Graduate Student Employee Union

GSEU Benefits

Your employment-related benefits are negotiated by New York state and your bargaining unit. These are your benefits if both are true:

  • Your affiliation to UB is with the state
  • Your negotiating unit is 28
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Medical, Dental and Vision Insurance

Medical Insurance Eligibility

The University at Buffalo offers you an exceptional medical insurance plan.

As part of your benefits package, you may be eligible for medical insurance. Listed below are eligibility criteria. If you are unsure if you meet this criteria, Human Resources is available to guide you.

State Benefits

Human Resources

Phone: 716-645-7777

Email: ub-hr-benefits@buffalo.edu

Requirements

  • Appointment as a state-funded Teaching or Graduate Assistant
  • Appointment is at least one-half an assistantship
  • Minimum stipend of a total annual compensation of $4,122 or more
  • You are a domestic student, F1 or J1 visa holder

Dependent Eligibility for Medical Insurance

You may be able to add dependent(s) to your medical insurance for family coverage. Listed below is the documentation that will be required to enroll your dependent(s). If you are unable to provide one of the required documents, contact Human Resources to discuss possible alternatives.

Eligible Dependents Required Documentation to Enroll Dependent
Spouse
  • Marriage certificate
  • Birth certificate
  • Social Security card
  • Proof of joint financial obligation (if married for more than one year)
Proof of Joint Financial Obligation

Multiple documents may be used for proof of joint financial obligation including a joint tax return, mortgage or lease agreement, bill or bank account. Financial information may be blacked out.

Eligible Dependents Required Documents to Enroll Dependent

Domestic Partner

 

  • Birth certificate
  • Social Security card
  • Application For Dependent Enrollment
  • Dependent tax affidavit
Dependent Children Under Age 26
  • Birth certificate
  • Social Security card

Student Medical Insurance Waiver

As a student, you may be required to carry medical insurance. The University at Buffalo offers health insurance to students who do not have required coverage through another source. The student insurance option is a separate option from the coverage offered to you as an employee and is not administered through Human Resources.

If you enroll in the Student Employee Health Plan (SEHP) plan, you do not need to carry the student health insurance. Human Resources will send a waiver to the Student Medical Insurance Office for the duration of the time that you are enrolled in the SEHP plan. The fee will be removed from your tuition bill once the waiver is complete.

If you do not enroll in the SEHP plan but have other insurance, you must complete a waiver directly with the Student Medical Insurance Office. You may otherwise be automatically enrolled in coverage and charged on your tuition bill.

F1 and J1 Visa Holders

If you enroll in the SEHP plan, you will be automatically enrolled in Medical Evacuation and Repatriation coverage through the Student Medical Insurance office as a rider to your plan. This is mandatory coverage and the cost will be added to your tuition bill.

Medical Insurance Enrollment

New Employees

I Am a New Employee

Welcome to the University at Buffalo! Human Resources will send you an invitation to an upcoming benefit orientation upon review of your medical benefits eligibility. Your benefits eligibility is reviewed by Human Resources when your employment information is submitted by your department.

Enrollment in medical insurance is voluntary — you will not be automatically enrolled in a plan. You must attend an entire orientation session in order to enroll.

Newly eligible employees must enroll within 45 days of their appointment begin date. Coverage is effective as of your appointment begin date. If you do not attend a session and do not enroll within 42 days of your appointment begin date, you may be subject to a late enrollment period, which would delay your benefits.

Current Employees

My Other Medical Insurance Ended

Action Required Forms Required Documents Deadline to Submit Paperwork Coverage Effective Date
Enroll in Medical Insurance GSEU Health Insurance Enrollment and Change (PS-404G)
  • Letter from prior coverage provider with termination date
  • If enrolling dependents, see required documentation below
30 days from date of prior coverage termination Date of prior coverage termination

Dependent Eligibility for Medical Insurance

You may be able to add dependent(s) to your medical insurance for family coverage. Listed below is the documentation that will be required to enroll your dependent(s). If you are unable to provide one of the required documents, contact Human Resources to discuss possible alternatives.

