The City University of New York NYS HEALTH INSURANCE PROGRAM NYSHIP Student Employee Health Plan...

The City University of New York

NYS HEALTH INSURANCE PROGRAMNYSHIP

Student Employee Health Plan (SEHP)

Office of Human Resources Management

University Benefits

Updated 12/10/09 The University Benefits Office 2

ELIGIBILITY

TO BE ELIGIBLE FOR NYSHIP BENEFITS YOU MUSTMEET ALL OF THE FOLLOWING CRITERIA:

Enrolled in a Doctoral Program at the CUNY Graduate Center or the Engineering Ph.D. Program at City College

AND Appointed to an eligible title at a Senior College

(Graduate Assistant A, B, C, Adjunct Instructor, Adjunct Lecturer, Adjunct College Laboratory Technician And Non- Teaching Adjunct I, II)

AND Make a minimum $4,122 per year or $2,061 per

semester


ENROLLMENT

Complete the Health Benefits Enrollment Form (PS-404G) and submit it along with supporting documentation to:

For students at the CUNY Graduate Center: Scott Voorhees – Office of Student Affairs, Room 7301Phone number 212.817.7406

For students at City College: Kim Ferguson - Benefit Officer, Shepard Hall Room 50Phone number 212.650.7963

NOTE: Refer to the “SEPH Eligibility Requirements” sheet for list of required documentation:

www.cuny.edu/doctoralstudenthealthplan


ENROLLMENT… (Cont’d)

YOU MAY ENROLL IN NYSHIP BENEFITS:

Within 45 days of your appointment - Late enrollments will be subject to a 30-day waiting period

Within 30 days of a qualifying event Within 30 days following involuntary loss of other

coverage .

During the Annual Open Enrollment Period – November 1st – November 30th

*Note: Employees of the CUNY Research Foundation are not eligible for these benefits


EFFECTIVE DATE OF COVERAGE

Coverage for you and your eligible dependents will be effective on the date of your appointment

Note: Services provided outside of the USA are treated as out-of network services. You must complete a claim form to obtain reimbursement.

Download this claim form at:http://www.cs.state.ny.us/ebd/ebdonlinecenter/pof/images/OutOfStateForm.pdf


INSURANCE CARDS

You should expect to receive your insurance card within 3-4 weeks following your enrollment

You will receive 3 cards separately by mail:

Medical/Hospitalization Dental Vision Care

Note: In case of an emergency, the carrier may use your SSN or NYSHIP card number to verify your coverage. Contact the University Benefits Office at 212-794-5342 if you need to obtain your NYSHIP card number.


ELIGIBLE DEPENDENTS

Spouse Domestic Partner Dependent Children - Up to age 19 (natural

children, adopted children, dependent step children)

Disabled Dependents

Notes: Refer to the “SEHP Eligibility Requirements” on the

CUNY website for a list of required documentation

www.cuny.edu/doctoralstudenthealthplan

[Parents are not considered eligible dependents]


NYSHIP BENEFITS PROVIDERS

Medical Benefit – UnitedHealthCare Hospital Benefit - Empire BlueCross

BlueShield Dental Benefit – GHI Vision Care Benefit – EyeMed Prescription Drug Benefit -

UnitedHealthCare / Medco Health Solutions Mental Health/Substance Abuse Benefit -

UnitedHealthCare / OptumHealth


NYSHIP BIWEEKLY PREMIUM RATES

[AS OF JANUARY 2010]

INDIVIDUAL - $6.32 PER PAY PERIOD

FAMILY - $47.36 PER PAY PERIOD

Pre-tax bi-weekly health insurance premiums will be automatically deducted from your paycheck

You may elect to have post-tax health insurance premium deduction by completing the appropriate section on the Health Benefits Enrollment Form


CHANGES TO COVERAGE

You may make changes to your coverage:

Within 30 days of a Qualifying Event

During the Annual Open Enrollment Period


QUALIFYING EVENTS

Marriage

Birth of a child

Becoming a child’s legal guardian, step-parent or adoptive parent

Arrival of an eligible dependent to the United States

Completion of the six month waiting period for attainment of Domestic Partner Status


ANNUAL OPEN ENROLLMENT PERIOD

Generally held in November. For calendar year 2009 it is November 1st - November 30th.

