For Employees of New York State Agencies Affected by Layoff:
Health Insurance Coverage and Related Benefits
This flyer explains how to continue health insurance and other benefits if you are laid off.
Requirements and benefits may change. See your agency Health Benefits Administrator (HBA)
and read plan materials for a complete description of your rights and responsibilities.
Health Coverage under Preferred List Provisions Following Layoff
If your name is placed on a New York State Department of
Insurance Civil Service Preferred List for reemployment, you may continue
your health insurance coverage under Preferred List provisions.
You may continue coverage for up to one year from the date your
health insurance in active employee status ends or until you are
reemployed in a benefits-eligible position by a public or private
employer, whichever occurs first.
If you are not eligible to have your name placed on a Preferred List
for reemployment, you may continue health insurance coverage
under Preferred List provisions if:
• You are in the noncompetitive class with tenure under
Section 75 of the Civil Service Law
Health Insurance or
Benefit Changes, • Your appointment was permanent. (You are not eligible if your
Your Identification Card, appointment was a provisional or temporary appointment or
Temporary Employment, you are an exempt class employee separated from State service.)
page 2 If you do not continue health insurance coverage under Preferred
List or other provisions, your New York State Health Insurance
Coverage as Program (NYSHIP) coverage will end 28 days following the last
a Retiree, as a Vestee, day of the payroll period in which you received your last payroll
under COBRA, or deduction for health insurance. Ask your agency Health Benefits
Administrator for further information.
Your Share of the Cost and How You Pay
page 4 You continue to pay only the employee share of the premium for
health insurance coverage under Preferred List provisions.
Your Other Benefits
Dental, Vision, COBRA, If you are in The Empire Plan, the State pays 90 percent of
Income Protection Plan, the cost for Individual coverage. If you have Family coverage,
Accident and Sickness the State also pays 75 percent of the additional cost for
Insurance dependent coverage.
If you are enrolled in an HMO, the State’s contribution will
Life Insurance, Long not exceed 100 percent of its dollar contribution toward the
Term Care Insurance
hospital/medical/mental health and substance abuse
page 6 components of The Empire Plan premium.
Answers Health Insurance continued on page 2
State of New York Department of Civil Service, Employee Benefits Division
While you are in Preferred List status, your job ends if the end date of your one year
health insurance premium will be billed of eligibility has not passed. Temporary
on a monthly basis instead of the biweekly employment does not extend your eligibility
premium that was deducted from your beyond the one year from the date your
paycheck. Ask your agency Health Benefits coverage as an employee ended. You must
Administrator for Preferred List health notify the Employee Benefits Division Preferred
insurance monthly premium rates. List Unit (see page 8) when you begin and end
The New York State Department of Civil temporary employment to protect your health
Service Employee Benefits Division will insurance coverage.
automatically bill you each month for your If Medicare Eligible, Medicare Is Primary
share of the premium. The first bill will be While you have NYSHIP coverage under
sent four to six weeks after your last day on the Preferred List provisions, Medicare does not
payroll and will include retroactive premiums. consider you an active employee. Therefore,
Be prepared for this expense. Medicare becomes primary for you and your
Benefit Changes covered dependents eligible for Medicare
Under Preferred List provisions, you receive because of age (65 or over) or disability.
the same benefits as Retirees. A health insurance plan provides “primary”
Empire Plan enrollees: Some benefits may coverage when it is responsible for paying
differ from your coverage as an active health benefits before any other group health
employee, as shown in the chart on page 4. insurance. Different rules apply for Medicare
primacy when your diagnosis is end-stage renal
HMO enrollees: If neither you nor any covered disease. Please see your agency Health Benefits
dependents are eligible for Medicare, there Administrator for additional information.
should be no changes in benefits.
