Dependents and Dependent Survivor Coverage

Uploaded by GOERWebServices on 20.01.2012


I am Susan MacLennan, and I want to welcome you
to the Video Guide -
Planning Your Successful Retirement for executive branch
New York State employees.
These videos were created to provide you with essential
information for planning your retirement.
For those of you with dependents,
this video entitled, Dependents and Dependent Survivor Coverage,
provides information regarding dependent eligibility coverage,
as well as disabled dependent eligibility coverage.
Coverage for dependent survivors if you predecease your
dependents is also discussed.
For additional information regarding the New York State
Health Insurance Program, please refer to Chapter 10 of the
online version of the Self-Help Guide to Pre-Retirement Planning
available on the Work-Life Services website,
Now, please welcome Sharon Beauregard,
a Department of Civil Service, Employee Benefits Division
Under NYSHIP, dependent eligibility requirements are the
same when you retire as they are when you are an active enrollee.
You may provide coverage to the following under your family
plan: your spouse, which includes a legally separated
spouse, but not a divorced spouse;
your domestic partner (in order to provide coverage,
proper documentation showing financial interdependence and
cohabitation for at least six months prior to the request for
coverage must be provided and approved);
children under the age of 19, which includes your natural or
biological children, your legally adopted children,
your stepchildren or children of your domestic partner.
Other dependent children, children who are financially
dependent upon and residing with the enrollee,
are eligible for coverage.
You must submit an application, complete a Statement of
Dependence, and provide the required documentation.
These dependents must be certified as eligible at least
once every two years.
As of January 1, 2011, eligible dependents include adult
children between the ages of 19 and 26.
Please note that dependents that are classified as "other
children" must have been certified and covered at age 19
to be eligible as your adult child up to age 26.
A dependent child over age 26 with a disability requires an
application completed by the enrollee,
the employer, and the physician of the dependent,
and approved by the health insurance carrier.
The disability must have commenced prior to the 26th
birthday or while covered as an eligible dependent under NYSHIP.
The standard used for certifying disabled dependent status is
incapable of self-support.
Again, the determination of eligibility is made by the
health insurance carrier.
New York State law allows unmarried young adults through
age 29 to be covered through their parent's
employer-sponsored group health insurance coverage.
The dependent is enrolled separately and is charged 100
percent of the premium.
The young adult must be the natural child,
adopted child, or stepchild of the NYSHIP enrollee.
The young adult cannot be married or be eligible for his
or her own employer-sponsored group health plan,
if that plan includes both hospital and medical coverage.
If you predecease your covered dependents,
they will receive three months of extended benefits at no cost
to them.
Under The Empire Plan, coverage continues under the same
identification number, so the dependents can continue using
the same identification cards during the extended benefits
However, if enrollment is through a NYSHIP HMO,
the HMO may issue new identification cards under a
different contract number for the three months of extended
As a retiree, your dependents are eligible to continue NYSHIP
coverage as dependent survivors if they are covered under your
family coverage at the time of your death,
or you deferred your health insurance coverage and they were
covered under your family coverage at the time of
deferral, and you had 10 or more years of service in a benefits
eligible position.
Remember, coverage under NYSHIP in a benefits eligible position
could be through the State or combined with service with an
employer that was eligible to participate in NYSHIP.
To initiate dependent survivor coverage,
your dependent should notify the Employees' Retirement System or
the Teachers Retirement System (if appropriate) of your death.
The Retirement System will then notify the Employee Benefits
Division if you were paying for your coverage through pension
However, if you were paying for your coverage directly to the
Employee Benefits Division, your dependent will need to notify
the Employee Benefits Division by providing a copy of your
death certificate.
If you belong to TIAA-CREF, your dependent should be advised to
contact the Employee Benefits Division and provide a copy of
your death certificate.
Once the Employee Benefits Division is notified,
we would then send out information to your surviving
dependent about continuing coverage under NYSHIP.
Dependent survivors of retirees pay 10 percent of the cost of
individual and 25 percent of the cost of dependent coverage.
If the Dual Annuitant Sick Leave Credit was selected by the
retiree, the Sick Leave Credit will be used to offset the cost
of the premium for the dependent survivor.
Please note, selecting the Dual Annuitant Sick Leave Credit
Option is not a requirement for dependent survivor coverage.
Coverage permanently ends if your dependent survivor: does
not elect to continue coverage, cancels coverage,
fails to make premium payments.
Eligibility rules for your surviving spouse,
domestic partner, and dependent children are the same as when
they are enrolled under your coverage.
Survivor eligibility for these dependents may be continued for
as long as such dependents would otherwise be eligible for
coverage if you had not pre-deceased them (for example,
child ages out, spouse remarries,
domestic partner re-partners or marries.)
That brings us to the end of this video segment.
For more details about the New York State Health Insurance
Program, we invite you to view the other health insurance
videos and visit the New York State Department of Civil
Service website, then go to the Retirees tab on the homepage.
Talk with your agency Health Benefits Administrator or call
to speak with a New York State Civil Service,
Employee Benefits Division representative.
To reach the Employee Benefits Division,
call 518-457-5754 if you are in the Albany area,
or call 1-800-833-4344.
Remember, once you retire the Employee Benefits Division will
serve as your Health Benefits Administrator.
Thank you for your service to New York State and have a
wonderful retirement!