MSC Buy-Out Waiver Program


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About the MSC Buy-Out Waiver Program

The MSC Health Benefits Buy-Out Waiver Program allows eligible employees who have non-City group health benefits to waive their New York City health benefits in return for an annual cash incentive payment. 


About the Incentive Payment

This incentive payment is considered ordinary income and, therefore, is taxable to the recipient.

The annual amount of the incentive payment is: 

Plan Year 2018

  • $1,000 to employees with family coverage who waive City health benefits
  • $500 to employees with individual coverage who waive City health benefits
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Incentive Benefit Periods

There are two incentive benefit periods per calendar year:

  • January 1 through June 30
  • July 1 through December 31

 

Incentive payments will be made in June and December of each Plan Year. Therefore, if you are eligible to receive a $1,000/$500 incentive payment, you will receive two payments of $500/$250 each in your regular paycheck, with the first payment issued in June and the second payment issued in December. Incentive payments will not be retroactive to a prior Plan Year.

Welfare Fund/Union Benefits

Your Welfare Fund/Union benefits may be affected by waiving your health benefits. Contact your Welfare Fund/Union Administrator directly if you have questions concerning your benefits.


Eligibility

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Employees eligible to participate in the Medical Spending Conversion (MSC) Health Benefits Buy-Out Waiver Program are those covered by:

 

  • New York City health insurance, and
  • The Citywide contract, or
  • The Management Benefits Fund.

Agencies include

  • Mayoralty
  • NYC Health + Hospitals (H+H)
  • Housing Authority
  • City University of New York (CUNY)
  • School Construction Authority (SCA)
  • Department of Education (DOE)

 

Employees of cultural institutions, libraries and DOE charter schools may be offered a Buy-Out Waiver Program through their individual institutions. Please contact your Agency Benefits Manager for additional information.

 

Employees Who Are Eligible to Waive Coverage

Employees can waive coverage if insured under:

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

 

Exclusions

You are ineligible for participation in the Health Benefits Buy-Out Waiver Program if you are:

  • Waiving health coverage in order to be covered by a spouse, domestic partner or parent who works for the City of New York (or a City of New York-related agency), who is covered through the City of New York's Health Benefits Program;
  • Retired from the City of New York;
  • Covered by an individual direct payment health plan (not a group plan);
  • Covered by Medicaid;
  • Covered by Medicare;
  • On Worker's Compensation leave;
  • Covered by 1199; or
  • New York State Health Care Exchange.

 


Enrolling

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You may enroll in the Health Benefits Buy-Out Waiver Program during the annual Open Enrollment Period.

 

Once enrolled, you will remain in the program until you reinstate your City of New York health benefits. Therefore, you do not need to re-enroll every year.

 

To enroll, you must complete and submit a Health Benefits Application and an MSC Health Benefits Buy-Out Waiver Program Enrollment/Change Form, which you can either download here or obtain from the FSA Program Administrative Office or your agency's benefits office.  You must also submit a copy of your non-City health insurance card as proof of other coverage.

 

You must complete a Health Benefits Application to waive your City of New York health benefits and an MSC Health Benefits Buy-Out Waiver Form in order to receive the annual incentive payment.

 

The completed forms and supporting documentation should be returned to your agency's Human Resources Department, NYCAPS personnel or NYC H+H Shared Services who will complete the benefits section, sign the forms, and return them to the MSC Administrative Office for processing.

 

Newly eligible employees may participate as soon as they become eligible for City of New York health benefits. To participate, newly eligible employees must complete and submit both the Health Benefits Application and the MSC Health Benefits Buy-Out Waiver Program Enrollment/Change Form to their benefits or personnel officer for review and completion.  In addition to these forms, employees must also submit a copy of their non-City group health insurance card as proof of other coverage. The two forms mentioned above and legal/supporting documentation, i.e. copy of the employee's non-City health insurance card, must be received by the MSC Administrative Office within 30 days after the employee becomes eligible for the program.

 

Enrollment after the initial 30-day period can only occur if you have a Qualifying Event. Any Qualifying Event that occurs in June will be effective after July 1st of that Plan Year. Any Qualifying Event that occurs in December will be effective after January 1st of the following Plan Year.

 

When covered for a portion of the benefit period, the amount of the incentive payment will be pro-rated by the number of days you have been enrolled in the MSC Health Benefits Buy-Out Waiver Program.


Note: Before deciding to waive City of New York health benefits coverage, make sure that your other coverage alone will meet your needs. Should you require assistance in completing the MSC Enrollment/Change Form, please call the MSC Administrative Office at (212) 306-7760 between 9:00 a.m. and 4:00 p.m., Monday through Friday. In-house counseling is by appointment only.

