No. Open Enrollment does not change the Opt-Out Program eligibility rules. To newly enroll in the Opt-Out Program, you must still be enrolled in a NYSHIP health plan continuously from April 1, or, if you became eligible after that date, from the date you first became eligible for NYSHIP health benefits.
You may enroll in the Opt-Out Program during Open Enrollment if you have other employer-sponsored health coverage and have remained enrolled in NYSHIP from April 1 through the end of the plan year. It is your responsibility to make sure your other coverage is in effect when your NYSHIP coverage ends so that you do not have a gap in coverage.
Yes. The Opt-Out Program applies only to health coverage. If you enroll in the program, your dental and vision coverage is not affected.
No. Once you enroll in the Opt-Out Program, you cannot reenroll in a NYSHIP health plan during the plan year unless you experience a qualifying event that allows you to make that change. If you do, you must submit your request within 30 days of the qualifying event to avoid a late enrollment waiting period.
No. If you are enrolled in Individual Opt-Out, you cannot receive Family incentive payments during the plan year, even if you get married or have a child.
To qualify for the Family incentive payment, you must have been enrolled in NYSHIP Family coverage (The Empire Plan or a NYSHIP HMO) continuously from April 1 through the end of the plan year before you enroll in Family Opt-Out.
You are eligible for the Family incentive payment if you changed from Individual NYSHIP coverage to Family coverage within 30 days of a qualifying event that allowed you to make that change. However, if your Family coverage started after April 1 and your dependent had a late enrollment waiting period, you are eligible for the Individual incentive payment, not the Family incentive payment.
No. If you are enrolled in the Opt-Out Program at the time you retire, you meet the NYSHIP enrollment requirement for retirement. However, you cannot continue participating in the Opt-Out Program after you retire.
It depends on whether you remain eligible for the State's contribution toward your health insurance while you are on leave. If you do, your Opt-Out incentive payments will accumulate while you are off the payroll and will be paid after you return. This includes workers' compensation leave, Family and Medical Leave, short-term disability through the Income Protection Plan and disciplinary suspension leave.
If you are not eligible for the State' contribution toward your health insurance while you are on leave, you will not receive Opt-Out incentive payments.