NY State Public Employees Federation

PEF 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 is with the state
  • Your negotiating unit is 05
Not Your Union?

Return to My Benefits.

Medical, Dental and Vision

Medical Insurance Eligibility

The University at Buffalo offers a variety of medical insurance options to suit your needs.

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.

Nadine Burns

Health Benefits Administrator

State Benefit Services

Phone: 716-645-4471

Email: nmburns@buffalo.edu

Full Time Appointments

  • Appointment must be for at least six complete biweekly pay periods
  • Must be paid salaried or hourly

Part Time Appointments

  • Appointment must be for at least six complete biweekly pay periods
  • Must be paid salaried or hourly
  • FTE must be equal to or greater than .50

 

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

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 a certain number of days (depends on Union or Group) of their appointment begin date. If you do not attend a session and do not enroll within the specified period of time after your appointment begin date, you may be subject to a late enrollment period, which would delay your benefits.

  • CSEA - Civil Service Employees Association: coverage is effective 42 calendar days from your appointment begin date
  • M/C Classified: coverage is effective 56 calendar days from your appointment begin date
  • M/C Professional: coverage is effective 56 calendar days from your appointment begin date
  • NYSCOPBA - NY State Correctional Officers and Police Benevolent Associaiton, Inc.: coverage is effective 56 calendar days from your appointment begin date
  • PBANYS - Police Benevolent Association of NY State, Inc.: coverage is effective 56 calendar days from your appointment begin date
  • PEF - NY State Public Employees Federation: coverage is effective 56 calendar days from your appointment begin date
  • UUP - United University Professions: coverage is effective 42 calendar days from your appointment begin date

Questions Regarding Benefits Orientation

Nancy Kacala

State Benefit Services

Phone: 716-645-4440

Email: kacala@buffalo.edu

Current Employees

My Other Medical Insurance Ended

Action Required Forms Required Documents Deadline to Submit Paperwork Coverage Effective Date
Enroll in Medical Insurance NYSHIP Health Insurance Enrollment or Change Form (PS-404)
  • 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 5 full pay periods (at least 10 weeks) 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 NYSHIP Health Insurance Enrollment or Change Form (PS-404)

If enrolling dependents, see required documentation below

30 days from date of prior coverage termination 5 full pay periods (at least 10 weeks) from the date all paperwork and documentation is received

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

Transferring Employees

I Am Changing Unions (Negotiating Units)

Contact Human Resources to verify if there will be any changes in your coverage:

Amy Myszka

Director

Benefits and Work Life Balance

Phone: 716-645-5357

Email: amyszka@buffalo.edu

I Am Transferring From Another State Employer

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 or continuation of 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 a certain number of days (depends on Union or Group) of their appointment begin date. If you do not attend a session and do not enroll within the specified period of time after your appointment begin date, you may be subject to a late enrollment period, which would delay your benefits.

  • CSEA - Civil Service Employees Association: coverage is effective 42 calendar days from your appointment begin date
  • M/C Classified: coverage is effective 56 calendar days from your appointment begin date
  • M/C Professional: coverage is effective 56 calendar days from your appointment begin date
  • NYSCOPBA - NY State Correctional Officers and Police Benevolent Associaiton, Inc.: coverage is effective 56 calendar days from your appointment begin date
  • PBANYS - Police Benevolent Association of NY State, Inc.: coverage is effective 56 calendar days from your appointment begin date
  • PEF - NY State Public Employees Federation: coverage is effective 56 calendar days from your appointment begin date
  • UUP - United University Professions: coverage is effective 42 calendar days from your appointment begin date

Questions Regarding Benefits Orientation

Nancy Kacala

State Benefit Services

Phone: 716-645-4440

Email: kacala@buffalo.edu

Biweekly Cost

2017 Rates

Grade 9 and Below

Plan Office Co-Pay Bi-weekly Cost
Individual Family
Empire Plan (PPO) $20 $39.91 $175.53
BlueCross BlueShield of WNY (HMO) $20 $36.12
$155.52
Independent Health Association (HMO) $20 $36.33 $155.04

