Planning for RetirementFebruary Important Information forEmployees of New York StateHealth Insurance Coverageand Related Benefitsin RetirementNew York State Department of Civil ServiceEmployee Benefits Division

Health Insurance Eligibility. 1Paying for Health Insurance. 5Sick Leave Credit. 5Choosing how to use yourSick Leave Credit. 6Deferring YourHealth Insurance. 7Choosing Your HealthPlan in Retirement. 8Understanding YourNYSHIP Options. 8Canceling NYSHIP Coverage. 9NYSHIP and Medicare. 9The Empire Plan. 9NYSHIP Health MaintenanceOrganizations (HMOs). 9Non-NYSHIP HMOs. 10What is Medicare?. 10Other Benefits.15Your Next Steps.17Resources.19After You Retire.20Important Terms to Know.21Contact Information.23A Website for You.25Health Insurance EligibilityRetirement means different things to different people –traveling, a winter home, even pursuing a new career.Whatever you have planned and wherever you go in yourretirement, your health benefits will be a key interest.As an active employee, the New York State HealthInsurance Program (NYSHIP) provides your healthinsurance coverage through The Empire Plan or aNYSHIP-approved Health Maintenance Organization(HMO). NYSHIP covers over 1.2 million State and localgovernment employees, retirees and their families.As a New York State retiree, you may be able tocontinue NYSHIP’s coverage for you and your eligibledependents, but there are requirements you must meetand steps you must take before you retire.This booklet explains your health benefits in retirementand answers questions about: Eligibility requirements for continuing coverageHow sick leave credit helps pay for health insurance*Single and Dual annuitant sick leave creditDependent survivor coverageMedicare and your NYSHIP coverageMedicare premium reimbursementDeferred coverageReturning to work and/or continued employmentYour Health Benefits Administrator (HBA) can answeryour questions and explain your benefits. Your HBA,located in your agency’s personnel office or in theNew York State Business Services Center, is yoursource for benefit information as an active employee.Once you retire, the New York State Department ofCivil Service Employee Benefits Division becomesyour HBA and your source for benefit information.* Judges, justices and certain M/C employees do not earn sickleave credit.1 Planning for Retirement February

Can I continue my NYSHIP coverage whenI retire?You can continue your coverage as a New York Stateretiree if you meet all of the eligibility requirements.What are the eligibility requirements tocontinue my NYSHIP coverage after I retire?There are three criteria that you must meet tocontinue NYSHIP coverage as a State retiree:First, you must complete the minimum benefitseligible service requirement that is determinedby the date on which you last entered Stateservice. Benefits-eligible service means a periodof employment during which you were eligible forNYSHIP coverage by paying only the employeeshare of premium.If you were last hired on or after April 1, 1975,you must have had at least 10 years of NYSHIPbenefits-eligible State service, or at least 10 yearsof combined NYSHIP benefits-eligible service withthe State and one or more Participating Employers(such as the Thruway Authority or MetropolitanTransportation Authority) and/or ParticipatingAgencies (such as towns and school districts).If you were last hired before April 1, 1975,you must have had at least five years of NYSHIPbenefits-eligible State service or at least five yearsof combined NYSHIP benefits-eligible service withthe State and one or more Participating Employersand/or Participating Agencies.Periods of employment in which you did notmeet the eligibility requirements for coverage atemployee share will not be counted. For example,periods when you were paying both the employershare and the employee share of the NYSHIPpremium while on Leave Without Pay do not counttoward the minimum service requirement.Benefits-eligible service with public employersother than the State may count toward the minimumservice requirement if that employer participatesin NYSHIP now or participated at the time theservice was earned. Contact your Health BenefitsAdministrator if you have prior service with anotherpublic employer to determine if this service countstoward the minimum service requirement.Documentation of this service is required. If theserecords are unavailable, you may be able tosubstitute records from the retirement system towhich you belong. You must have a minimum of oneyear of State service in a benefits-eligible positionfrom the employer you are retiring from.Second, you must qualify for retirement as amember of a retirement system administered byNew York State (such as the New York State andLocal Retirement System, the New York StateTeachers’ Retirement System, or the New YorkState and Local Police and Fire Retirement System)or any of New York State’s political subdivisions.If you are not a member of a publicly administeredretirement system or you are enrolled in theState University of New York Optional RetirementProgram with a plan sponsor such as TIAA, you mustsatisfy one of the following: Meet the age requirement for pension eligibility inthe New York State and Local Retirement Systemretirement tier in effect when you last enteredservice, or Be qualified to receive Social Securitydisability payments.Third, you must be enrolled in NYSHIP asan enrollee or dependent at the time of yourretirement. For example, if you were on leave andcanceled your coverage, and then retired, you maynot be eligible for health coverage as a retiree.Planning for Retirement February 2

