Changing Your NYSHIP Health Insurance Option for 2020
It’s that time of year to determine your 2020 health insurance options. The annual NYSHIP option transfer period will be held after the 2020 health insurance premiums are approved.
Changes Allowed During the Option Transfer Period:
- Changing your Pre-Tax Contribution Program (PTCP) election;
- Changing your New York State Health Insurance Program (NYSHIP) option to one of the following:
- The Empire Plan
- A NYSHIP Health Maintenance Organization (HMO) where you live or work
- The Opt Out Program
New in 2020:
- The PTCP election period will run concurrently with the Option Transfer Period. The dates will be announced once the rates have been approved.
- For State enrollees currently enrolled in the Opt-Out Program, no action is necessary if you are still eligible and wish to maintain your enrollment in the Opt-out Program for the 2020 plan year.
- Contact your Agency Health Benefits Administrator, located in your Personnel Office or the New York State Business Services Center, regarding any change which would impact your eligibility to receive the Opt-out incentive payments or if you lose your other employer-sponsored health coverage.
Other Changes Permitted During the Option Transfer Period
- Change from Family to Individual coverage (regardless of whether a qualifying event has affected your dependents’ eligibility)
- Change from Individual to Family coverage (late enrollment provisions will apply)
- Voluntarily cancel your coverage (regardless of whether a qualifying event has affected your eligibility)
- Enroll in NYSHIP coverage (late enrollment provisions will apply)
Your agency has been sent Health Insurance Choices for 2020, your guide to NYSHIP options. If you are thinking about changing your option or newly enrolling in NYSHIP, ask your HBA for a copy or go to NYSHIP Online and read the descriptions of plans in your area to compare the benefits that are important to you and your family.
What is New for the Empire Plan in 2020:
• Empire Plan enrollees are eligible for hospice care if the doctor and hospice medical director certify that the covered patient is terminally ill and likely has less than 12 months to live (this benefit is retroactive to July 1, 2019).
• Enrollees age 9 through 45 are covered for the human papillomavirus (HPV)-9 immunization at no cost when the vaccine is received from a participating provider. Other forms of HPV vaccines continue to be covered through age 26 (this benefit is retroactive to Oct. 1, 2019).
• Effective Jan. 1, 2020, Empire Plan infertility benefits will cover enrollees for a minimum of three IVF cycles per lifetime. Additionally, standard fertility preservation services are covered when a medical treatment, such as treatment for cancer (radiation therapy or chemotherapy), will directly or indirectly lead to infertility.
• Effective Jan. 1, 2020, HIV-prevention medication for Pre-Exposure Prophylaxis (PrEP) will be covered with no co-payment, deductible or any other out-of-pocket costs for enrollees who do not have HIV but are at high risk of acquiring it. Screening for HIV continues to be covered with no out-of-pocket costs when using a network provider.
• Effective Jan. 1, 2020, modified solid food products (MSFPs) are no longer subject to a $2,500 total maximum reimbursement per covered person, per year. Modified solid food products are covered when prescribed by a physician or provider. This benefit is not subject to deductible or coinsurance.
Please see the January 2020 Empire Plan At a Glance for more detailed information regarding these benefits or outreach to the Empire Plan at 1-877-769-7447.