NYSHIP will no longer be primary beginning
If you or your covered dependents are Medicare the first day of the month following a “runout”
eligible and enrolled in an HMO that offers of 28 days after the last day of the last payroll
a Medicare Advantage plan, there may be period for which you were paid. NYSHIP
significant changes in coverage. automatically becomes secondary to Medicare
Your Identification Card at that time, even if you or a dependent fail to
Empire Plan enrollees: If benefit changes enroll in Medicare.
require a new card, you will receive a new If you or a dependent are eligible for Medicare,
NYSHIP Empire Plan Benefit Card. Otherwise, you must have Medicare Parts A and B in
continue to use your current NYSHIP Empire effect when first eligible for primary Medicare
Plan Benefit Card. Your agency Health Benefits coverage, or there will be a drastic reduction in
Administrator will update your enrollment to your health insurance coverage. The New York
reflect any changes in your health insurance State Health Insurance Program will not provide
benefits and give you publications to explain any benefits for coverage available under
any changes. Medicare. If you or a dependent is eligible
HMO enrollees: Check with your HMO if you for primary Medicare coverage because of age,
are Medicare eligible. disability, end-stage renal disease or amyotrophic
lateral sclerosis (ALS), but do not enroll, you
Temporary Employment will be responsible for the full cost of medical
If you are temporarily employed by the State services that Medicare would have covered.
or another employer and are eligible for
When you are eligible for primary coverage
health insurance, your Preferred List health
from Medicare for you and/or your dependent,
insurance coverage ends. You may reinstate
the State will reimburse you for the standard
Preferred List coverage when your temporary
Medicare Part B premium. Reimbursement is
2 Layoff Flyer 1-11
made as a credit that reduces your monthly Continuing Health Insurance Coverage
NYSHIP bill. Please follow the instructions as a Retiree
that the Employee Benefits Division mails If you will be laid off, but meet the requirements
to you on an annual basis regarding the for continuing health insurance in retirement,
Medicare Part B Income-Related Monthly you may continue NYSHIP coverage under
Adjustment Amount (IRMAA). retiree provisions rather than Preferred List
You are not required to enroll in Medicare provisions, even if you do not draw your pension.
Part D for prescription drug coverage unless you If you have sick leave credits, continuing your
are enrolled in a NYSHIP Medicare Advantage health insurance under retiree provisions will
plan. If you choose to enroll in a Medicare reduce your premium cost.
Part D plan outside of NYSHIP, the State will If you meet the requirements, you may choose
not reimburse you for the Part D premium. health insurance coverage as a retiree at the
If You Are Not Eligible Under time you are laid off or during the one-year
Preferred List Provisions or period that you have health insurance under
When Preferred List Coverage Ends Preferred List provisions or at the time your
If you are not eligible for Preferred List health Preferred List health insurance ends. However,
insurance coverage or if your year of coverage time on a Preferred List does not count toward
under Preferred List provisions ends, you may the service time required for continuing health
be eligible to continue coverage: insurance in retirement.
• as a retiree As a retiree, you will pay an amount equal to
• as a vestee the employee share of the premium. However,
• temporarily under COBRA and State retirees may convert the value of unused sick
continuation of coverage laws or leave, up to 200 days (165 days for PBA and
• under a direct-pay conversion contract PIA), into a monthly credit. This credit is
applied toward your health insurance premium.
See your NYSHIP General Information Book for
information on continuing health insurance There are three eligibility requirements to
in any of these categories. There are deadlines continue health insurance as a retiree:
and other requirements. • completion of a minimum service period
Be sure to talk with your agency Health • eligibility for a pension from a New York
Benefits Administrator about continuing State publicly administered retirement system
your health insurance. • enrollment in NYSHIP
If you still have questions, call the Employee If your coverage is canceled for any reason
Benefits Division at 518-457-5754 (Albany area), while you are on a Preferred List, in most
or 1-800-833-4344 (U.S., Canada, Puerto Rico, cases, you will be subject to a three-month
Virgin Islands). waiting period before your coverage becomes
effective. Note: Your coverage must be in effect
at the time of your retirement to be eligible to
If you will be leaving the payroll, plan for continue health insurance coverage as a retiree.
your health insurance payments.
