New York State Health Insurance Program (NYSHIP)
What Health Benefits are available to me?
State employees and retirees may choose The Empire Plan or a Health Maintenance Organization (HMO) that has been approved for participation in NYSHIP in the geographic area where the enrollee lives or works. To compare The Empire Plan to local available HMOs please visit:
When do I become eligible for health benefits?
New employees negotiating with unit 47 have a 42 day wait period upon hire. New employees negotiating with unit 46 have a 56 day wait period upon hire. Employees who transfer from other agencies may not have waiting periods for benefits (contact Tina Lehning, agency health benefits administrator, for determination).
Additionally, employees continue with coverage for 28 days after they terminate or resign from state service.
Can I change benefits providers?
Yes! Option changes for benefit providers are permitted once a year during the Open Enrollment Period.
There are qualifying events that permit changes outside of the Open Enrollment Period (contact Tina Lehning, agency health benefits administrator, for additional information).
NYS Health Insurance Transaction Form https://www.cs.ny.gov/forms/ps404.pdf
NYSHIP Online https://www.cs.ny.gov/mynyship/welcome/
Health Insurance Opt Out Information and Form https://www.cs.ny.gov/forms/ps409.pdf
Dental and Vision
CSEA employees are entitled to a $2,500 a year annual maximum on dental benefits available to each member and dependent(s). Whenever an estimated cost of a recommended dental treatment exceeds $250.00, it must be submitted to the Employee Benefit Fund before work begins.
Also as a CSEA members and their eligible dependents using participating optometric providers are entitled to an eye examination and one pair of glasses (lenses & frames) or contacts. Members/employees whose job duties require 50% or more of their work hours on a computer display terminal (CDT) are eligible to receive a second pair of glasses if a different prescription is needed or the lenses require tinting for use on the CDT. Members using a non-participating provider are reimbursed based on the fee schedule appearing in the Summary Plan Descriptions provided to the member. If using a non-participating provider, reimbursement is made on one set of eyewear per person.
Benefit Enrollment Form https://www.cseaebf.com/OLE/enroll.php
Management Confidential (M/C)
M/C employees are provided with a group dental insurance plan, currently administered by Group Health Incorporated (GHI). After six months of service, the employee and dependents are covered on the first day of the next calendar month. The plan covers a broad range of dental work. If an employee chooses to use a participating dentist, all covered fees are paid by the plan after a $25 deductible, up to $2000 per year for each individual enrollee and dependents. If the employee chooses to use a non-participating dentist, reimbursement is made in accordance with an indemnity fee schedule.
M/C employees their dependents are eligible for vision care coverage under the M/C Vision Care Plan. Vision care benefits are available to each covered employee or dependent once in any 24-month period. If an employee chooses to use a participating provider for vision care needs, the Plan covers the entire cost of an examination and an allowance toward eyeglasses (selected from among a large variety of frames available under the Plan). Daily wear contact lenses are also covered, but require a co-payment. If the employee chooses a non-participating provider, he or she must pay the provider and reimbursement will be made directly to the employee according to a fixed schedule. An occupational vision care benefit covers the cost of an additional pair of eyeglasses for employees determined to have occupation-related vision problems and who require special eyeglasses for work; however, this benefit must be used in conjunction with a regular examination provided by a participating optometrist.
Continuing Medical Coverage For Graduating Students and Dependent Children.
The Patient Protection and Affordable Care (PPAC) Act allows enrollees in the New York State Health Insurance Program to provide continued health insurance coverage for their eligible dependents through the end of the month in which they reach age 26. Your eligible dependents can remain on your plan until they reach age 26, and you do not need to make any changes to continue health insurance coverage. Please note the PPAC Act is for health insurance coverage and does not apply to the dental and vision coverage.
Dependent children who are age 19 or over, but under age 25, are eligible to remain on an enrollee's dental and vision plan as a dependent only if he or she is a full-time student and provides verification of this to the carriers. Student verification forms for Davis Vision and Emblem Health links are found below. The effective date of a child's loss of eligibility for coverage as a student dependent varies based on the reasons for the loss.
Personnel Actions - Have you had any personal changes in your life? Don’t forget to update your information with Human Resources. MNHS should have up to date Current Information Forms and Emergency Contact Forms for each employee. It is the responsibility of each employee to provide changes in address, telephone number, marital status and dependents to the Human Resources Office.
Also remember to update your beneficiaries for your death benefit payout, pension and deferred compensation with the retirement system.
For all questions regarding health benefits please contact Tina Lehning 518/786-4715 or firstname.lastname@example.org.