Policy/Memo 149r1

Number: Policy Memo 149r1
Date Issued: February 10, 2023
Date Revised: July 6, 2026
Subject: Eligibility Criteria for Members of Volunteer Ambulance and EMS Organizations to Participate in NYSHIP

PURPOSE:

To establish and clarify the eligibility criteria for members of volunteer ambulance and emergency medical services (EMS) organizations to participate in the New York State Health Insurance Program (NYSHIP).

Background:

Section 163(2) of the New York State Civil Service Law (CSL) provides that the President of the Department may authorize the inclusion of employees and retired employees of public authorities, public benefit corporations and other types of public entities in NYSHIP. The full list of eligible entity types is as follows:

public authorities, public benefit corporations, school districts, special districts, district corporations, municipal corporations¹ excluding active employees and retired employees of cities having a population of one million or more inhabitants whose compensation is or was before retirement paid out of the city treasury, or other appropriate agencies, subdivisions or quasi-public organizations of the state, including active members of volunteer fire and volunteer ambulance companies serving one or more municipal corporations pursuant to subdivision seven of section ninety-two-a of the general municipal law (emphasis added), and their spouses and dependent children as defined by the regulations of the president.

New York State municipal corporations which offer NYSHIP coverage to their employees may elect to offer NYSHIP coverage to active members of volunteer ambulance companies serving the municipality if the total cost of the participation for the volunteer and their family is covered by the volunteer².

Further, pursuant to CS Law Section 163(2), “Active members of volunteer ambulance companies serving one or more municipal corporations pursuant to subdivision seven of section ninety-two-a of the general municipal law shall be eligible for health benefits regardless of the amount of funds derived from public sources.”

Municipalities (e.g., Cities, Counties, Towns, Villages, etc.) are understood to be fully governmental organizations and are eligible to participate in NYSHIP as Participating Agencies (PA). Active volunteer members of ambulance and EMS organizations who serve a municipality or municipalities are eligible to participate in NYSHIP through any municipality they serve, assuming the municipality participates in NYSHIP. Participation is discretionary with the municipality.

When determining whether active volunteer members of an ambulance or EMS organizations can participate in NYSHIP through their organization, the Employee Benefits Division (EBD) will follow the criteria established in NYS General Municipal Law §100 to first determine if an organization meets the definition of “volunteer ambulance company,” which provides that the organization must:

• Be in the business of providing “ambulance services,” and;
• Not operate for financial profit or gain, and;
• Not distribute assets or income of the organization to the benefit of its members or staff, and;
• Possess a valid ambulance service certificate issued by the Department of Health.

If an entity meets the above criteria as a “volunteer ambulance company,” active volunteer members, and their dependents, may participate in NYSHIP through participation of the entity. For purposes of the policy, “active volunteer members” are defined under New York State Volunteer Ambulance Workers' Benefit Law³. Once an individual is no longer deemed an “active volunteer member” of the volunteer ambulance company, they would no longer be eligible to participate in NYSHIP. Further, there are no retiree benefits associated with a volunteer ambulance member’s NYSHIP eligibility, and the total cost of participation by such volunteers and their families is the responsibility of the volunteer.

Notwithstanding the above, volunteer members of volunteer ambulance or EMS corporations retain the ability to participate in NYSHIP through a participating municipality they serve.

Policy:

A municipality which offers NYSHIP eligibility to its employees may also extend eligibility to active members of volunteer ambulance and EMS organizations serving within the municipality’s jurisdiction. Volunteer members of ambulance and EMS corporations which act as extensions of one or more New York State municipalities may apply to join NYSHIP through the participating municipality.

Any ambulance or EMS organization applying for NYSHIP eligibility, independently of a municipality, must be evaluated to determine if they are a volunteer ambulance company as defined in NYS General Municipal Law §100. As part of the evaluation process, an ambulance or EMS company which identifies as volunteer ambulance service will be required to provide the following documentation to confirm they are a volunteer ambulance or EMS organization:

• A certificate of incorporation and bylaws.
• Most recent annual financial statements.
• Application for their EMS Operating Certificate Filed with the NYS Department of Health and associated attachments.
• A copy of a current servicing contract with a municipality.
• A current listing of active volunteer members as of the date of application.

Additionally, EBD will confirm the organization appears on the publicly posted Department of Health listing of licensed ambulance and EMS organizations. As a condition of participation in NYSHIP, an approved volunteer ambulance company may be reviewed annually to confirm they have maintained their status as a volunteer ambulance company. Failure of continued compliance will be grounds for removal from the plan.

If a volunteer ambulance or EMS organization employs paid personnel who wish to participate in NYSHIP, the organization must meet EBD’s internal eligibility criteria for a quasi-public organization in order for paid staff to be eligible to participate in NYSHIP. If approved, the organization will be admitted as a PA, and paid staff would be eligible for participation.

As a reminder, volunteer ambulance or EMS member participation in NYSHIP comes with certain requirements. In accordance with Civil Service Law Section 163.2 and NY General Municipal Law Section 92-a, Subdivision 7, active volunteer ambulance and EMS personnel participating in NYSHIP will be required to pay both the employer and employee share of the premium for coverage, whereas paid members would be entitled to an employer contribution of at least 50% of individual premium or 35% of dependent premium. Volunteer ambulance and EMS personnel who separate from service will not be eligible to continue in NYSHIP, receive retiree benefits, or COBRA benefits.

¹ Under General Municipal Law Section 92-a (1), “the term “public corporation” shall mean a municipal corporation, a district corporation, a school district, a consolidated health district and a county or town special district or a joint special district, governed by a separate board of commissioners.”
Under General Construction Law Section 66, a “municipal corporation” includes a county, city, town, village and school district.

² General Municipal Law Section 92-a (7) provides:
The provisions of this section shall permit a public corporation to provide coverage for volunteer firefighters, as defined in section three of the volunteer firefighters' benefit law, and volunteer ambulance workers, as defined in subdivision one of section three of the volunteer ambulance workers' benefit law, provided however, that the total cost of participation by such volunteers and their families shall be borne by such volunteers.

³ Under Volunteer Ambulance Workers' Benefit Law § 3 (1) “Volunteer ambulance worker” means an active volunteer member of an ambulance company as specified on a list regularly maintained by that company for the purpose of this chapter.