The Daily Bulletin Archive

The New York State Health Insurance Program (NYSHIP) will continue to offer the Opt-Out Program for 2021. 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 incentive payment. The annual incentive payment is $1,000 for opting out of individual coverage or $3,000 for opting out of family coverage. The incentive payment is prorated and credited through the employee's biweekly paycheck throughout the year (payable only when the employee is eligible for NYSHIP coverage at the employee share of the premium). Note: Opt-out incentive payments increase your taxable income.

Eligibility Requirements to Participate in the Opt-Out Program
Please note: Employees who are represented by UUP are not eligible to participate in the Opt-Out Program.

You must be a member of a group eligible for the Opt-Out Program, and you must have been enrolled in NYSHIP by April 1, 2020 (or on your first date of NYSHIP eligibility if that date is later than April 1) and remained continuously enrolled while eligible for the employee share of the premium through the end of 2020. Once you enroll in the Opt-Out Program, you will not be eligible for the incentive payment during any period that your status changes and, as a result, you do not meet the requirements for the state contribution to the cost of your NYSHIP coverage. Also, if you are receiving the incentive for opting out of family coverage and your last dependent loses NYSHIP eligibility during the year, you will only be eligible for the individual incentive payment ($1,000) for the remainder of the tax year.

Electing to Opt Out
If you are currently enrolled in NYSHIP coverage and wish to participate in the Opt-Out Program, you must elect to opt out and attest to having other employer-sponsored group health insurance during the annual Option Transfer Period. Other employer-sponsored group health coverage cannot be NYSHIP coverage that is the result of your or your spouse’s, domestic partner’s, or parent’s employment relationship with New York State, or the result of your own employment with a NYSHIP Participating Agency (PA) or Participating Employer (PE).

Complete the Opt-out Attestation Form (PS-409; PDF, 161 KB) and a NYS Health Insurance Transaction Form (PS-404; PDF 78 KB) and submit both to the Benefits Office (Cleveland Hall 410) before Thursday, December 31. Your NYSHIP coverage will terminate at the end of the current plan year, and the incentive payments will begin with the first payroll period of the new plan year. If you are a newly benefits-eligible employee who has other employer-sponsored group health insurance and you wish to participate in the Opt-Out Program, you must make your election before the end of your NYSHIP waiting period.

It is no longer necessary to re-enroll in the Opt-Out Program each year. No action is required for current Opt-Out enrollees who are still eligible and wish to remain in the program during the 2021 plan year.

Re-enrollment in a NYSHIP Health Plan
Once you elect to participate in the Opt-Out Program, you may not re-enroll in a NYSHIP health plan until the next annual Option Transfer Period unless you experience a qualifying event as defined by Internal Revenue Service (IRS) rules, such as a change in family status (e.g., marriage, divorce, or birth of a dependent) or loss of your other employer-sponsored health insurance. To avoid a waiting period, your request for enrollment must be made within 30 days of the qualifying event.

Please call the Benefits Office at 878-4821 with questions.