Human Resources

The 2024 Option Transfer Period runs through December 29, 2023. During this period, employees may change their New York State Health Insurance Program (NYSHIP) plan option for the 2024 plan year.

• Information and Instructions
• Employee Benefits Office Contact Information
• Choices and Rates
• Health Insurance Opt-Out Program
• Pre-Tax Contribution Program (PTCP)

Option Transfer Period Information and Instructions 

During the annual health insurance option period continuing through December 29, 2023 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. 
• Change your Pre-Tax Contribution Program (PTCP) election for the 2024 plan year.

In addition, 2023 Opt-Out Program participants may:

• Change your option and elect to enroll in health insurance during the 2024 plan year;
• Remain in the Opt-Out Program for the 2024 plan year.
  *The requirement to re-enroll in the Opt-Out Program each plan year is no longer in effect.

Changes will go into effect on January 4, 2024. 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 29, 2023.

To change your health insurance plan (insurance carrier):

• Complete items 1-12 on page 1 of the PS-404 form.
• Check "Change NYSHIP Option" under item 16 and write your new plan name and code on page 2.
• Sign and date the Authorization section at the bottom of page 2.
• Mail or deliver the form using the contact information below.
• Forms must be received in the Employee Benefits Office by December 29, 2023.
• SAMPLE Completed PS-404 - Changing health insurance carrier during Option Transfer.

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 1-12 on page 1 of the PS-404 form.
• To change to individual coverage: Check item 15a, Change to Individual, and write Option Transfer next to "Other" in the list below.
• To cancel coverage: Check item 15b and write Option Transfer by "Qualifying Event".
• Sign and date the Authorization section at the bottom of page 2.
• Mail or deliver the form using the contact information below.
• Forms must be received in the Employee Benefits Office by December 29, 2023.
• SAMPLE Completed PS-404 - Changing from family to individual coverage during Option Transfer.
• SAMPLE Completed PS-404 - Cancelling coverage during Option Transfer.

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

Plan Name	Plan Code Number
The Empire Plan	001
CDPHP	063
EmblemHealth - HIP	220
MVP	060
Highmark BS of Northeastern NY	069

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 2024, you do not need to take any action during the Option Transfer Period.

You may enroll or add a dependent at any time of the year (a waiting period may apply). Instructions can be found here:

• Instructions for Late Enrollment or Adding a Dependent

Employee Benefits Office Contact Information and Paperwork Submission Options 

Forms can be submitted to the Office of Human Resources (HR) by mail (campus or U.S.), dropped off to the front desk or left in the drop box outside of  UAB-300.

Employee Benefits
Office of Human Resources 
University at Albany
1400 Washington Ave - UAB 300
Albany, NY 12222
[email protected]
Phone: (518) 437-4700

Please note that we are unable to accept faxed or emailed documents that contain Personal Identifiable Information (PII). Health Insurance Transaction PS-404 forms should not be submitted by fax or email.

 

Option Transfer Choices, Rates, and Opt-Out Period 

Health Insurance Plan Choices

• CHOICES 2024 - 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.  Obtain these documents on the Civil Service Website.  

Health Insurance Rates

• CSEA, PEF, MC, and UUP CHOICES User Guide - includes Rates as of January 2024 and will assist in navigating the CHOICES Booklet.
• NYSCOPBA and PEF CHOICES User Guide - includes Rates as of January 2024 and will assist in navigating the CHOICES Booklet.

Forms

• PS-409 Opt-out Attestation Form 
• PS-404 Health Insurance Transaction Form

 

Health Insurance Opt-Out Program 

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 5 of Planning for Option Transfer. 

To cancel your coverage and elect to newly participate in the Opt-out Program for an incentive payment, during the 2024 plan year:

• On page 1 of the PS-404, Complete items 1-12.
• On page 2, check item 16, Elect Opt-Out (if eligible) and select individual or family. If you are opting out of family coverage, information for all eligible dependents must be listed in section 14.
• Sign and date the PS-404 authorization section at the bottom of page 2.
• Complete and sign the PS-409 Opt-Out Attestation Form to attest to having other employer-sponsored group coverage.  All sections of this form must be completed in order for it to be processed.
• 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 or deliver BOTH forms with proof of other coverage, using the contact information below. Opt-out submissions that do not include both forms will be considered incomplete and not processed. Forms must be received in the Employee Benefits Office by December 29, 2023.
• SAMPLE Completed PS-404 and PS-409 - Electing Opt-Out Participation

*The Opt-Out Program is not available for UUP-represented employees.