NYSHIP UPDATE

NYSHIP INFORMATION 10/19/11:

The Special Option Transfer Period that is occurring from September 29 - October 31, 2011, will allow employees to make changes to their health insurance, if they so desire.  This could be moving from an HMO to the Empire Plan, etc.

The Opt Out or Buy Out in which employees will receive $1,000 if they had individual coverage or $3,000 if they had family coverage, if they have proof of other insurance, will not occur until after 1/1/12.  In order to be eligible to receive the buy out, employees must have been insured through the state continuously from 4/1/11 until the buy out period.  If any employee drops their state insurance before the buy out period, they will not be eligible to receive the buy out.

Also, any State employee who retired from 1983 through 12/31/11, will pay a 2% increase on their health insurance.

The extended collective bargained changes effective October 1, 2011 results in premium contribution increases.  This change resulted in enrollees being responsible for an additional 6% of the total health insurance premium contributions.  Enrollees with individual coverage (above a grade 10) are now required to pay 16% of the individual premium (was 10%); enrollees with family coverage (above a grade 10) are now required to pay 31% of the dependent portion of premium (was 25%).

The increase in premium contribution affects all NYSHIP Options (The Empire Plan and various Health Maintenance Organizations), however, the increase varies by plan due to many factors.

Effective October 1, 2011, for grade 10 and above, New York State will contribute 84% toward the individual coverage and 69% toward the dependent portion of the Empire Plan premium.

For enrollees in an HMO, there is an added twist to New York State's contribution which makes comparison of HMO premiums more difficult.  New York State's contribution to the HMO premium (hospital, medical, mental health/substance abuse components) is capped at the State's dollar contribution for the same components under the Empire Plan.  The HMO prescription drug premium component is not capped at the Empire Plan contribution; prescription drug component is paid 84% for individual and 69% for dependent (no cap).

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