Page 18 - Work Force November 2025

Important 2026 NYSHIP updates for state employees
The Empire Plan maximum
out-of-pocket limits for covered
in-network services will be updated
for 2026 in accordance with the
terms of the collective bargaining
agreements. Detailed information will
be contained in the 2026 Empire
Plan “At a Glance.”
(HBA), or make the change online
using MyNYSHIP, before the Option
Transfer deadline (rate flyer released
in November).
NYSHIP HMO: As of
Jan. 1, 2026, Emblem
Health will expand its
Downstate NYSHIP
service area (Option
#050) to include
Rockland County.
NYSHIP Option
Transfer: If you are
contemplating a change to
your NYSHIP health insurance option
for 2026, ensure a completed NYSHIP
Health Insurance Transaction Form
(PS-404) is returned to your agency
Health Benefits Administrator
Planning to retire or vest in
2026: If you continue your NYSHIP
enrollment as a retiree or
vestee, health insurance
options can be changed
once any time during a
12-month period, for
any reason. Take the
time now to familiarize
yourself with the
eligibility requirements
for continuing your
health insurance
coverage. Refer to your
General Information Book and
ask your HBA for copies of “Planning
for Retirement” and “Choices for
2026 for Retirees.”
Notify HBA of changes: You must
notify your HBA of any changes
to your enrollment record (home
address, phone number, marital
status, dependent eligibility) in a
timely manner. Changes in your
family status, such as the addition
or loss of a dependent, may mean
that you need to change your health
insurance coverage from individual
to family or from family to individual.
If you submit a request within 30
days of a change in family status,
you may make these coverage
changes without being subject to
a late enrollment waiting period.
Promptly inform your HBA about any
change to ensure it is effective as of
the actual date of change in family
status.
Cost of NYSHIP Coverage: The
2026 NYSHIP health plan rates will
be mailed to your home and posted
on the NYSHIP website as soon
as they have been approved. The
rates flyer announces the option-
change deadline and dates on which
changes in health insurance payroll
deductions will occur.
Pre-Tax Contribution Program:
The PTCP is a voluntary program
that allows employees to have
their share of health insurance
premiums deducted from their
wages before taxes are withheld.
Employees must initially decide
whether to participate in PTCP when
first eligible for NYSHIP coverage.
Employees may change their PTCP
status each year during the PTCP
Election Period, which coincides with
the annual Option Transfer Period.
If you wish to change your PTCP
election for 2026 plan year, complete
and sign a NYSHIP Health Insurance
Transaction Form (PS404) and
submit it during the PTCP Election
Period to your HBA.
State Executive Branch employees:
Reminder to check, use Flex
Spending Account funds
The Flex Spending Account (FSA)
is a negotiated state employee
benefit that helps save money by
allowing individuals to pay certain
out-of-pocket expenses using pretax
dollars.
The Health Care Spending
Account (HCSA), the Dependent
Care Advantage Account (DCAA)
and the Adoption Advantage
Account are benefit programs
available under New York State’s
FSA.
As we get closer to the end of the
calendar year, it’s a good time to
evaluate the remaining funds in
your FSA and take steps to make
sure all funds are spent before the
plan year ends.
Because of the tax advantages
of the FSA, the Internal Revenue
Service (IRS) has strict guidelines
for its use. One of these guidelines
is commonly known as the “use it or
lose it” rule.
HCSA carryover allowances
Unused contributions will carry
over to the next plan year for you
to use for previous year expenses
during the plan year runout
period (Jan. 1- March 31, 2026).
Unsubmitted claims from 2025 can
be submitted during the runout
period.
After the runout, any remaining
funds, up to the IRS limit from the
previous year ($660 for 2025 into
2026), will then carry over into your
2026 plan year account balance.
It’s important to plan accordingly
to avoid forfeiting any of your FSA
funds.
DCAA and adoption grace
period
The grace period allows an
additional 2 ½ months to incur
dependent care or adoption-related
expenses. You can use any funds
remaining in your account after the
plan year ends to pay for expenses
incurred between Jan. 1, 2026 and
March 15, 2026. Claims must be
submitted by the March 31 deadline.
To check your 2025 balance, visit
https://uba.tasconline.com/login
or call the FSA administrator, Total
Administrative Services Corporation
(TASC) at 800-358-7202.
18 The Work Force November 2025