 


Mid-Year Changes

Certain Qualifying Events allow you to make changes to your Health Benefits Buy-Out Waiver Program status mid-year.Read More

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Your waiver will remain in effect unless you file an MSC Health Benefits Buy-Out Waiver Enrollment/Change Form indicating a Qualifying Event that permits you to withdraw from the Program.

Similarly, employees who have not enrolled in the Health Benefits Buy-Out Waiver Program may waive City health benefits coverage mid-year only if they incur a Qualifying Event.

 

Qualifying Events

The events listed below qualify you for mid-year changes:

  • A change in family status such as marriage, divorce, annulment, or legal separation;
  • The death of a participant, spouse/domestic partner or dependent;
  • The birth or adoption of a child who will be the participant's dependent;
  • The participant becomes divorced and is required under court order to provide health insurance coverage for eligible dependent children;
  • The start or termination of employment (benefits) of participant or participant's spouse for any reason including retirement (Forms must be submitted to terminate the Health Benefits Buy-Out Waiver Program);
  • A change in spouse's/domestic partner's coverage that is significant and outside the control of the spouse, e.g. benefit reduction (see reinstatement of City health benefits section);
  • The participant's spouse/domestic partner has a change in employment status that results in a change of health insurance coverage, either acquiring or losing eligibility for coverage (See instructions for reinstatement);
  • A change in employment status from part-time to full-time or vice-versa by the participant or the participant's spouse/domestic partner (increase above 20 hours or reduction below 20 hours in regular hours worked per week);
  • The taking of, or returning from, an approved unpaid leave of absence by the participant or the participant's spouse/domestic partner; or
  • An increase in the non-City group health insurance premium by more than 20%.

Note: Participants will not be allowed to make changes inconsistent with the Qualifying Event.

If you experience a Qualifying Event, contact your benefits or personnel officer within 30 days after the Qualifying Event to obtain the appropriate forms. Completed forms must be received by the MSC Administrative Office within that time period.


Reinstatement of Benefits

Find out what steps to take if you are currently enrolled in the Health Benefits Buy-Out Waiver Program but want to be covered by the City Health Benefits Program.Read More

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Reinstatement Mid-Year

To reinstate health benefits mid-year, the employee must provide proof of a Qualifying Event. If proof is received within 30 days after the event, reinstatement into the City's Health Benefits Program will be retroactive to the date of the Qualifying Event.

 

Any change must be consistent with and on account of a valid Qualifying Event.

 

When covered for a portion of the benefit period, the amount of the incentive payment will be pro-rated for any period less than six months by the number of days the employee is enrolled in the Health Benefits Buy-Out Waiver Program.

 

The employee must complete a Health Benefits Application and an MSC Health Benefits Buy-Out Waiver Program Enrollment/Change Form. Both forms must be submitted to his/her agency benefits officer, or NYCAPS Personnel/or H+H Shared Services if applicable.

 

Reinstatement at Retirement

Access to benefits at retirement will be unaffected by participation in the Health Benefits Buy-Out Waiver Program.

 

To reinstate City health benefits at retirement, the employee must complete a Health Benefits Application and an MSC Health Benefits Buy-Out Waiver Program Enrollment/Change Form to withdraw from the Health Benefits Buy-Out Waiver Program.


Employees Currently on Waiver

Find out how to proceed if you are currently waiving your City health benefits but have not yet enrolled in the Health Benefits Buy-Out Waiver Program.Read More

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Employees who are currently waiving their City health coverage and who are not enrolled in the Health Benefits Buy-Out Waiver Program will need to apply for the Health Benefits Buy-Out Waiver Program by completing a Health Benefits Application and an MSC Health Benefits Buy-Out Waiver Program Enrollment/Change Form and submit these forms to their agency benefits officer, NYCAPS personnel, or NYC H+H Shared Services, if applicable.


Agency Transfer and Leave of Absence

If you switch agencies or take a paid or unpaid leave of absence, find out how to continue or withdraw from the Health Benefits Buy-Out Waiver Program.Read More

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Employees who transfer from one agency to another within the City must notify the FSA Administrative Office at least 30 days prior to the transfer.

 

Employees who take an approved unpaid leave of absence must complete the MSC Health Benefits Buy-Out Waiver Program Enrollment/Change Form to withdraw from the Health Benefits Buy-Out Waiver Program. Returning employees who wish to be reinstated into the Program must re-enroll by completing an MSC Health Benefits Buy-Out Waiver Program Enrollment/Change Form and submitting it within 30 days after returning to work.


Download FSA Program Forms and Brochures

Have a Question? See the MSC Buy-Out Waiver FAQs