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
NY24-25
TO: New York State Health Benefits Administrators
FROM: Employee Benefits Division
SUBJECT: 2025 Annual Option Transfer and Pre-Tax Contribution Program Election Period
DATE: November 27, 2024
Annual Option Transfer Period and Pre-Tax Contribution Program Dates
The 2025 Option Transfer and Pre-Tax Contribution Program (PTCP) Election Period for New York State employees is November 29, 2024, through December 31, 2024. 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 through MyNYSHIP by December 31, 2024. 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. 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. 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 plans. Notification delays of loss of other employer-sponsored coverage will result in a late enrollment waiting period when requesting NYSHIP coverage. Enrollees will be required to repay Opt-out incentive payments provided to them after the date of cancellation of their other employer-sponsored coverage.
2024/2025 Opt-out Incentive Payment Dates
Please refer to the chart below for the final 2024 incentive payment and first 2025 incentive payment dates, in accordance with each payroll cycle.
| Employee's Payroll Cycle | Last Paycheck with 2024 Opt-out Payment |
First Paycheck with 2025 Opt-out Payment |
| Administration Lag | 12/18/24 | 12/31/24 |
| Administration Current | 12/04/24 | 12/18/24 |
| Institution Lag | 12/12/24 | 12/26/24 |
| Institution Current | 11/27/24 | 12/12/24 |
| Triple Lag | 12/26/24 | 01/09/25 |
2025 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 when they may request changes that will affect their biweekly premium deduction for the new plan year, for example, changing from family coverage to individual coverage or canceling coverage altogether.
The NYBEAS benefit plan effective dates for Plan Year 2025 are:
- January 2, 2025, for employees on the Administration Payroll
- December 26, 2024, 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 28-day waiting period will be considered late enrollees. Refer to the NYSHIP General Information Book for NY active employees for more information.
Effective dates of enrollments, cancellations, and changes in coverage between two 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 (open from November 29, 2024, through January 31, 2025), you can process the following 2025 Option Transfer Period transactions.
NYBEAS Transactions Only Available During Annual Option Transfer Period1
| Action / Reason | Description | Reason to Use Transaction |
| PLN / CHG | Benefit Plan Change during the Option Transfer Period | 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 | Process an employee’s request to change from Family coverage to Individual coverage. |
| CAN / OPN | Cancel Coverage during the Option Transfer Period | Process an employee’s request to voluntarily cancel their coverage. |
| TAX/CHG | Changing Enrollee’s Tax Election | Process an employee’s request to change their health insurance deductions to either “Pre-Tax” or “Post-Tax”. |
1These 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.
NYBEAS ANNUAL OPTION TRANSFER PERIOD KEYING WINDOW AND RETROACTIVITY DATES
The keying window in NYBEAS will be open to HBAs through January 31, 2025. Since the Option Transfer Period begins in December, more enrollees may experience retroactivity, with many transactions impacting pay checks in January and February. To avoid retroactive premium adjustments, 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 |
1/2/25 |
12/17/24 | 12/31/24 | 11/29/24 –1/31/25 |
| Administration Current | 12/3/24 | 12/18/24 | ||
| Administration Triple Lag | 12/24/24 | 1/9/25 | ||
| Institution Lag* |
12/26/24 |
12/10/24 | 12/26/24 | |
| Institution Current* | 11/26/24 | 12/12/24 |
*Institution Payroll Cycle benefit change transactions effective December 26, 2024, MUST be entered prior to any PTCP Election changes, effective January 9, 2025. To avoid 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 retroactive premium adjustments to the enrollee’s NYSHIP account. All enrollees on the Institution Current payroll will be subject to retroactivity as the cutoff date is prior to the beginning of the Option Transfer Period.
If an 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. The employee will be subject to deductions 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 if not enrolled in PTCP in a separate check 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 11/29/24 – 12/31/24). The appropriate effective date will automatically populate in NYBEAS based upon the employee’s payroll cycle.
Additional guidance on how to process transactions during the annual Option Transfer Period can be found in the HBA Manual.
MyNYSHIP for Annual Option Transfer Requests for 2025 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 November 29, 2024, through December 31, 2024. The majority of Option Transfer transactions processed through MyNYSHIP will not require action on the part of HBAs, but you must view the NYBEAS worklists to determine if any have been “pended” and require approval. All other health insurance changes including Opt-out Program election must be submitted to the HBA for processing.
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) through HBA Online.
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/employee-benefits/login/ for information on the 2025 Rates or www.cs.ny.gov/employee-benefits/hba/ to access the HBA Manual.