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Annual Opt Out Program for NSHIP Enrollees in CSEA, PEF, MC, NYSCOPBA, and NYBANYS

The Opt-out Program allows allow eligible employees who have other employer sponsored group health insurance, to opt out of their NYSHIP coverage in exchange for an incentive payment. The incentive payment is $1,000 for waiving Individual coverage or $3,000 for waiving Family coverage on an annual basis. The incentive payments will be prorated and reimbursed through your biweekly paycheck throughout the year (payable only when an employee is on the payroll). Note: The payments will be taxable income.

- Currently participating in the program OR
- Enrolled in NYSHIP (Blue Choice, Empire, MVP etc.) since 4/1/12 or date of hire
- Remain enrolled in NYSHIP through the end of this plan year
- The employee must provide information and attest to having other employer sponsored group health insurance in effect for the Opt-Out period. (you may not opt out to go without health insurance coverage)

Eligibility Continued- MC & PEF

- Switching to another NYSHIP policy does not qualify you for the benefit (example: your spouse works for SUNY Geneseo. You may not opt out of your plan here and switch to theirs to receive an opt out payment).

Eligibility Continued - CSEA

- A CSEA represented employee who has a spouse or domestic partner who is a State employee, whether that spouse or domestic partner is a CSEA represented employee, represented by another state employee union, an M/C employee or an employee of the Legislature or the Unified Court System, and both are covered by NYSHIP (dual enrollment) may elect to opt out and receive $1,000 for calendar year. The CSEA employee must be opting out of individual coverage.

Incentive Payments
The annual incentive amount for opting out of NYSHIP coverage is $1,000 for Individual coverage or $3,000 for Family coverage. The incentive payments will be prorated and reimbursed through the employee's biweekly paychecks throughout the year (payable only when an employee is on the payroll and meets the requirements to be eligible for the State to contribute to the cost of NYSHIP coverage).

The incentive amount will be credited to the employee's bi-weekly pay check and will be treated as taxable income. The bi-weekly incentive amounts will be $38.46 for opting out of Individual coverage ($1,000/26 paychecks) or $115.38 for opting out of Family coverage ($3,000/26 paychecks).

Incentive payments to employees participating in the Opt-Out Program for 2013 will begin 1/2/13.

1. Complete a PS-404 form indicating you wish to cancel your coverage
2. Complete a PS-409 (opt out) form and attach to the PS-404
3. Submit to The Office of Human Resources by 12/30/12

NOTE: You must re-enroll each year.