State Employees Can Change Health Insurance Carriers Or Opt Out Through December 18

Republished December 17, 2015

Insurance carriers announce changes for 2016. State employees can make allowed changes to health insurance from 11/18/2015 through 12/18/15.  

In this article:

Eligibility

Active state employees (not retirees) who are enrolled in the  NY State Health Insurance Program (NYSHIP) are eligible to transfer health care options or cancel insurance.

No Change? No action is required from you

Want to Continue Opting Out of Health Insurance?

Renew Your Opt-Out

Summary Of Health Benefit Changes

Changes will go into effect Friday, 1/1/2016.

Blue Cross/Blue Shield of Western New York (BC/BS WNY)

Plan Benefit Change
2015 2016
Copay office visit $15.00 $20.00
Prenatal visit — initial $15.00 $20.00
Outpatient surgery — Hospital $75.00 $100.00
Outpatient surgery — Outpatient facility $50.00 $100.00
Urgent care facility $50.00 $35.00
Durable medical equipment 20% coinsurance 50% coinsurance
Diabetic supplies $15.00/item $20.00/item
Insulin and oral agents $15.00/item $20.00/item
Prescription Drugs Retail 2015 2016
Tier one $5.00 $5.00
Tier two $25.00 $30.00
Tier three $40.00 $60.00
Prescription Drugs Mail Order 2015 2016
Tier one $12.50 $12.50
Tier two $62.50
$75.00
Tier three $100.00 $150.00

Empire Plan

Plan Benefit Change
2015 2016
Outpatient Drug or Alcohol Rehab No copayment $20.00/visit

Independent Health

Plan Benefit Change
2015 2016
Urgent Care in service area for after-hours care $50.00/visit $35.00/visit

Health Insurance Premium Rates Compared For 2015 and 2016 By Negotiating Unit

CSEA, PEF, PBANYS and NYSCOPBA Represented Employees

Salary Grade 9 and Below

  Empire Blue Cross Blue Shield of WNY Independent Health
Year
Individual Family Individual Family Individual Family
2015
$35.42 $149.56 $36.40 $157.04 $32.24 $137.86
2016
$37.50 $161.62 $33.94 $146.25 $38.43 $147.07

Salary Grade 10 and above

  Empire Blue Cross Blue Shield of WNY Independent Health
Year
Individual Family Individual Family Individual Family
2015
$47.23 $178.28 $48.52 $187.04 $42.98 $164.25
2016
$50.01 $192.52 $45.26 $174.21 $49.73 $175.24

UUP Represented Employees

Salary Less Than $41,756

  Empire Blue Cross Blue Shield of WNY Independent Health
Year
Individual Family Individual Family Individual Family
2015
$35.42 $149.56 $36.40 $157.04 $32.24 $137.86
2016
$37.50 $161.62 $33.94 $146.25 $38.43 $147.07

Salary Greater Than $41,755

  Empire Blue Cross Blue Shield of WNY Independent Health
Year
Individual Family Individual Family Individual Family
2015
$47.23 $178.28 $48.52 $187.04 $42.98 $164.25
2016
$50.01 $192.52 $45.26 $174.21 $49.73 $175.24

Management Confidential (M/C) Designated Employees

Salary Less Than $41,756

  Empire Blue Cross Blue Shield of WNY Independent Health
Year
Individual Family Individual Family Individual Family
2015
$35.42 $149.56 $36.40 $157.04 $32.24 $137.86
2016
$37.50 $161.62 $33.94 $146.25 $38.43 $147.07

Salary Greater Than $41,755

  Empire Blue Cross Blue Shield of WNY Independent Health
Year
Individual Family Individual Family Individual Family
2015
$47.23 $178.28 $48.52 $187.04 $42.98 $164.25
2016
$50.01 $192.52 $45.26 $174.21 $49.73 $175.24

Health Insurance Carriers

Check with the insurance carrier directly if you have questions about coverage.

Health Insurance Carrier Contact Information

Insurance Carrier
Contact
Empire Plan www.cs.ny.gov.ebd
1-877-769-7447
Blue Cross Blue Shield of Western New York www.bcbswny.com
716-887-8840
Independent Health Association (HMO) www.independenthealth.com
800-501-3439

How To Make Allowable Changes

Changing Insurance Carriers

  1. Download the NY State Health Program (NYSHIP) Enrollment and Change form (PS 404)
  2. Print the form
  3. Complete all the information in items 1-9
  4. Select your change option in item 1 — if you choose HMO, enter Independent Health or BC/BS in the Name field
  5. Sign the form
  6. Make a copy for your own records
  7. Send the form to:

Benefits
120 Crofts Hall
North Campus
Attn: Christine Williams
 

Deleting Dependent(s) From Your Coverage

  1. Download the NY State Health Program (NYSHIP) Enrollment and Change form (PS 404)
  2. Print the form
  3. Complete all the information in items 1-9
  4. In Item 10:
    1. Enter each dependent's name you want to cancel
    2. Select D for delete
    3. Choose M, D and/or V for Medical, Dental and/or Vision to cancel
  5. In Item 12, choose a reason for the change — enter Option Transfer in Other
  6. Sign the form
  7. Make a copy for your own records
  8. Send the form to:

Benefits
120 Crofts Hall
North Campus
Attn: Christine Williams
 

Opting Out Of Your Insurance Coverage

  1. Download the NY State Health Program (NYSHIP) Enrollment and Change form (PS 404)
  2. Print the form
  3. Complete all the information in items 1-9
  4. In Item 13 select either Individual or Family to opt out
  5. Sign the form
  6. Download the NY State Opt Out Attestation form (PS 409)
  7. Complete the information requested
  8. Sign the form
  9. Make a copy of each form for your own records
  10. Send the forms together to:

Benefits
120 Crofts Hall
North Campus
Attn: Christine Williams

Making Other Insurance Changes

Other changes that are based on life events, such as marriage, can only be made when the event occurs.  

Contact an Expert About Submitting Changes