Eligible Dependents Required Documentation to Enroll Dependent
Spouse
  • Marriage certificate
  • Birth certificate
  • Social Security card
  • Proof of joint financial obligation (if married for more than one year)
Proof of Joint Financial Obligation

Multiple documents may be used for proof of joint financial obligation including a joint tax return, mortgage or lease agreement, bill or bank account. Financial information may be blacked out.

Eligible Dependents Required Documents to Enroll Dependent

Domestic Partner

 

  • Birth certificate
  • Social Security card
  • Application For Dependent Enrollment
  • Dependent tax affidavit
Dependent Children Under Age 26
  • Birth certificate
  • Social Security card

I Want to Enroll in Medical Insurance

If you would like to enroll in medical insurance and you have not lost prior coverage within the last 30 days, you can enroll but will be subject to a waiting period of 30 days from the time you submit all required paperwork and documentation for coverage to begin.

Deductions for medical insurance will be taken on an after-tax basis. A notice with instructions will be sent out at the end of each calendar year for you to switch to pre-tax deductions for the upcoming calendar year.

Action Required Forms Required Documents Deadline to Submit Paperwork Coverage Effective Date
Enroll in Medical Insurance GSEU Health Insurance Enrollment and Change (PS-404G)

If enrolling dependents, see required documentation below

30 days from date of prior coverage termination Date of prior coverage termination

Dependent Eligibility for Medical Insurance

You may be able to add dependent(s) to your medical insurance for family coverage. Listed below is the documentation that will be required to enroll your dependent(s). If you are unable to provide one of the required documents, contact Human Resources to discuss possible alternatives.

Eligible Dependents Required Documentation to Enroll Dependent
Spouse
  • Marriage certificate
  • Birth certificate
  • Social Security card
  • Proof of joint financial obligation (if married for more than one year)
Proof of Joint Financial Obligation

Multiple documents may be used for proof of joint financial obligation including a joint tax return, mortgage or lease agreement, bill or bank account. Financial information may be blacked out.

Eligible Dependents Required Documents to Enroll Dependent

Domestic Partner

 

  • Birth certificate
  • Social Security card
  • Application For Dependent Enrollment
  • Dependent tax affidavit
Dependent Children Under Age 26
  • Birth certificate
  • Social Security card

Reappointed Employees

I Am Currently Enrolled and Have Been Reappointed

If you are reappointed to your position and you are currently enrolled in the plan, your coverage will automatically be extended based on the dates of your reappointment received by Human Resources from your department. You will not need to attend an enrollment session or submit new enrollment forms.

I Am NOT Currently Enrolled and Have Been Reappointed

Human Resources will send you an invitation to an upcoming benefit orientation upon review of your medical benefits eligibility. Your benefits eligibility is reviewed by Human Resources when your employment information is submitted by your department.

Enrollment in medical insurance is voluntary — you will not be automatically enrolled in a plan. You must attend an entire orientation session in order to enroll.

Newly eligible employees must enroll within 42 days of their appointment begin date. Coverage is effective 42 calendar days from your appointment begin date. If you do not attend a session and do not enroll within 42 days of your appointment begin date, you may be subject to a late enrollment period, which would delay your benefits.

Biweekly Cost

2017 Rates

Plan Office Co-Pay Bi-weekly Cost
Individual Family

Empire Plan (PPO)

Student Employee Health Plan (SEHP)

$10 $15.79 $95.27

Manage My Medical Insurance

Once enrolled, you may be able to make changes to your medical insurance. Choose your event from the life events listed below to find the actions to take.  

All required forms and documentation must be received in Human Resources by the listed deadline in order for the change to be made. Submit all forms and documentation to:

Human Resources
120 Crofts Hall
North Campus

State Benefits

Human Resources

Phone: 716-645-7777

Email: ub-hr-benefits@buffalo.edu

Adding Dependents

I Got Married

Action Required Forms Required Documents Deadline to Submit Paperwork Coverage Effective Date
Enroll my spouse GSEU Health Insurance Enrollment and Change (PS-404G)
  • Marriage certificate
  • Birth certificate
  • Social Security card
30 days from date of marriage
Date of marriage

I Want to Add a Domestic Partner

Action Required Forms Required Documents Deadline to Submit Paperwork Coverage Effective Date

