums. As a result, the employee will be subject to special deductions of up to $100 per paycheck in addition to the employee’s regular health insurance deduction amount, until the outstanding NYSHIP health insurance premium is paid in full.
If an employee’s annual Option Transfer request results in a decrease in the employee’s NYSHIP premium (for example a change to a less expensive NYSHIP Option), and the transaction is processed after the Retroactivity Cutoff Dates, the employee’s account will show an overpayment of NYSHIP premium. This overpayment will be used to reduce the next health insurance premium deduction. If the credit balance is larger than the next deduction, or no premium is owed, the employee will receive the remaining credit as a refund either in a subsequent paycheck (if enrolled in PTCP) or via a separate check (if not enrolled in PTCP) issued by the NYS Office of the State Comptroller.
When processing these transactions, HBAs should use the signature date on the
PS-404 as the request date (Option Transfer Period Dates 12/1/22 – 12/30/22). The appropriate effective date will automatically populate in NYBEAS based upon the employee’s payroll cycle.
Video tutorials and additional guidance on how to process transactions during the annual Option Transfer Period can be found in the HBA Manual and E-Learning section of HBA Online at https://www.cs.ny.gov/employee-benefits/hba/shared/e-learning/index.cfm.
MyNYSHIP for Annual Option Transfer Requests for 2023 Plan Year
Active NYS employees can submit online requests for a change of their health insurance option through MyNYSHIP (https://www.cs.ny.gov/mynyship) during the Option Transfer Period. The Option Transfer transaction will be made available for enrollees from December 1, 2022 through December 30, 2022.The majority of Option Transfers processed through MyNYSHIP will not require action on the part of HBAs, but it is important to view the NYBEAS worklists to determine if any Option Transfers have been “pended” and require approval. All other health insurance changes (including Opt-out Program election) must be submitted to the HBA for processing.
Changes for NYSHIP HMO’s
CDPHP will be changing their Prescription Benefit Manger to Capital Rx from CVS Caremark effective January 1, 2023. This will result in members enrolled in both Commercial and Medicare Advantage Plans receiving a new benefit card in early December 2022. CDPHP’s pharmacy network is not changing as a result of switching to Capital Rx. CDPHP mailed a Side-by-Side benefit comparison for plan years 2022 and 2023 to current members noting this change. Additional communications will be mailed to members in early December.
CDPHP will be changing their wellness rewards administrator to Virgin Pulse from CafeWell effective January 1, 2023. CDPHP has mailed a Side-by-Side benefit comparison for plan years 2022 and 2023 to current members noting this change.
Open Enrollment for the Young Adult Option (YAO)
The Open Enrollment period for the YAO will coincide with the annual Option Transfer Period. The YAO provides coverage to children of NYSHIP enrollees, up to age 30. For additional YAO information, employees may visit: http://www.cs.ny.gov/employee-benefits/young-adult-option/.
Ordering Plan Materials for Enrollees
Please ensure you are ordering Plan materials for enrollees changing to an HMO or the Empire Plan (not necessary if changing from one HMO to another). You may reference HBA Memo NY22-18 “Communications Plan: Option Transfer (OT) Period for 2022” regarding ordering plan materials.
If you have questions about this memo, please contact the HBA Helpline at 518-474-2780. Visit NYSHIP Online at https://www.cs.ny.gov for information on the 2023 Rates or www.cs.ny.gov/employee-benefits/hba/ to access the HBA Manual.
[1] These transactions (PLN/CHG, CCO/OPN, CAN/OPN) are especially important for employees in the PTCP. HBAs should use these transactions when processing a PTCP employee’s request in order to ensure the request change is in effect for the new plan year.