Enrollment

Looking to enroll in NYSHIP? Here's what you should know.

NYSHIP offers health insurance coverage through two main plan options: The Empire Plan and approved HMO options. To learn more about how these options differ, visit our comparison resource:

The Empire Plan vs. HMOs 

New employee sits at a desk as she gets onboarded, paperwork and a laptop are in front of her.

Getting Started

Your NYSHIP enrollment is managed by a health benefits administrator (HBA). Enrollment typically involves submitting required forms and documentation through your designated HBA. Coverage generally begins after a 28-day waiting period, though specific timelines may vary based on individual circumstances.

Finding Your HBA

Public Employers

Public employers are able to join NYSHIP via one of the following categories: 

Participating Agency

A city, town, municipality, school district, or any local government entity in New York State that takes part in NYSHIP.

Participating Employer

A New York State government agency that takes part in NYSHIP. Examples include the Thruway Authority or Metropolitan Transportation Authority. These agencies are kept and paid for by special or administrative funds.

Returning to State Service?

Previously Retired

If you are retired from State service and wish to return to work for New York State, your NYSHIP benefits and benefit eligibility may change. After you are rehired, talk with your HBA to discuss your options.

Previously Employed

Welcome back! If you were previously employed by New York State, you will need to reenroll in NYSHIP to receive benefits. NYSHIP requires at least five years of non-continuous benefits-eligible service for retirement. Talk with your HBA for more details.

Already enrolled? See what's covered for you. 

If you're already enrolled in NYSHIP, select your plan type to see exactly what's available to you. 

Welcome to the New York State Health Insurance Program or NYSHIP. As an enrollee of NYSHIP, you have several health insurance options available for you to select. We will explore enrollment, eligibility and changes to your NYSHIP options as active employees of New York State. To be eligible for NYSHIP coverage, you must be appointed or elected to a position in State service and fulfill eligibility requirements for your employee group. When newly eligible, you'll be subject to a 28-day waiting period before coverage begins.

To enroll in NYSHIP, you need to choose The Empire Plan, a NYSHIP-approved HMO in the geographic area you live or work in, the Opt-Out Program, or decline coverage. If you do not enroll when newly eligible, you will be subject to a late enrollment waiting period. For more information on eligibility requirements, refer to your General Information Book available on the NYSHIP website or through your health benefits administrator or HBA.

NYSHIP does not offer an Open Enrollment Period. During the annual Option Transfer Period, usually in November or December, you may change your NYSHIP option to any NYSHIP option for which you are eligible for any reason. To change your options during this period, contact your HBA. You may change options outside the designated Option Transfer Period only for the following qualifying life events: 

  • you add a newly eligible dependent to your coverage in a timely manner, including marriage, domestic partnership, birth, adoption or other child eligibility
  • you are no longer eligible to continue coverage in your HMO or a new HMO is now available to you because you moved or your job location has changed
  • your dependent moves permanently and is no longer in your HMO service area
  • you return to State payroll after military leave or after a break in State service
  • you retire or vest your health insurance

All requests must be made no later than 30 days after the qualifying life event to ensure continued access to benefits.

If you do not enroll in NYSHIP coverage when newly eligible, you will be subject to a late enrolment waiting period of five biweekly pay periods. This late enrollment waiting period may also apply if you do not add a newly eligible dependent within 30 days or if you want to add a previously eligible dependent to your coverage. You should always contact your HBA when something changes in your enrollment information.

For more information on enrollment and eligibility, refer to your General Information Book available on the NYSHIP website or through your HBA.

FEATURED VIDEO

Eligibility, Enrollment and Changes

Watch this brief overview video to understand the requirements to enroll in the New York State Health Insurance Plan. 

Video Library

Additional Enrollment Options and Information

NYSHIP offers various programs that may help eligible participants manage healthcare costs and premiums. These programs may include options for:

  • Coverage for young adults
  • Pre-tax payment arrangements
  • Premium credit programs
  • Flexible spending accounts for eligible expenses
  • Life insurance for Management/Confidential employees
  • Income protection plans (available only to specific bargaining units)

Specific program availability and details vary based on employment status and eligibility. 

Frequently Asked Questions

The Option Transfer Period lets you change your NYSHIP health insurance plan to an eligible option. Option Transfer usually takes place in November or December each year. During this period, you may:

  • Change your NYSHIP plan to either The Empire Plan, a NYSHIP HMO, or participate in the Opt-Out Program
  • Change from Family to Individual coverage
  • Change from Individual to Family coverage
  • Cancel your coverage
  • Enroll in NYSHIP

To be eligible, an employee must meet the following conditions:

  • Be expected to work at least three months
  • Work 20+ hours per week OR earn at least $2,000 annually OR be a local elected official, legislative body member, school board member, public authority board member (with 6+ months service), or receive their main family income from public employment
  • Not already be enrolled in NYSHIP as an employee

Some groups, like volunteer firefighters and emergency medical services, might qualify. However, they must pay the full premium cost.

NYSHIP requires your governing body to pass a formal resolution to join The Empire Plan. Call the Employee Benefits Division of the Department of Civil Service at 518-485-1771 for details.