PEF Benefits

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.

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). 

The NYSHIP General Information Book provides full dependent eligibility information.

Your spouse, including a legally-separated spouse, is eligible for NYSHIP coverage. If you are divorced or your marriage has been annulled, your former spouse is not eligible, even if a court orders you to maintain coverage.

For eligibility under NYSHIP, you will be required to provide additional documentation and certification of your domestic partnership.

Under Internal Revenue Service (IRS) rules, the fair market value cost of your domestic partner’s coverage, referred to as imputed income, is considered to be a taxable fringe benefit. The imputed income will increase your taxable gross income for federal and state income taxes, as well as Social Security and Medicare payroll taxes.

The following children are eligible for coverage until age 26:

• Your natural child
• Your stepchild
• Your domestic partner’s child 
• Your legally-adopted child, including a child in a waiting period prior to finalization of adoption 

"Other" Children as defined by NYSHIP:

You may cover “other” children by filing a NYSHIP Statement of Dependence for “Other” Children (PS-457) form to verify eligibility (recertification required every two years).

Disabled children age 26 or older:

You will be required to submit a NYSHIP Statement of Disability for Dependents (PS-451) form to the Plan administrator and provide medical documentation to qualify a disabled child over age 26 for NYSHIP coverage. You will be asked to recertify periodically based on Social Security Administration criteria. 

Young Adult Option:

The Young Adult Option allows a qualifying child age 29 or younger of a NYSHIP enrollee to purchase Individual health insurance coverage through NYSHIP when they do not otherwise qualify as a dependent. The young adult or their parent is required to pay the full cost of premium for Individual coverage.

Welcome to the University at Buffalo! Benefit Services (State) will contact you with initial benefit enrollment information. Review enrollment instructions and deadlines included in the benefit information you receive carefully. Failure to enroll timely may result in an extended waiting period for coverage to begin.

Enrollment in medical insurance is voluntary. You will not be automatically enrolled in a plan. Your waiting period for coverage to begin will be based on your appointment with the University.

Contact Benefit Services (State) for guidance if you are transferring from another SUNY Institution and/or New York State Agency or changing negotiating units.

Following your initial eligibility for health insurance, you may want to enroll in a NYSHIP plan, cancel coverage or make changes to your current plan. Allowable options will be based on your request and whether you are experiencing a qualifying event. Certain changes are not allowable outside of the annual option transfer period. Contact Benefit Services (State) as soon as possible as deadlines may apply.

The employee cost share is based on salary grade as detailed on the current health insurance rate information.

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.

• 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.

• UUP (United University Professions)
• GSEU (Graduate Student Employees Union)
  

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. Contact Benefit Services to reivew your specific event and determine:

• Your eligibility to make changes to existing coverage or enroll in a NYSHIP program
• Necessary forms and documentation
• Deadline to submit forms and required documentation

All required forms and documentation must be succssfully submitted to Benefit Services within required deadlines for the change to be made. Submit all forms and documentation to our Secure UB Box Folder: 

Under Internal Revenue Service (IRS) rules, if you are enrolled in pre-tax contribution program (PTCP), you may change your health insurance deduction during the tax year only after one of the following PTCP qualifying events:

• Change in marital status
• Change in number of dependents 
• Change in your (or your dependent’s) employment status that affects eligibility for health benefits
• Change in your dependent’s status that affects eligibility for health benefits
• Change in your (or your dependent’s) place of residence or worksite that affects eligibility for health benefits
• Significant change in health benefits and/or premium under NYSHIP
• Significant change in health benefits and/or premium under your (or your dependent’s) other employer’s plan
• COBRA events
• Judgment, decree or order to provide health benefits
• Medicare or Medicaid eligibility
• Leaves of absence
• HIPAA special enrollment rights 

The PTCP qualifying event must affect eligibility for health benefits, and any requested change to your pre-tax health insurance deductions must be consistent with the event.

If no pre-tax qualifying event has occurred, you must wait until the next annual PTCP Election Period during the annual Option Transfer Period to change your pre-tax deduction for the next plan year. 

During option transfer, active state employees who are enrolled in the New York State Health Insurance Program (NYSHIP) are eligible to:

• Transfer health care options
• Change from family to individual coverage
• Voluntarily cancel coverage 
• Enroll in the Opt-out Program (if eligible)
• Change your Pre-Tax Contribution Program (PTCP) election

Option Transfer is generally announced at the end of a calendar year, for changes effective in the next calendar year.

Medical insurance coverage ends two full pay periods 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.

Dental and vision coverage is provided through the state of New York. There is no cost for enrollment. There is a 28 calendar day waiting period. Enroll during waiting period and coverage is effective on your 29th day of employment.