For more details on these three requirements,
If you leave the payroll, the Employee Benefits you can request a copy of the Planning for
Division will bill you each month for your Retirement booklet from your agency Health
health insurance. Your first bill will cover a Benefits Administrator, or visit the NYSHIP
retroactive payment (beginning with the Online web site at https://www.cs.state.ny.us.
period your employment status changed) From the home page, click on Benefit Programs
and an advance payment for the next month. and follow the prompts to access NYSHIP
Please be prepared for this larger than Online. Then click on Planning to Retire?
Layoff Flyer 1-11 3
Empire Plan Benefits Under Preferred List Provisions – January 1, 2011 (Amounts may change yearly.)
ALESU CSEA C-82 DC-37 M/C NYSCOPBA PBA PBA PEF PIA UUP1
Active $388 $250 $388 $300 $388 $388 $388 $388 $388 $388 $388
Layoff Flyer 1-11
Pref List $388 $388 $388 $388 $388 $388 $388 $388 $388 $388 $388
Active $1,438 $515*,** $828 $642** $1,069 $828 $855 $855 $1,069 $855 $1,069
Pref List $1,069 $1,069 $1,069 $1,069 $1,069 $1,069 $1,069 $1,069 $1,069 $1,069 $1,069
Active yes yes yes yes yes yes yes yes yes yes yes
Routine Health Exams
Pref List no no no no no no no no no no no
Active $15 $15 $20 $20 $20 $20 $20 $20 $20 $20 $20
Pref List $20 $20 $20 $20 $20 $20 $20 $20 $20 $20 $20
Active $15 $15 $20 $20 $20 $20 $20 $20 $20 $20 $20
Managed Physical Network
Pref List $20 $20 $20 $20 $20 $20 $20 $20 $20 $20 $20
Hospital Outpatient Copayment/ Active $35/50 $30/60 $35/60 $40/70 $40/70 $35/60 $40/70 $40/70 $40/70 $40/70 $40/70
Emergency Room Copayment
Pref List $40/70 $40/70 $40/70 $40/70 $40/70 $40/70 $40/70 $40/70 $40/70 $40/70 $40/70
Mental Health/ Active $15 $15 $20 $20 $20 $20 $20 $20 $20 $20 $20
Treatment Copayment Pref List $20 $20 $20 $20 $20 $20 $20 $20 $20 $20 $20
Active *** *** *** *** *** *** *** *** *** *** ***
Prescription Drug Copayment
Pref List *** *** *** *** *** *** *** *** *** *** ***
* Each program’s deductible, coinsurance and maximum coinsurance amount is separate and not combined with any other deductible, coinsurance or maximum coinsurance amount.
** The coinsurance maximum expense is reduced to $300 for DC-37 and $309 for CSEA for calendar year 2011 for employees in (or equated to) salary grade 6 or below on January 1, 2011. Newly eligible
employees who meet these requirements become eligible for the reduced coinsurance maximum on the later of January 1, 2011 or the date their coverage begins.
***Prescription Drug Copayment is based on whether the drug is Level 1, 2 or 3, the supply dispensed, and whether the prescription is filled at a retail mail service, or specialty pharmacy. See your Empire Plan
Report and Empire Plan Certificate. Mandatory generic substitution. For a brand-name drug with a generic equivalent, you pay the copayment plus the difference in cost between the brand and generic drug.
Prior authorization is required for certain drugs.
1 Except employees in lifeguard titles
This chart highlights some benefit differences. There are other differences. For a complete description of benefits and an explanation of terms used in this flyer, read your Empire Plan Certificate and Empire Plan Reports or ask
your agency Health Benefits Administrator. If you are enrolled in an HMO, ask your HMO about changes in your coverage when you leave the payroll.