Enroll my domestic partner

 

GSEU Health Insurance Enrollment and Change (PS-404G)

 

NYSHIP Application for Enrolling Domestic Partners (PS-425.1)

 

NYSHIP Dependent Tax Affidavit (PS-425.3)

  • Birth certificate
  • Social Security card
  • See Instructions
No deadline
Determined upon review

I Had a Child

Action Required Forms Required Documents Deadline to Submit Paperwork Coverage Effective Date
Enroll my child
GSEU Health Insurance Enrollment and Change (PS-404G)
  • Birth certificate
  • Social Security card
30 days from date of birth
Date of birth  

My Dependent Lost His or Her Coverage

Action Required Forms Required Documents Deadline to Submit Paperwork Coverage Effective Date
Enroll my spouse
GSEU Health Insurance Enrollment and Change (PS-404G)
  • Marriage certificate
  • Social Security card
  • Birth certificate
  • Proof of joint financial obligation
  • Letter from prior coverage provider with termination date   
30 days from date of prior coverage termination
Date of prior coverage termination  
Proof of Joint Financial Obligation

Multiple documents may be used for proof of joint financial obligation including a joint tax return, mortgage or lease agreement, bill or bank account. Financial information may be blacked out.

Action Required Forms Required Documentation Deadline to Submit Paperwork Coverage Effective Date
Enroll my child GSEU Health Insurance Enrollment and Change (PS-404G)
  • Social Security card
  • Birth certificate
  • Letter from prior coverage provider with termination date   
30 days from date of prior coverage termination Date of prior coverage termination
Action Required Forms Required Documentation Deadline to Submit Paperwork Coverage Effective Date

Enroll my domestic partner

 

GSEU Health Insurance Enrollment and Change (PS-404G)

 

NYSHIP Application for Enrolling Domestic Partners (PS-425.1)

 

NYSHIP Dependent Tax Affidavit (PS-425.3)

  • Birth certificate
  • Social Security card
  • See Instructions
  • Letter from prior coverage provider with termination date
30 days from date of prior coverage termination Date of prior coverage termination

My Dependent Arrived in the United States

Action Required Forms Required Documents Deadline to Submit Paperwork Coverage Effective Date
Enroll my spouse

GSEU Health Insurance Enrollment and Change (PS-404G)

  • Marriage certificate
  • Social Security card
  • Birth certificate
  • Proof of joint financial obligation
  • Copy of arriving plane ticket 
30 days from date of arrival
Date of arrival 
Proof of Joint Financial Obligation

Multiple documents may be used for proof of joint financial obligation including a joint tax return, mortgage or lease agreement, bill or bank account. Financial information may be blacked out.

Action Required Forms Required Documents Deadline to Submit Paperwork Coverage Effective Date
Enroll my child

GSEU Health Insurance Enrollment and Change (PS-404G)

  • Social Security ard
  • Birth certificate
  • Copy of arriving plane ticket
30 days from date of arrival Date of arrival
Action Required Forms Required Documents Deadline to Submit Paperwork Coverage Effective Date

Enroll my domestic partner

 

GSEU Health Insurance Enrollment and Change (PS-404G)

 

NYSHIP Application for Enrolling Domestic Partners (PS-425.1)

 

NYSHIP Dependent Tax Affidavit (PS-425.3)

  • Birth Certificate
  • Social Security Card
  • see Instructions
  • Copy of arriving plane ticket
30 days from date of arrival Date of arrival

Removing Dependents

I Want To Add a Dependent

I Am Changing from Individual to Family Coverage

If you want to change from individual to family coverage and one of the above events does not apply, you may still change but there will be a waiting period for benefits for your dependent. In addition, your deductions for health insurance will be after tax. 

Action Required Forms Required Documents Deadline to Submit Paperwork Coverage Effective Date
Enroll my spouse
GSEU Health Insurance Enrollment and Change (PS-404G)
  • Marriage certificate
  • Social Security card
  • Birth certificate
  • Proof of joint financial obligation
Prior to desired date of enrollment
30 days from date forms and documentation received
Enroll my child GSEU Health Insurance Enrollment and Change (PS-404G)
  • Social Security card
  • Birth certificate
Prior to desired date of enrollment 30 days from date forms and documentation received
Proof of Joint Financial Obligation

Multiple documents may be used for proof of joint financial obligation including a joint tax return, mortgage or lease agreement, bill or bank account. Financial information may be blacked out.

