10 Things To Know About NYSHIP Retiree Coverage
If you’re a New York State employee retiring soon, here are 10 things you should know about NYSHIP retiree coverage.
1. There are a few requirements to begin NYSHIP retiree coverage.
In general, to begin NYSHIP retiree coverage:
- You must have at least 10 years of benefits-eligible service.
- You must be pension-eligible.
- You must already be enrolled in NYSHIP when you stop working.
Certain exceptions apply.
In addition, you and your covered dependent(s) must be enrolled in Medicare when eligible. If you don’t enroll when eligible, your overall health coverage will be reduced—or your NYSHIP coverage will be canceled.
Be sure Medicare is in place before your retirement.
2. When eligible for Medicare, Medicare pays first.
After your retirement, Medicare is the primary coverage for you (and your covered dependents) when eligible. This means Medicare pays for your care first, and NYSHIP handles the remaining balance.
NYSHIP won’t cover what Medicare pays—so be sure you’re enrolled in both.
3. Non-NYSHIP Medicare plans will terminate your NYSHIP coverage.
If you sign up for a non-NYSHIP Medicare Advantage (Part C) or Part D plan, your NYSHIP coverage will be automatically canceled.
4. NYSHIP reimburses Medicare Part B premiums and IRMAA.
After you retire, NYSHIP reimburses the standard Part B premium for you and your covered dependent(s). You’ll receive this through your pension check, a premium reduction or a quarterly refund check. You must apply for Part B IRMAA reimbursement each year.
NYSHIP doesn’t reimburse Part D premiums or IRMAA.
5. You can change your plan option once every 12 months.
As a retiree, you can change your NYSHIP plan option once every 12 months for any reason (you don’t have to wait for Open Enrollment).
In addition, you can change your plan option anytime a qualifying event occurs. See When You Retire.
6. Your unused sick leave will offset your NYSHIP premium.
When you retire, your unused sick leave will be converted into a dollar amount and applied to offset your premium. Use the Sick Leave Credit Calculator or talk to your HBA to get an estimate.
Your sick leave credit ends after your death—unless you choose the dual annuitant option. This option reduces the value of your sick leave credit to 70% but allows your dependent survivors to use it later. To enroll, submit a NYSHIP Sick Leave Credit Option Election Form (PS-405) before you stop working.
7. You’re no longer eligible for the Opt-Out Program.
After you retire, you can’t be in the Opt-Out Program. To stay in NYSHIP, you’ll have to enroll in The Empire Plan or a NYSHIP HMO.
8. You’re no longer eligible for the Pre-Tax Contribution Program.
Since your NYSHIP premium won’t be taken from a paycheck, you can’t participate in the Pre-Tax Contribution Program as a retiree.
9. If you’re enrolled in dental or vision coverage through NYS, that coverage ends after retirement.
State dental and vision coverage both end two pay periods (usually 28 days) after the last day of the last payroll period you worked.
For dental, you can enroll in a direct-pay plan with Anthem. You can also enroll in COBRA benefits for dental and vision.
If you receive dental and vision coverage through a union employee benefit fund, check with them—your benefits may be different.
10. After you retire, the Employee Benefits Division (EBD) in the Department of Civil Service is your health benefits administrator.
Contact EBD with questions about enrollment, eligibility and reimbursements. Call 518-457-5754 or 1-800-833-4344.