Your Other Benefits
Dental, Vision and COBRA Coverage If you do not continue coverage under COBRA,
To continue dental and vision coverage: your dental and vision coverage will end 28 days
• CSEA, UUP and DC-37: If you receive these after the last day of the payroll period in which
benefits through a union Employee Benefit your last day on the payroll occurs.
Fund, you may be eligible to continue You are no longer eligible for COBRA coverage
dental and vision coverage temporarily if you become entitled to Medicare benefits
under COBRA. Contact your union during the COBRA continuation period.
Employee Benefit Fund for information. To Continue Dental Coverage If You Retire
• M/C, PEF, Council 82, ALESU, Regardless of your negotiating unit, if you retire,
NYSCOPBA, PBA and PIA: If you are you may choose retiree dental coverage through
enrolled in NYSHIP, you will automatically the Group Health Inc. (GHI) Preferred Dental
receive information on continuing State Plan. Within 15 days after your coverage ends,
dental and vision coverage temporarily you should receive written notice of conversion
under COBRA. If you are not enrolled in rights from GHI. You must apply for conversion
NYSHIP, but you receive dental and vision coverage within 45 days of this notice. If you
benefits through the State and want to do not receive notice of your conversion rights,
continue coverage, you must write to the contact GHI. You will have 90 days from
Employee Benefits Division for a COBRA the date your coverage ends to apply for
application. Send your name, your conversion coverage.
identification number, address, telephone
number with area code and reason for Income Protection Plan
requesting the application to: (M/C, DC-37 and Legislature)
COBRA Unit Your coverage under the Income Protection
Employee Benefits Division Plan ends when you are laid off, retire or vest.
State of New York Coverage ends on your last day on the payroll
Department of Civil Service as an active employee.
Albany, NY 12239 Group Life Insurance and
In 2011, the COBRA monthly premium Accident and Sickness Insurance
rate for State dental coverage is $29.68 for If your position is assigned to a negotiating
Individual coverage or $77.60 for Family unit that provides Life/Accident and Sickness
coverage. The COBRA monthly rate for Insurance through a union Employee Benefit
State vision care coverage is $4.03 for Fund and you have coverage under that
Individual coverage or $11.07 for Family program, contact your union Employee
coverage. The COBRA monthly vision rates Benefit Fund for information about your
for Council 82, ALESU and NYSCOPBA are rights to continue that insurance after you
$47.81 for Individual coverage or $54.85 for are separated from State service.
Family coverage. Rates may change yearly. If you are a Management/Confidential employee
COBRA deadlines: You must request with Accident and Sickness Insurance, there are
continuation coverage under COBRA no no conversion privileges for this coverage, and
later than 60 days after your coverage would you may not continue it when you retire, vest or
otherwise end or within 60 days from the are covered under Preferred List provisions.
date you are notified of your eligibility for Your Other Benefits continued on page 6
continuation of coverage, whichever is later.
Layoff Flyer 1-11 5
Continuing M/C Life Insurance Coverage Administrator for a PS-932, Transition to
If you are enrolled in the M/C Life Insurance Retirement Form, and indicate on the form
Program, you may continue Program coverage whether you want to continue your benefits,
under the following provisions: convert to an individual policy or cancel
• If you transfer, either temporarily or your life insurance benefits. You will pay
permanently, to a position not designated your premium directly to the Employee
Management/Confidential, you will be Benefits Division or through pension
permitted to continue life insurance deductions if you choose to continue
coverage under the M/C Program for up your coverage under this Plan.
to six months to provide time to obtain If you choose to convert to an individual
other coverage. policy, you must obtain a Conversion of
To continue your M/C Life Insurance for Group Life Benefits to an Individual Policy
up to 13 biweekly payroll periods after the form from your agency Health Benefits
date of transfer, you must make your request Administrator. You must call the insurance
in writing to the Employee Benefits Division. carrier at the telephone number on the
Premiums will be deducted from your form to discuss conversion. If you convert
payroll check. to an individual policy, payments would
be made directly to the insurance carrier.