Grade 10 and Above

Plan Office Co-Pay Bi-weekly Cost
Individual Family
Empire Plan (PPO) $20 $53.21 $208.92
BlueCross BlueShield of WNY (HMO) $20 $48.16
$185.25
Independent Health Association (HMO) $20 $48.44 $184.73

The Opt-Out Program

If you have coverage under another employer-sponsored health insurance program, you may be eligible for an incentive payment if you opt-out of your (New York State Health Insurance Program) NYSHIP coverage.

The annual incentive payment is $1,000 for opting out of individual coverage or $3,000 for opting out of family coverage. The payment is considered taxable income and prorated and reimbursed in your biweekly paycheck throughout the year.

Eligibility

  • You must be covered under an employer-sponsored group health insurance plan through other employment of your own or a plan that your spouse, domestic partner or parent has as the result of his or her employment.
  • The other coverage may not allow you to opt out if it is NYSHIP coverage provided through employment with another state employer.
  • NYSHIP coverage through another employer, such as a municipality, school district or public benefit corporation, qualifies as other coverage.

Enrollment

  • You may be eligible to enroll when you are newly eligible for NYSHIP coverage. Human Resources can assist with enrollment during your benefits orientation.
  • If you do not opt-out within a specified period from your appointment begin date (varies by union or group), you will no longer be eligible based on new employment.
    • CSEA - Civil Service Employees Association: 42 calendar days from your appointment begin date
    • M/C Classified: 56 calendar days from your appointment begin date
    • M/C Professional: 56 calendar days from your appointment begin date
    • NYSCOPBA - NY State Correctional Officers and Police Benevolent Associaiton, Inc.: 56 calendar days from your appointment begin date
    • PBANYS - Police Benevolent Association of NY State, Inc.:  56 calendar days from your appointment begin date
    • PEF - NY State Public Employees Federation:  56 calendar days from your appointment begin date
    • UUP - United University Professions:  42 calendar days from your appointment begin date
  • You may be eligible to enroll during the Option Transfer period if you were enrolled in NYSHIP by April 1 of the prior plan year and remained enrolled through the end of that plan year.
Option Transfer Period

Each year New York state employees can change medical plans for the next calendar year.

The Option Transfer Period occurs over a specific period of time.

Except under very limited circumstances, this is the only time an employee is allowed to change plans.

Enrollment in the opt-out program does not continue automatically from year to year. You must enroll during each Option Transfer period and attest to having other coverage for the coming plan year.

Managing My Medical Insurance

Once enrolled, you may be able to make changes to your medical insurance. Listed below are events that allow you to make changes to your plan.

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.

Nadine Burns

Health Benefits Administrator

State Benefit Services

Phone: 716-645-4471

Email: nmburns@buffalo.edu

Adding Dependents

Look Up Eligibility Requirements For Dependents

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 Got Married

Action Required Forms Required Documents Deadline to Submit Paperwork Coverage Effective Date
Enroll my spouse NYSHIP Health Insurance Enrollment or Change Form (PS-404)
  • 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

 

NYSHIP Health Insurance Enrollment or Change Form (PS-404)

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

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 Had a Child

Action Required Forms Required Documents Deadline to Submit Paperwork Coverage Effective Date
Enroll my child
NYSHIP Health Insurance Enrollment or Change Form (PS-404)
  • 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 NYSHIP Health Insurance Enrollment or Change Form (PS-404)
  • Marriage certificate
  • Birth certificate
  • Social Security card
  • 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 Documents Deadline to Submit Paperwork Coverage Effective Date
Enroll my child
NYSHIP Health Insurance Enrollment or Change Form (PS-404)
  • Birth certificate
  • Social Security card
  • Letter from prior coverage provider with termination date
30 days from date of prior coverage termination Date of birth  
Action Required Forms Required Documents Deadline To Submit Paperwork Coverage Effective Date

