Jeffrey Wade
The New York State Health Insurance Program (NYSHIP) provides health insurance benefits to New York State civil service employees. The Empire Plan is a health insurance plan offered by NYSHIP, which is available to approximately 800 local government employers and their employees. For Provisional, Temporary, and Non-Competitive employees, coverage begins on the ninety-first day of continuous employment, provided that a Health Benefits Application has been submitted. For employees appointed from Civil Service lists, coverage begins on the appointment date, provided that the Health Benefits Application has been received within 30 days.
| Characteristics | Values |
|---|---|
| Insurance coverage for provisional, temporary, and non-competitive employees with no experience or education requirement | Begins on the 91st day of continuous employment, provided that the Health Benefits Application has been submitted within that period |
| Insurance coverage for employees appointed from Civil Service lists, exempt employees, and non-competitive employees with an experience or education requirement | Begins on the appointment date, provided the Health Benefits Application is received within 30 days |
| Coverage for eligible dependents | Begins on the day the employee becomes covered; for dependents acquired after submission, coverage begins on the date of marriage, domestic partnership, birth, or adoption, provided notification and documentation are submitted within 30 days |
| Health insurance provider | New York State Health Insurance Program (NYSHIP) |
| Health insurance plan | The Empire Plan |
| Medicare coverage | The Empire Plan becomes secondary coverage and reduces the premium; it covers the Medicare Part A hospital deductible and some other expenses not covered by Medicare |
| NYSHIP identification card | Mailed separately |
| Participating provider directory | Mailed separately |
| Certificate of Insurance | Mailed separately |
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What You'll Learn
- Provisional, temporary, and non-competitive employees' coverage begins on the 91st day of employment
- Civil Service list appointees, exempt employees, and experienced non-competitive employees are covered from their appointment date
- Dependents are covered from the date of marriage, domestic partnership, birth, or adoption
- NYSHIP benefits are negotiated by the State with State employee unions every 3-4 years
- The Empire Plan is available worldwide and covers some medical expenses not covered by Medicare
Provisional, temporary, and non-competitive employees' coverage begins on the 91st day of employment
For provisional, temporary, and non-competitive employees with no experience or education requirements for employment, health insurance coverage with the New York State Health Insurance Program (NYSHIP) begins on the 91st day of continuous employment. This is provided that your Health Benefits Application has been submitted within this period.
This means that, as long as you have been continuously employed for at least 91 days and have submitted the required paperwork, you will be covered by NYSHIP as a provisional, temporary, or non-competitive employee. This type of coverage typically applies to those who do not need to meet any specific experience or education criteria to be hired.
On the other hand, if you are a non-competitive employee with experience or education requirements for your role, your coverage will begin on your appointment date. However, for this to apply, your Health Benefits Application must be received by your agency's personnel or payroll office within 30 days of your appointment. This provision also applies to employees appointed from Civil Service lists and Exempt employees.
It is important to note that coverage for eligible dependents listed on your Health Benefits Application will commence on the day you become covered. For dependents acquired after you submit your application, coverage will be provided from the date of marriage, domestic partnership, birth, or adoption. To ensure coverage for these dependents, you must submit the necessary notification and documentation within 30 days.
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Civil Service list appointees, exempt employees, and experienced non-competitive employees are covered from their appointment date
For Civil Service list appointees, exempt employees, and non-competitive employees with experience or education requirements, health insurance coverage begins on their appointment date. This is provided that their Health Benefits Application has been received by their agency personnel or payroll office within 30 days of that date.
This means that, for these groups of employees, there is no waiting period for health insurance coverage to kick in. Their coverage starts as soon as they are appointed to their position, as long as they have submitted the necessary paperwork on time.
On the other hand, provisional employees, temporary employees, and non-competitive employees without experience or education requirements must wait 91 days of continuous employment for their coverage to begin. Again, this is contingent on their Health Benefits Application being submitted within this time frame.
It is important to note that the start date of health insurance coverage for eligible dependents listed on an employee's Health Benefits Application will be the same as the employee's coverage start date. Any dependents acquired after the submission of the application will be covered from the date of marriage, domestic partnership, birth, or adoption, provided that the employee submits the required notification and documentation within 30 days.
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Dependents are covered from the date of marriage, domestic partnership, birth, or adoption
For provisional, temporary, and non-competitive employees with no experience or education requirements, health insurance coverage begins on the ninety-first day of continuous employment, provided that a Health Benefits Application has been submitted within that period. For employees appointed from civil service lists, exempt employees, and non-competitive employees with experience or education requirements, coverage begins on the appointment date, as long as the Health Benefits Application has been received within 30 days of that date.