• If you retire, or if you are eligible to
retire as a member of a New York State When coverage ends: If you are no longer
retirement system, and are an enrollee eligible to continue participation in the M/C
in the group life insurance program for Life Insurance Program, your life insurance
Management/Confidential employees, will terminate on the last day of the coverage
you may choose to continue in the program period for which a contribution was made.
or convert to a direct-pay policy. If you At that time, you may be eligible to convert to
choose to remain in the program, you may a standard direct-pay policy with the carrier.
continue both personal and dependent life See your agency Health Benefits Administrator
insurance in retirement subject to the age- for conversion information.
related life insurance reductions or you may Long Term Care Insurance
choose to convert to a standard direct-pay If you purchased long term care insurance
policy with the carrier. through NYPERL, the New York State
• If you are not a member of a retirement Public Employee and Retiree Long Term
system administered by New York State, but Care Insurance Plan, your long term care
you meet the age and service requirements insurance will continue without interruption
of the Employees’ Retirement System and without any change in benefits as long
tier in effect at the time you would have as you pay your premium and have not
joined when you were first employed, exhausted your lifetime benefit amount.
you can be considered a retiree for life If you pay your long term care premium
insurance purposes. through payroll deduction, you will need
If you meet the requirements to continue to change your method of payment. If you
M/C Life Insurance as a retiree, your have questions, contact the NYPERL insurer
benefits will automatically continue unless toll free at 1-866-474-5824.
you request in writing that your benefits be
canceled. Ask your agency Health Benefits
6 Layoff Flyer 1-11
Questions and Answers
Q: My job is being abolished. It is not a job Q: I may retire during the year that I have
that falls under the Civil Service Law or health insurance under Preferred List
negotiated agreements related to layoffs provisions. May I use the value of my
and Preferred List rights. Am I eligible unused sick leave to reduce the cost of
to continue my health insurance? my retiree health insurance?
A: If your appointment to your position was a A: Yes, if you retire from Preferred List status,
permanent appointment, you are eligible to you may use the value of your sick leave
continue health insurance under Preferred credit to reduce The Empire Plan or
List provisions. If your appointment was a NYSHIP HMO premium.
temporary appointment, you are not eligible
to continue under Preferred List provisions. You may use the value of your sick leave
Be sure to discuss your eligibility with your credit whether you retire at the time you are
agency Health Benefits Administrator. laid off, during the year of your Preferred
List coverage or at the end of your coverage
Q: I am in a job that falls under Civil Service under Preferred List provisions. When
Law and negotiated agreements related to you leave the payroll, ask your agency to
layoffs and Preferred List. I’m provisional complete form PS-410 listing your sick leave
in the job and will not be eligible to be on accruals, negotiating unit and salary. Keep
a Civil Service Preferred List. Am I eligible this form in a safe place. When you are ready
for health insurance under Preferred List to retire, you will need the PS-410.
provisions? You may not use the value of your sick
A: You are not eligible for health insurance leave credit to reduce the cost of your
under Preferred List provisions. Ask your health insurance while you are covered
agency Health Benefits Administrator if you under Preferred List provisions or under
are eligible under retiree or vestee provisions. vestee provisions or in COBRA status.
If not, ask about COBRA provisions and
direct-pay conversion contracts. Q: I am eligible for health insurance under
Preferred List provisions. May I change
Q: When will my health insurance coverage coverage during this period? May I
as an active employee end? Will there be change options?
a gap in coverage before my coverage A: You may change coverage. You may add or
under Preferred List provisions begins? remove dependents from your coverage or
A: If you are laid off, you will not have a gap in change to Individual or Family coverage in
your health insurance coverage. Your health accordance with NYSHIP rules. You may
insurance in active employee status ends change options (plans) once at any time
28 days after the last day of the payroll period during a 12-month period. In general, you
in which your last day on the payroll occurs. may change options more than once in a
Your coverage under Preferred List provisions 12-month period only if you move, and then
will begin on the 29th day. only under certain circumstances described
in your NYSHIP General Information Book
(for example, if you no longer live or work
in your HMO’s NYSHIP service area).
