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New York State Health Insurance Program (NYSHIP)

NYSHIP Choices & Plan Rates 2021

NYSHIP online

NYSHIPonline is your online tool for health benefits information. The NYSHIP Online Guidelines flyer can assist you with the navigation of this site.

lookNYSHIPonline also provides a NYSHIP Plan Comparison tool:

1. Under Active Employees, select "I am a New York State Active Employee (NY),
2. then choose your Group (Negotiating Unit) and whether you are in the NYS Empire Plan or an HMO (Blue Choice, MVP of Rochester, BCBS of WNY, Independent Health, etc.),
3. then choose "Health Benefits Option Transfer",
4. then choose "Rates and Health Plan Choices",
5. and then click on the NYSHIP Plan Comparison link. 

Health Insurance Information

Healthcare Plan Benefit Summaries

The Summary of Benefits and Coverage (SBC) is a 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

Eligible 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. 

*UUP-represented employees are not eligible for the opt-out program.

There are two times a year when employees may elect to opt-out of coverage:

  1. as newly eligible for health benefits
  2. for current NYSHIP enrollees - during the option transfer period.

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), a 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. 

Affordable Care Act Postings