If you are not yet enrolled in NYSHIP, you will berequired to satisfy a late enrollment period. Thismeans that if you wish to be eligible as a retiree,you must apply for coverage at least eleven weeksprior to your retirement date.If you have maintained continuous NYSHIPcoverage as a vestee or while covered underPreferred List provisions, or as the dependent of aNYSHIP enrollee, you have met this third eligibilityrequirement. Also, enrollment in the State’s Optout Program at the time of retirement satisfies thisrequirement. However, you cannot continue toparticipate in the Opt-out Program as a retiree.I am eligible to retire but don’t want to startcollecting my pension. Can I still have retireehealth coverage?If you are eligible to retire and delay collectingyour State pension, you may continue your NYSHIPcoverage under retiree provisions if you meetthe eligibility requirements. Ask your HBA aboutconstructive retirement for health benefits purposes.With this option, you will pay the health insurancepremium (if any) directly to the Employee BenefitsDivision. You also may use any unused sick leavecredit to offset the cost of your health insurance.See pages 5 to 7.As a vestee, you must pay both the State andemployee shares of the premium. You will bebilled monthly by EBD.Will my dependent survivors be eligible forhealth insurance under NYSHIP when I die?If you had a total of 10 years of service with theState and/or a public employer eligible to participatein NYSHIP, your enrolled dependent survivors willhave the opportunity to continue NYSHIP coveragein the event of your death in retirement. To beginthe process, your dependent survivors must send acertified copy of your death certificate to the New YorkState and Local Retirement System or New YorkState Teachers’ Retirement System.If you were not a member of a retirement systemadministered by New York State or you chose notto pay your premium by pension deduction, yourdependent survivors must send a copy of yourdeath certificate to the Employee Benefits Division.Dependent survivor coverage, including the cost,is explained in your NYSHIP General InformationBook. Make sure your family knows they mustcontact the Employee Benefits Division within90 days of your death to enroll for dependentsurvivor coverage if you die in retirement.If I end my employment before retirementage, will I still be eligible to continue NYSHIPcoverage when I qualify for retirement?To be eligible for coverage as a retiree, you mustmaintain continuous NYSHIP coverage from thetime you leave the payroll until you are eligible toretire. Contact your HBA before your last day ofwork to see if you are eligible to continue healthcoverage as a vestee.You must have the required benefits-eligible service(see pages 1 to 2) and be enrolled in NYSHIP either asan enrollee or dependent when you leave the payroll.If you are eligible to continue coverage as a vesteebut fail to make the required premium payments asa vestee, coverage for you and your dependents willbe terminated permanently. You may not reenroll asa vestee at a later date, and you lose eligibility forcoverage as a retiree.3 Planning for Retirement February To be eligible for coverage as a retiree,you must maintain continuous NYSHIPcoverage from the time you leave thepayroll until you are eligible to retire.If you leave State service before youare eligible to retire and your spouse ordomestic partner is eligible for NYSHIPcoverage in his or her own right,continuing coverage as a dependent ofyour spouse or domestic partner is oneway to meet this requirement. This is aless expensive alternative to full-sharevestee coverage.

After I retire, how does my dependentsurvivor continue NYSHIP coveragewhen I die?If I have NYSHIP coverage as a dependentthrough my spouse/domestic partner, amI eligible for my own coverage as a retiree?If you die in retirement, your enrolled dependentswill have extended health insurance coverage forthree months beyond the month in which you die.NYSHIP provides these three months of coverageat no cost.If you have NYSHIP coverage as a dependent throughyour spouse/domestic partner and otherwise meeteligibility requirements for coverage as a retiree,you may establish coverage as a retiree in yourown right at any time. You may use your own sickleave credit with proper documentation.Your dependent survivor must notify the New YorkState and Local Retirement System or the NewYork State Teachers' Retirement System and theEmployee Benefits Division of your death (seepage 23 for contact information). The EmployeeBenefits Division will then send information aboutcontinuing coverage to your dependent survivor.If your dependent survivor is eligible to continuecoverage, an application will be included with thisinformation. The application should be completedand returned to the Employee Benefits Divisionas soon as possible. Publications that explain theNYSHIP health benefits will be sent separately.Before you retire, ask your HBA for a copy of FormPS-410, State Service Sick Leave Credit Preservation.Keep this form with your important papers.Notify the Employee Benefits Division in writingif a pending divorce or other change means youwill need to reactivate your NYSHIP coverage inyour own name. Attach a copy of Form PS-410. Seepages 5 to 7 for additional information on using sickleave credit in retirement.If you choose the dual annuitant sick leave creditoption when you retire and you die before yourdependents, that credit would continue to reducetheir premium cost. See pages 6 and 7.If your dependent survivor spouseremarries, he or she is no longereligible for NYSHIP coverage.This also applies if your domesticpartner who is a dependent survivormarries or acquires another partner.However, any children enrolled inNYSHIP will continue to be eligible forcoverage for as long as they meet thedependent eligibility requirements.Planning for Retirement February 4

Paying forHealth InsuranceAs an active employee, your share of the NYSHIPpremium is deducted from your paycheck. Whenyou retire, you pay through deductions from yourmonthly retirement check or you make monthlypayments directly to the Employee Benefits Division.Your Health Benefits Administrator (HBA) can answeryour questions and help you determine the cost ofyour health insurance option in retirement.What portion of the cost of health insurancewill I pay as a retiree?The amount you must contribute toward the costof your health insurance coverage as a retiree willbe based on your salary grade (or equivalent) atthe time of retirement. Ask your HBA what yourpremium will be. You may be able to use your sickleave credit to reduce your cost. See pages 5 to 7.Although health insurance premiums generallyincrease annually, your sick leave credit is afixed monthly amount and will not change.How will I pay for my health insurance asa retiree?When you retire, you will pay your share of theNYSHIP premium through deductions from yourmonthly retirement check or by making monthlypayments directly to the Employee Benefits Division.Once your pension is finalized by the RetirementSystem, the Employee Benefits Division will begintaking monthly health insurance deductions fromyour pension. In the interim, if you owe premiums,you will be billed directly each month. You mustpay the monthly bills or risk having your healthinsurance canceled for nonpayment.If your coverage is canceled for nonpayment, youcan later reenroll. However, in most cases, you willbe subject to a three-month waiting period beforeyour coverage becomes effective.It may take several months for billing to begin.At that point, you will be billed from the date yourretiree health benefits went into effect throughthe current billing period.5 Planning for Retirement February Sick Leave CreditWhat is sick leave credit?S