Layoff Flyer 1-11 7
for Employees of New York State Agencies Affected by Layoff
Talk with Your Agency HBA For Group-Specific Questions
• Ask if you are eligible to continue health CSEA
insurance in one of the following five ways: Employee Benefit Fund (dental, vision)
– under Preferred List provisions 1-800-323-2732..................................nationwide
– as a retiree 518-782-1500....................................Albany area
– as a vestee www.cseaebf.org
– under COBRA (federal continuation Pearl Carroll & Associates
of coverage law) or (Accident and sickness, home, auto and
– by converting to a direct-pay policy renters insurance)
Also, ask about continuing related 1-800-366-7315 ...................................nationwide
benefits, such as dental and vision care. Group Life Insurance
• If you are changing to another negotiating 1-800-342-4146..................................nationwide
unit because of layoffs, ask if your health 518-257-1000....................................Albany area
insurance and other benefits will change. Council 82, NYSCOPBA, PEF, PBA and PIA
Ask for a copy of the NYSHIP General GHI Dental......................................1-800-947-0101
Information Book for your new negotiating EyeMed Vision Care
unit. If you are enrolled in The Empire Plan, 1-877-226-1412..................................nationwide
be sure to ask for an Empire Plan Certificate of DC-37
Insurance for your new negotiating unit. Health and Security Plan (dental, vision)
Also ask for all materials updating those 212-815-1234
publications for your new negotiating unit. www.dc37.net
Read these materials carefully. M/C
• Get answers to any questions you still have Pearl Carroll & Associates (home, auto, renters)
after reading this flyer. 1-800-833-4657.....................................nationwide
More Questions? GHI Dental......................................1-800-947-0101
Please call the Employee Benefits Division EyeMed Vision Care
Preferred List Unit at 518-457-5754 (Albany area) 1-877-226-1412..................................nationwide
or 1-800-833-4344 (U.S., Canada, Puerto Rico, PEF
Virgin Islands) between 9 a.m. and 3 p.m. Group Life Insurance
Eastern time weekdays. Once you have health 518-785-1900, Extension 243
insurance coverage under Preferred List UUP
provisions, or as a retiree, vestee or COBRA Benefit Trust Fund
enrollee, the Employee Benefits Division serves 1-800-887-3863..................................nationwide
as your personnel office. www.uupinfo.org
Visit our web site at https://www.cs.state.ny.us. Delta Dental........................................1-800-471-7093
The Department of Civil Service web site has www.deltadental.com
NYSHIP publications and information on your EyeMed Vision Care
health insurance and other benefits. 1-877-226-1412..................................nationwide
It is the policy of the State of New York Department of Civil Service to provide reasonable accommodation to ensure effective communication of information in benefits publications to individuals with
disabilities. These publications are also available on the Department of Civil Service web site (https://www.cs.state.ny.us). Check the web site for timely information that meets universal accessibility
standards adopted by New York State for NYS agency web sites. If you need an auxiliary aid or service to make benefits information available to you, please contact your agency Health Benefits
Administrator. Preferred List and COBRA enrollees may call the Employee Benefits Division at (518) 457-5754 (Albany area) or 1-800-833-4344 (U.S., Canada, Puerto Rico, Virgin Islands.)
This flyer was printed using recycled paper and environmentally sensitive inks. Layoff Flyer 1-11 AL1042
State of New York Department of Civil Service, Employee Benefits Division, Albany, New York 12239 https://www.cs.state.ny.us
8 Layoff Flyer 1-11