During the annual open enrollment period you may:

Enroll in health benefits Change from individual to family coverage Change from family to individual coverage Add eligible dependents without 30-day

waiting period


CHANGES TO TAX STATUS FOR PREMIUM DEDUCTION

OPTION TRANSFER PERIODGenerally held in November

For calendar year 2009 it is November 1st- November 30th

You may change from pre-tax to post tax status

You may change from post-tax to pre-tax status


TERMINATION OF COVERAGE

Coverage will cease when you no longer meet both of the requirements indicated below:

1. Enrolled in a Doctoral Program at the CUNY Graduate Center or in the Engineering Ph.D. Program at City College

AND

2. Appointed in an eligible title (Graduate Assistant A, B, C, Adjunct Instructor, Adjunct Lecturer, Adjunct College Laboratory Technician And Non- Teaching Adjunct I, II)


TERMINATION OF COVERAGE… (Cont’d)

Coverage will terminate two pay periods following your graduation, leave from the doctoral program or appointment end date, which ever comes first.

You must notify the University Benefits Office immediately once you no longer meet the eligibility requirements. Otherwise, it may result in unanticipated cost to you.


CONSOLIDATED OMNIBUS BUDGET RECONCILIATION ACT OF 1985 (COBRA)

NOTIFICATION

Under COBRA you and your dependents may continue group health coverage at a monthly premium of 102% of the group rate. The maximum period of coverage will vary depending on the reason for continuation.

The COBRA application process begins once the University Benefits Office is notified of your loss of eligibility. The NYS Department of Civil Service will send a COBRA package to your home address once the University Benefits Office has terminated your NYSHIP benefits.


COBRA APPLICATION

Complete and return the COBRAenrollment application to the addressindicated on the COBRA application

formon a timely basis

NOTE: Effective January 2010 dependent child coverage is extended through age 29


COBRA MONTHLY PREMIUM RATES

[AS OF OCTOBER 2009]

INDIVIDUAL - $120.43

FAMILY - $514.59 You will receive a monthly bill from the NYS

Department of Civil Service for your COBRA premium payments

You may be eligible for The American Recovery and Reinvestment Act of 2009 – The ARRA provides for COBRA premium assistance for you and your covered dependents who have a continuation of coverage election opportunity related to an involuntary termination of employment that occurred during the period September 1, 2008 through February 28, 2010


DEPENDENT CHILD ELIGIBILITY

A recently enacted NYS Law has extended dependent child eligibility through age 29

Coverage for young adults dependents will be “COBRA-like”:

Charged at the Full Share Individual Rate

Each dependent will enroll in their own individual policy


TO FIND A LIST OF PARTICIPATING PROVIDERS…

Medical - www.empireplanproviders.com

Dental - www.ghi.com

Vision Care - EyeMed 1-877-226-1412

General Information - 1-877-7-NYSHIP


FILL OUT A NYSHIP TRANSFER FORM (NYSHIP001 TRF-UBO) IF YOU ARE:

Transferring to a new college

Changing title

Both transferring and changing title

DOWNLOAD THE FORM FROM:http://www.cuny.edu/administration/ohrm/university-benefits/

dshp.html

TRANSFERS


ONLINE HOME ADDRESS CHANGE

To update your home address online:

Go directly to www.cs.state.ny.us/mynyship Choose a Civil Service ID and password You will receive an Activation Code in the mail

within 3 to 5 business days .

Once you receive your Activation Code, return to MyNYSHIP and log in with the Civil Service ID and password

Then go to Employee Self Service and update your home address


If you are working at a CUNY Community College, contact the Student Affairs Office at the Graduate Center to be transferred to the Graduate Center payroll

COMMUNITY COLLEGES


PSC/CUNY WELFARE FUND ADJUNCT HEALTH INSURANCE

If you are eligible for NYSHIP coverage, you will no longer be eligible for adjunct health insurance through the PSC/CUNY Welfare Fund


SUMMER COVERAGE

Graduate Assistants - Coverage continues for all who remain on payroll and receive paychecks during the months of June, July and August

Adjunct Instructor, Adjunct Lecturer, Adjunct College Laboratory Technician and Non- Teaching Adjunct I, II - Coverage continues if: a) you have or are expected to have a Fall 2010 appointment; and b) you prepay premiums to cover health insurance deductions for the summer months in which you are not expected to receive a paycheck


CONTACTS

Scott Voorhees – Office of Student Affairs, Room 7301, Phone number 212.817.7406

Kim Ferguson – City College Benefit Officer, Shepard Hall Room 50, Phone number 212.650.7963

You may also contact the University Benefits Office at 212.794.5342 or [email protected]

You may contact NYSHIP at 1-877-7-NYHSIP

The City University of New York NYS HEALTH INSURANCE PROGRAM NYSHIP Student Employee Health Plan...

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