Dependents acquired after the submission of the Health Benefits Application will be covered from the date of marriage, domestic partnership, birth, or adoption. This is provided that the required notification and documentation are submitted within 30 days of the date of the change in the employee's dependent status. This ensures that the dependent's coverage begins as soon as possible and that there is no gap in their access to healthcare services. The 30-day window allows for a prompt update of the employee's benefits and ensures that any necessary adjustments to their insurance plan can be made efficiently.
The New York State Health Insurance Program (NYSHIP) offers comprehensive health insurance coverage for state employees, including medical, dental, and vision care benefits. The program aims to provide accessible and quality healthcare services for its enrollees and their dependents. By offering coverage for dependents from the date of marriage, domestic partnership, birth, or adoption, NYSHIP ensures that employees can secure immediate healthcare support for their changing family circumstances.
It is important for employees to be aware of the specific requirements and procedures for adding dependents to their health insurance coverage. While the coverage for dependents begins from the significant life events mentioned, employees must still notify the relevant authorities and provide the necessary documentation within the specified timeframe. This ensures that there are no disruptions in the continuity of healthcare coverage for the employee's dependents.
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NYSHIP benefits are negotiated by the State with State employee unions every 3-4 years
NYSHIP, or the New York State Health Insurance Program, is a comprehensive health insurance program for New York State public employees. It is one of the largest employer-sponsored group health insurance programs in the United States, protecting over 1.2 million state and local government employees, retirees, and their families.
The NYSHIP health insurance benefits are negotiated by the State with State employee unions every 3-4 years. The President of the Civil Service Commission typically extends negotiated benefit changes to unrepresented groups, such as Participating Agencies. Sometimes, a benefit change is gradually introduced over time. Policies and benefits may also be influenced by State and federal legislation and court decisions. The New York State Department of Civil Service Employee Benefits Division provides quarterly reports to employers and directly mails Empire Plan information to enrollees.
The Empire Plan is NYSHIP's exclusive health insurance plan for New York State public employees and employers. It covers hospital services, physicians' bills, prescription drugs, and other medical expenses. Enrollees can choose between participating and non-participating providers, affecting their share of the cost. The Empire Plan also participates in the Medicare crossover process, where Medicare, as the primary insurer, automatically forwards claims to The Empire Plan insurance carriers for secondary payment.
The Empire Plan has specific confidentiality practices in place to protect the confidentiality of Protected Health Information (PHI). This includes individually identifiable health information related to physical and mental health, healthcare services provided, and payments made for care.
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The Empire Plan is available worldwide and covers some medical expenses not covered by Medicare
The Empire Plan is a comprehensive health insurance program for New York State public employees. It is part of the New York State Health Insurance Program (NYSHIP), which comprises The Empire Plan and NYSHIP-approved Health Maintenance Organizations (HMOs).
The Empire Plan is available worldwide, which means that enrollees can access its benefits outside of the U.S.—something that Medicare does not cover. This worldwide coverage includes benefits such as the Home Care Advocacy Program (HCAP), which covers home care/skilled nursing services, durable medical equipment, and certain medical supplies, including diabetic and ostomy supplies.
The Empire Plan also covers some medical expenses not covered by Medicare. For example, Medicare does not cover prescription drugs and hearing aids under Part A or Part B, but The Empire Plan does. Additionally, The Empire Plan covers the Medicare Part A hospital deductible, which was $1,132 per hospital stay of one to 60 days in 2011, and this amount may change yearly.
The Empire Plan works in conjunction with Medicare as a secondary form of coverage, and it reduces the premium cost for the agency's Medicare-primary enrollees. This means that retirees who are eligible for primary coverage under Medicare can still benefit from The Empire Plan as a supplementary form of insurance.
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Frequently asked questions
Coverage begins on the ninety-first day of continuous employment, provided that your Health Benefits Application has been submitted within that period.
Coverage begins on your appointment date, provided your Health Benefits Application has been received by your agency personnel or payroll office within 30 days of that date.
Coverage for eligible dependents listed on your Health Benefits Application will begin on the day that you become covered. Dependents acquired after you submit your Application will be covered from the date of marriage, domestic partnership, birth or adoption, provided that you submit the required notification and documentation within 30 days.
