Human Resources

Health Insurance
Option Transfer Period Information 

The 2017 Option Transfer Period runs through December 16, 2016. During this period, employees may change their New York State Health Insurance Program (NYSHIP) plan option for the 2017 plan year. 

  • Information and Instructions
  • Employee Benefits Office Contact Information
  • Choices and Rates
  • Choices User Guide
  • Health Insurance Opt-Out Program

     

    Option Transfer Period Information and Instructions Top

    During the annual health insurance option period starting on November 14, 2016 and continuing through December 16, 2016, you may:
    • Change your health insurance plan (insurance carrier);
    • Change your coverage from Family to Individual without a qualifying event;
    • Cancel your coverage entirely, and if eligible Opt-Out of NYSHIP for incentive payment. 

    In addition, 2016 Opt-Out Program participants may:

    • Change your option and elect to enroll in health insurance during the 2017 plan year;
    • Re-enroll in the Opt-Out Program for the 2017 plan year.

    Changes will go into effect on December 29, 2016. Complete a  PS-404 Health Insurance Transaction Form  if you will be changing your health insurance option. Forms must be received in the Employee Benefits office by December 16, 2016.

    To change your health insurance plan (insurance carrier):

    • Complete items 1, 2, 4, and 6 on page 1 of the PS-404 form.
    • Check item 13 and write your new plan name and code at the top of page 2.
    • Sign and date the Authorization section at the bottom of page 2.
    • Mail, fax or deliver the form using the contact information below.
    • Forms must be received in the Employee Benefits Office by December 16, 2016.
    To change from Family to Individual health insurance coverage or cancel your coverage without opting out (if Opt-Out Program eligibility requirements are not met):
    • Complete items 1, 2, 4, and 6 on page 1 of the PS-404 form.
    • To change to individual coverage: Check item 12, Change to Individual, and write Option Transfer next to "Other" in the list below.
    • To cancel coverage: Check item 12b and write Option Transfer by "Qualifying Event".
    • Sign and date the Authorization section at the bottom of page 2.
    • Mail, fax or deliver the form using the contact information below.
    • Forms must be received in the Employee Benefits Office by December 16, 2016.

  • There are five health insurance plan choices available to UAlbany employees: 

     Plan Name
    Plan Code Number
    The Empire Plan
     001
    CDPHP HMO
     063
    Empire BlueCross BlueShield HMO
     280
    HIP
     220
    MVP HMO
    060

    Insurance information, rates, benefits, and deadlines can be obtained by visiting http://www.cs.ny.gov/ebd/ or www.albany.edu/hr/health.php. You may also call or visit the Benefits Office if you have questions.

    If you wish to keep your current insurance carrier as your election for 2017, you do not need to take any action during the Option Transfer Period.

    Employee Benefits Office Contact Information  Top

    You may mail, deliver, or fax your insurance forms to the attention of the Health Benefits administrator at:

    Employee Benefits
    Office of Human Resources Management
    University at Albany
    1400 Washington Ave - UAB 300
    Albany, NY 12222
    Phone: (518) 437-4729  Fax: (518) 437-4731
    Office Hours: M-F, 8:00am to 5:00pm

    Option Transfer Choices, Rates, and Opt-Out Period  Top

    Health Insurance Plan Choices
    • CHOICES 2017 - Includes benefit information for each of the available insurance plans.
    • A Summary of Benefits and Coverage, which provides more detailed information than the CHOICES booklet is available for each plan.  Use the link provided to obtain these documents or obtain them by calling Civil Service/NYSHIP at 1-877-769-7447.

    Health Insurance Rates

    •  CHOICES User Guide  - Includes Rates as of January 1, 2017 and will assist in navigating the CHOICES Booklet. 

    Forms

     

    Health Insurance Opt-Out Program  Top

    The Opt-out Program allows eligible employees who have other employer-sponsored group health insurance, to opt out of their NYSHIP coverage in exchange for an annual incentive payment of $1,000 for waiving Individual coverage, or $3,000 for waiving Family coverage. Additional details, including eligibility requirements can be found on page 3 of Planning for Option Transfer

    To cancel your coverage and elect to participate in the Opt-out Program for an incentive payment, or to continue participation in the Opt-Out Program during the 2017 plan year:

    • On page 1 of the PS-404, Complete items #1, 2, 4, and 6.
    • On page 2, check item 13, Elect Opt-Out (if eligible) and select individual or family. If you are re-opting out of family coverage, dependent names must be listed in section 10.
    • Sign and date the PS-404 authorization section at the bottom of page 2.
    • Complete and sign the 2016 PS-409 Opt-Out Attestation Form to attest to having other employer-sponsored group coverage.
    • Attach proof of other coverage (copy of other group employer health insurance card, or signed statement on other employer's letterhead confirming current coverage).
    • Mail, fax or deliver BOTH forms with proof of other coverage, using the contact information below. Forms must be received in the Employee Benefits Office by December 16, 2016.

    You must re-enroll in the Opt-Out Program annually. This election does not carry over from year to year.