NYSHIP Eligibility

Some New York State Participating Agencies offer NYSHIP health insurance options to their employees. Review the eligibility rules to see if you qualify.

This page provides an overview of eligibility requirements. For specific information, speak with your HBA or refer to your General Information Book.

Employee Eligibility

Minimum eligibility requirements for coverage are established by New York State Law. Participating Agency eligibility requirements may exceed NYSHIP minimum eligibility requirements. For information about your employer’s specific eligibility requirements, contact your HBA.

When newly eligible for coverage, you may be subject to a waiting period before coverage begins. If you do not enroll when newly eligible, you may be subject to a late enrollment waiting period.

NYSHIP requires you to meet all the following criteria to be eligible for coverage:

  • You are expected to work for at least three months.
  • You meet one of the following:
    • You work a regular schedule of 20 hours or more per week
    • You are paid an annual salary at a rate of $2,000 or more per year
    • You meet one of the following criteria:
      • You are a local elected official
      • You are a paid member of a public legislative body
      • You are an elected member of a school board
      • You are an unpaid board member of a public authority with at least six months’ service as a board member
      • You are a volunteer firefighter or ambulance worker and your employer offers NYSHIP coverage
      • Your public employment provides the major source of your family’s income
  • You are not already enrolled in NYSHIP as the result of your current or former employment.

In addition to NYSHIP’s minimum eligibility requirements, your agency may require:

  • A longer anticipated term of employment (your employer cannot require that your anticipated employment term be greater than six months)
  • A regular schedule of more than 20 hours per week or
  • A required minimum annual salary of more than $2,000 per year or
  • Work week or annual salary eligibility requirements for local elected officials, paid members of public legislative bodies or elected members of school boards

Employer discretion based on class or category of employee

Your employer may determine which classes or categories of employees are eligible for NYSHIP coverage.

Dual Coverage in NYSHIP

NYSHIP prohibits dual coverage as the enrollee. If you are already enrolled in NYSHIP as an employee or retiree, you cannot enroll again through a different employer as an employee or retiree. You must choose the employer through which you wish to be enrolled.

You can have dual NYSHIP coverage if you are covered under your own Individual coverage and also as a dependent on your partner’s Family coverage. However, New York State does not permit two Family coverages.

Refer to your General Information Book for more details.

Dependent Eligibility

You may cover your eligible dependents under NYSHIP by enrolling in Family coverage or adding eligible dependents to existing Family coverage. Dependents who meet the requirements described in this section are eligible for NYSHIP coverage. To enroll your dependent who is eligible for NYSHIP but not yet enrolled, contact your HBA.

Spouse, Domestic Partner and Divorce Coverage   Dependent Children Coverage

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