MSC Health Benefits Buy-Out Waiver Program


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Frequently Asked Questions



What is the MSC Health Benefits Buy-Out Waiver Program? View the Answer

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The MSC Health Benefits Buy-Out Waiver Program allows City of New York employees to receive an annual incentive payment for waiving their City of New York health benefits when non-City of New York group health coverage is available to them.

How can I benefit by joining this program? View the Answer

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For Plan Year 2018 an employee will receive $1,000 annually for waiving family health coverage or $500 annually for waiving individual health coverage. Payments are made semi-annually in June and December and will be taxable to the recipient.

 

Who is eligible? View the Answer

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Any employee who is eligible to receive City of New York health benefits may participate. Employees may waive their health benefits if they are insured through:

  • A spouse's, domestic partner's or parent(s)' employer-provided non-City of New York group health plan; or
  • A group health plan available through other employment.

Who is NOT eligible? View the Answer

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An employee is not eligible to waive City of New York health benefits if retired or if his or her spouse, domestic partner, or parent is an employee of the City of New York or a City of New York-related agency. An employee is also excluded if he/she is covered by an individual direct payment health plan, including enrollment in COBRA as a result of losing coverage through a non-City of New York group health plan; covered by Medicaid; covered by Medicare; on Worker's Compensation leave; or covered by New York State Health Care Exchange.

How can I enroll?  View the Answer

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To enroll in the program, an employee must complete and submit the Health Benefits Application and the MSC Health Benefits Buy-Out Waiver Program Enrollment/Change Form to his/her agency benefits officer or NYCAPS personnel/HR Shared, if applicable.  Along with these forms, the employee must also submit a copy of the employee's non-City health insurance card as proof of other coverage.  Each year the Open Enrollment Period for the following calendar year will generally be held in September and October.

New employees may enroll within 30 days after becoming eligible to receive City of New York health benefits coverage. Enrollment during the Plan Year is possible only if a Qualifying Event occurs. After initial enrollment, annual re-enrollment is not required.

What is a Qualifying Event?  View the Answer

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A Qualifying Event is a change in family or employment status. Examples of family status changes are:

  • Marriage;
  • Death;
  • Divorce; or
  • A change in a spouse's, domestic partner's or parent's insurance coverage.


Examples of employment status changes are:

  • Termination of employment;
  • A change in a spouse's, domestic partner's, or parent's employment status that results in a change in insurance coverage; or
  • A change in the employee's status from part-time to full-time, or vice versa.

 

For enrollment of less than six months, the incentive payment is pro-rated by the number of days of enrollment in the Buy-Out Waiver Program.

Once I enroll, can I reinstate my City health benefits?  View the Answer

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Yes. As an active employee, you may withdraw from the program during the annual Open Enrollment Period. To withdraw at any other time, you must experience a Qualifying Event and provide proof of loss of coverage within 30 days after that loss.