New York State Health Insurance Program (NYSHIP)
You can learn about the New York State Health Insurance Program by visiting NYSHIP Online. The NYSHIP Online Guidelines flyer can assist you with navigation of this site. NYSHIP Online is an online resource that keeps you up-to-date on what's new in your health insurance programs. You can also find general information about how your health insurance programs works and when to notify your Health Benefits Administrator (HBA) on life changes that may affect your health insurance. Life changes such as marriage, the birth of a child, leave of absences, employment status changes, etc. affect your health insurance coverage. Notifying your HBA timely affects whether or not changes can be made without experiencing an extended waiting period before changes become effective.
When should you contact your Health Benefits Administrator (HBA)?
NYSHIP Choices 2018
The NYSHIP choices for 2018 booklet explains the options available to you under the New York State Health Insurance Program (NYSHIP) for your health insurance and other elections. You may choose coverage under The NYS Empire Plan or one of the NYSHIP-approved health maintenance organizations (HMOs) in your area. Or, if you can be covered under other employer-sponsored group health benefits, you may be eligible to elect the Opt-out Program.
NYSHIP Rates & Deadlines 2018
The NYSHIP Rates & Deadlines 2018 booklet explains the health insurance biweekly costs per paycheck for each health care plan in NYSHIP and when the NYS Health Insurance Transaction Form, PS 404 is due to your HBA to make changes for the next plan year. Remember, to enroll in an HMO, you must live or work in the HMO’s service area. If you no longer live or work in the NYSHIP service area of the HMO in which you are enrolled, you must change to another plan. Service areas may change from year to year.
Local Rates for SUNY Geneseo Employees 2018
The Local Rates for SUNY Geneseo Employees 2018 document breaks out the biweekly cost of your health insurance premium by paycheck in the Western New York area.
Healthcare Plan Benefit Summaries
The Summary of Benefits and Coverage (SBC) is simple and standardized comparison document required by the Patient Protection and Affordable Care Act (PPACA). All insurance plans are required to produce a Summary of Benefits and Coverage based on a uniform template and customized to reflect the plan’s unique terms. At this website, you will need to click on your Bargaining Unit and then click on the name of the healthcare provider to view the benefit summaries. These summaries are printable and helpful when comparing the different plans available in our area.
NYSHIP Opt-out Program
Employees who can demonstrate and attest to having other employer-sponsored group health insurance may elect to opt out of NYSHIP's Empire Plan or Health Maintenance Organizations. Employees who elect to opt out of NYSHIP will receive $1,000 for waiving Individual coverage or $3,000 for waiving Family coverage. This amount will be credited to bi-weekly paychecks as taxable income over the plan year. Unless newly eligible to enroll, employees must be enrolled in NYSHIP Individual or Family coverage prior to April 1st of the previous plan year to be eligible to opt out of that coverage. In order to participate, employees must have other employer-sponsored group health insurance.
There are two times a year when employees may elect to opt out of coverage:
- as newly eligible for health benefits
- for current NYSHIP enrollees - during the option transfer period.
**Current opt-out program participants MUST complete forms and provide proof of other coverage every year to stay enrolled in this program and to continue receiving incentive payments. Failure to submit forms each year will result in automatic termination from this program.**
Only employees who experience a qualifying event will be allowed to withdraw their opt-out election and enroll in a health insurance plan mid-year.
Enrolling in the opt-out program requires a NYS Health Insurance Transaction form (PS404), the Opt-out Attestation form (PS409), copy of other employer-sponsored health insurance card and any required proofs (social security card, birth certificate, marriage certificate, joint financial obligation document, etc). See HR forms page.
The NYSHIP General Information Book (GIB)
Other NYSHIP Programs
View the Other NYSHIP Programs page for Domestic Partner Information, Student Employee Health Information and the Young Adult Option.
Healthcare Plan Contacts and Service Area
View the Healthcare Plan Contacts and Service Area page for contact information for your healthcare provider.