Enroll my domestic partner

 

NYSHIP Health Insurance Enrollment or Change Form (PS-404)

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 30 days from 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

NYSHIP Health Insurance Enrollment or Change Form (PS-404)

  • 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

NYSHIP Health Insurance Enrollment or Change Form (PS-404)

  • Social Security card
  • 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

NYSHIP Health Insurance Enrollment or Change Form (PS-404)


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

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. You may change the after-tax deduction during the option transfer period to take effect beginning in January of the next year.

Option Transfer Period

Near the end of every year, New York state employees can change medical plans for the next calendar year.

This Option Transfer Period lasts a specific period of time and is the only time you are allowed to change plans without a qualifying life event.

Action Required Forms Required Documents Deadline to Submit Paperwork Coverage Effective Date
Enroll my spouse
NYSHIP Health Insurance Enrollment or Change Form (PS-404)
  • Marriage certificate
  • Social Security card
  • Birth certificate
  • Proof of joint financial obligation
Prior to desired date of enrollment
5 full pay periods from date forms and documentation received
Enroll my child NYSHIP Health Insurance Enrollment or Change Form (PS-404)
  • Social Security card
  • Birth certificate
Prior to desired date of enrollment 5 full pay periods from date forms and documentation received

I Am Already Enrolled in Family Coverage

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

Removing Dependents

I Got Legally Separated or Divorced

Action Required Forms Required Documents Deadline to Submit Paperwork Coverage Effective Date
Remove my spouse NYSHIP Health Insurance Enrollment or Change Form (PS-404)

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)
NYSHIP Health Insurance Enrollment or Change Form (PS-404)

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)
NYSHIP Health Insurance Enrollment or Change Form (PS-404)

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

NYSHIP Health Insurance Enrollment or Change Form (PS-404)

 

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. You may change during the option transfer period to take effect beginning in January of the next year.

I Will Maintain Family Coverage

Action Required Forms Required Documentation Deadline to Submit Paperwork Coverage Effective Date
Remove my dependent
NYSHIP Health Insurance Enrollment or Change Form (PS-404)

None

Prior to desired date of coverage termination
Determined upon review

Cancelling Coverage

I Enrolled in Other Coverage

Action Required Forms Required Documentation Deadline to Submit Paperwork Coverage Termination Date
Cancel my enrollment NYSHIP Health Insurance Enrollment or Change Form (PS-404)

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 Documentation Deadline to Submit Paperwork Coverage Termination Date
Cancel my enrollment

NYSHIP Health Insurance Enrollment or Change Form (PS-404)

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. You may change during the option transfer period to take effect beginning in January of the next year. 

Option Transfer Period

Near the end of every year, New York state employees can change medical plans for the next calendar year.

This Option Transfer Period lasts a specific period of time and is the only time you are allowed to change plans without a qualifying life event.

I Want to Participate in the Opt-Out Program

You may be eligible to enroll in the opt-out program during the option transfer period to take effect beginning in January of the next year. Please refer to the eligibility guidelines in the option transfer information for the upcoming year.

Option Transfer Period

Near the end of every year, New York state employees can change medical plans for the next calendar year.

This Option Transfer Period lasts a specific period of time and is the only time you are allowed to change plans without a qualifying life event.

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

Plan Office Co-Pay Monthly Cost
Individual Family
Empire Plan (PPO) $20 $737.06 $1,850.18
BlueCross BlueShield of WNY (HMO) $20 $667.09
$1,647.12
Independent Health Association (HMO) $20 $670.92 $1,645.20

Updated 04/17

Dental and Vision Coverage

Dental and vision coverage is provided through the state of New York. Coverage takes effect following a 56 calendar day waiting period. There is no cost for enrollment.

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