I Am Already Enrolled In Family Coverage

Action Required Forms Required Documents Deadline to Submit Paperwork Coverage Effective Date
Enroll my spouse
GSEU Health Insurance Enrollment and Change (PS-404G)
  • Marriage certificate
  • Social Security car
  • Birth certificate
  • Proof of joint financial obligation
Prior to desired date of enrollment
Determined upon review
Enroll my child GSEU Health Insurance Enrollment and Change (PS-404G)
  • Social Security card
  • Birth certificate
Prior to desired date of enrollment Determined upon review

I Got Legally Separated or Divorced

Action Required Forms Required Documents Deadline to Submit Paperwork Coverage Effective Date
Remove my spouse GSEU Health Insurance Enrollment and Change (PS-404G)

Legal separation or divorce documentation

30 days from date of separation or divorce
Date of separation or divorce

My Dependent Enrolled in Other Coverage

Action Required Forms Required Documents Deadline to Submit Paperwork Coverage Effective Date
Remove my dependent(s)
GSEU Health Insurance Enrollment and Change (PS-404G)

Letter from new coverage provider stating effective date of coverage

30 days from new coverage effective date
Date new coverage begins

My Dependent Left the United States

Action Required Forms Required Documents Deadline to Submit Paperwork Coverage Effective Date
Remove my dependent(s) GSEU Health Insurance Enrollment and Change (PS-404G)

Copy of arriving plane ticket(s)

30 days from arrival in new country
Date of arrival in new country

I Want to Remove My Domestic Partner

Action Required Forms Required Documents Deadline to Submit Paperwork Coverage Effective Date
Remove my domestic partner

GSEU Health Insurance Enrollment and Change (PS-404G)

 

NYSHIP Termination of Domestic Partnership (PS-425.4)

 None No deadline
Determined upon review

I Want to Remove a Dependent

I Want to Change from Family to Individual Coverage

If you want to change from family to individual coverage and one of the above events does not apply, you cannot change your health insuranance. 

I Will Maintain Family Coverage

Action Required Forms Required Documents Deadline to Submit Paperwork Coverage Effective Date
Remove my dependent
GSEU Health Insurance Enrollment and Change (PS-404G)

None

Prior to desired date of coverage termination
Determined upon review

Cancelling Coverage

I Enrolled in Other Coverage

Action Required Forms Required Documents Deadline to Submit Paperwork Coverage Termination Date
Cancel my enrollment

GSEU Health Insurance Enrollment and Change (PS-404G)

Letter from new coverage provider stating effective date of coverage

30 days from new coverage effective date
Date new coverage begins

I Am On a Leave Without Pay

Action Required Forms Required Documents Deadline to Submit Paperwork Coverage Termination Date
Cancel my enrollmen
t

GSEU Health Insurance Enrollment and Change (PS-404G)

Documentation stating effective date of leave without pay

30 days from start date of leave Date leave began

I Want to Cancel My Coverage

If you want to cancel your coverage and one of the above events does not apply, you cannot change your health insurance. 

Coverage Termination

Medical insurance coverage ends two full payperiods following your appointment end date.

The Department of Civil Service, Employee Benefits Division, will send information regarding COBRA to your home address after your coverage has terminated. COBRA is a federal law that allows the voluntary continuation of the same coverage at full cost.

Contact the Employee Benefits Division at 800-833-4344 with questions regarding COBRA continuation of coverage.

Monthly COBRA Cost

2016 Rates

Plan Office Co-Pay Monthly Cost
Individual Family

Empire Plan (PPO)

Student Employee Health Plan (SEHP)

$10 $255.95 $817.88

Dental and Vision Coverage

Dental and vision coverage is provided in addition to your medical insurance. Benefits take effect as of your appointment begin date. The cost is included in your medical insurance biweekly deduction. You must enroll in medical, dental and vision benefits together.

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