Q: Will I continue to be eligible for benefits if I am temporarily not working and do not receive a pay check?
A: Coverage while you are on an unpaid leave is not automatic and depends on the nature of the absence. You should speak with your department’s Human Resources Representative in order to determine your eligibility. In most cases, you must pay the health insurance premium to continue coverage during an unpaid absence. If you do not make your premium payment, coverage will terminate on the last day of the month for which you received a paycheck.
Q: What happens if my coverage lapses when I am not working?
A: If your coverage lapses due to non-payment while you are on an unpaid leave and you never return to work, you will have no rights to coverage as a former enrollee, nor will your dependents. You also risk losing health insurance coverage when you retire.
Q: I am on leave without pay and have recently become disabled. Can I have my health insurance contribution waived?
A: Yes, premium waivers are granted for up to one year in certain instances. There are several criteria that must be met in order to qualify for a premium waiver:
You must have been totally disabled as a result of sickness or injury, on a continuous basis, for a minimum of three months;
You must be on authorized leave without pay; and
You must have kept your coverage in effect by paying the required cost of your health insurance premium while you were on leave without pay.
If eligible, you may Contact Us at the Comptroller’s Health Benefits Unit to obtain a PS-452 Form or call (516) 571-2369.
This option is only available to NYSHIP enrollees.
In order to apply for a waiver of premium, this form should be completed by you, your agency, and your physician and sent to:
Eligibility Unit 505
Kingston, New York 12401