- Dependent Eligibility Verification Audit (DEVA): As you are aware, the NYS Department of Civil Service conducted a DEVA which ended August 5, 2016. Any dependents that were not verified during the audit were removed as of January 1, 2016. Please be aware that the NYS Department of Civil Service intends to conduct continuous and random audits to identify ineligible dependents. It is therefore imperative that you notify your HR representative of any change in your dependents’ eligibility.
- The Waiting Period Policy stated below has been postponed by NYSHIP until further notice. Previously Eligible Dependents will be added to an existing family coverage, upon submission to your HR personnel and the Health Benefits Unit, as of the signature date on the Health Insurance Transaction Form.
- Adding Previously Eligible Dependents: With the exception for those dependents who were verified and processed after August 5, 2016 but prior to September 13, 2016. As of September 13, 2016 NYSHIP implemented a new policy for adding “previously eligible” dependents to an existing family policy. Previously eligible dependents are defined as individuals who met the eligibility requirement for enrollment on your policy at an earlier date, but were not enrolled. The new policy states that all “previously eligible” dependents will experience a three-month wait before being added to an existing policy – except if the dependent experienced a qualifying event such as loss of coverage.
- Please be advised that the new policy also mandates that no dependent will be added to the policy before all required proofs of eligibility are submitted. The policy also sets a timeframe of 30 days from the date the Form 503 is submitted for the proofs to be provided. If the proofs are not provided within the 30-day timeframe, a new Form 503 will have to be submitted. This may lead to the dependent experiencing a waiting period of three months. There is an exception for newborn children. Newborn children will be added upon request. Proofs of eligibility are to be submitted upon becoming available to avoid interruption in coverage
- 65th Birthday Letter for Active Employees and their Dependents: As of August 2016 NYS Department of Civil Service administrators of NYSHIP will be mailing out 65th Birthday Letter to active employees, and dependents of active employees. The 65th birthday mailing provides general guidance regarding Medicare and NYSHIP rules while working, and reminds enrollees of their responsibility to enroll in Medicare when they are planning to retire. The mailing includes a personalized letter (see sample attached), and the Medicare & NYSHIP booklet with DVD, which provides more detailed information.
HEALTHPLEX DENTAL COVERAGE
- Effective January 1st, 2017, dependent children enrolled in the dental plan can remain covered through age 26. This is similar to the policies now in effect for the health and optical plans. Employees with dependent children under age 26 who are paying COBRA for their dental plan can stop paying beginning January 2017. These dependent children will be automatically re-enrolled on the employee’s policy. Dependent children who aged-out, but did not sign up for COBRA will also be re-enrolled if they are currently listed as a dependent for health insurance.
PATIENT PROTECTION and AFFORDABLE CARE ACT (PPACA)
- If you experience loss of coverage due to separation from County employment, loss of eligibility or are a surviving dependent of a deceased County employee and is entitled to continue benefits through COBRA. You may qualify for a special enrollment opportunity for another group health plan through the Marketplace if you request enrollment within 30 days. For tax credit eligibility and/or premium estimates, visit the Official Health Plan Market Place at www.healthbenefitexchange.ny.gov.
Please note: We can only provide information about benefits offered through Nassau County and
not any potential benefits available through the marketplace.