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NYC Health Benefits Program


Introduction

Through collective bargaining agreements, the City of New York and the Municipal Unions have cooperated in choosing health plans and designing the benefits for the City’s Health Benefits Program. These benefits are intended to provide you and your eligible dependents with the fullest possible protection that can be purchased with the available funding.

The OLR website and the NYC Health Benefits Program Summary Program Description (SPD) provide you with information about your benefits under the New York City Health Benefits Program. 

 


 

2017 Health Benefits Transfer Period for Active Employees - October 2nd through October 31st

During the Transfer Period, you may transfer from your current health plan to any other plan for which you are eligible, or you may add or drop Optional Rider coverage to your present plan. If you do not apply for an Optional Rider when you first enroll, you may add these additional benefits only during a Transfer Period, upon retirement, or if there is a change in your union or welfare fund coverage.

In order to transfer from one plan to another or to add Optional Rider coverage, and to obtain the effective date of the change, the employee must contact their agency health benefits or payroll office during the Annual Transfer Period (beginning October 2nd):

  • NYCAPS Central: (212) 487-0500
  • Department of Education HR Connect: (718) 935-4000
  • NYC H+H: (646) 458-5634

All other employees can obtain an application by contacting their agency personnel office.

All changes will take effect on the first day of the first payroll period in January 2018.


Important Changes to Your HIP HMO Plan

Effective July 1, 2017

Through the joint efforts of the City of New York Office of Labor Relations and the City’s Unions, represented by the Municipal Labor Committee, there are important changes to the HIP HMO plan that are effective on July 1, 2017.

Learn more about the HIP HMO Plan Changes


Opioid Treatment Drug Coverage

Effective July 1, 2017

Your base health plan will cover you and your dependents for medicines used to treat substance-use disorders. This includes medicines usually prescribed for opioid addiction and dependence. These medicines, along with counseling and behavioral therapies, can successfully treat these disorders and help with recovery. Visit your health plan for a list of covered opioid medicines and copays.

 


 

Health Plan Websites

Use the links below to visit your health plan where you will be able to find an in-network doctor, urgent care center, lab or pharmacy.

 

  • MetroPlusMetroPlus
  • CignaCigna
  • VytraVytra
  • GHI HMOGHI HMO
  • HIP POSHIP POS
  • HIP VIPHIP VIP
  • Empire Non-Medicare HMOEmpire HMO
  • Empire Non-Medicare EPOEmpire Non-Medicare EPO
  • Empire MediBlue HMOEmpire MediBlue HMO
  • Aetna EPOAetna EPO
  • Aetna PPO-ESAAetna PPO-ESA
  • HumanaHumana
  • ElderplanElderplan
  • AvmedAvmed
  • United Secure HorizonsUnited Secure Horizons
  • BCBS of FloridaBCBS of Florida
  • DC 37 Med TeamDC 37 Med Team

 

 
  • GHI CBPGHI CBP

NOTE: Hospitalization coverage for GHI CBP is underwritten and administered by Empire BlueCross BlueShield (EBCBS).

View the EBCBS Directory of participating NY, NJ, CT hospitals*

 

*Provider information contained in the Empire BlueCross BlueShield Directory is updated on a regular basis and may have changed. Therefore, please check with your provider before scheduling your appointment or receiving services to confirm participation.

   
  • HIP HMOHIP HMO
Important Changes to HIP HMO Effective July 1, 2017. Learn More

List of Health Plans

Listed are the non-Medicare Health Plans offered by the New York City Health Benefits Program to its employees and non-Medicare retirees.  View the List of Health Plans

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Aetna EPO Basic Plan
Aetna EPO Basic Plan with Prescription Drugs 
Cigna HMO Basic Plan 
Cigna HMO Basic Plan with Prescription Drugs 
DC 37 Med-Team 
Empire BlueCross BlueShield EPO Plan with Prescription Drugs
Empire BlueCross BlueShield EPO Plan without Prescription Dugs
Empire BlueCross BlueShield HMO with Prescription Drugs
Empire BlueCross BlueShield HMO without Prescription Drugs
Empire BlueCross BlueShield PPO with Prescription Drugs (Hawaii and Alaska Only)
Empire BlueCross BlueShield PPO without Prescription Drugs (Hawaii and Alaska Only)
Empire BlueCross BlueShield Hospital Plan Only (Companion to GHI CBP Medical Coverage)
GHI CBP Basic Plan 
GHI CBP Basic Plan with Enhanced Schedule and Prescription Drugs (Optional Rider)
GHI HMO Basic Plan   
GHI HMO Basic Plan with Prescription Drugs 
HIP HMO Basic Plan  
HIP HMO Basic Plan with DME and PDN
HIP HMO Basic Plan with Prescription Drugs 
HIP POS Basic Plan 
HIP POS Basic Plan with Prescription Drugs 
MetroPlus Gold 
Vytra Basic Plan  
Vytra Basic Plan with Prescription Drugs 

View the Summary of Benefits and Coverage (SBC) for each Plan.


Form 1095-C

Form 1095-C is a tax form under the Affordable Care Act ("ACA") which contains information about your health care insurance coverage.  Form 1095-C was distributed to all full-time employees working an average of 30 hours or more per week, for all or part of calendar year 2016.  For information about Form 1095-B, please contact your health care provider directly.

Learn more about Form 1095-C

 


 

2015 Cyber-Attack Impacting Empire Blue Cross Blue Shield

Anthem, Inc., the parent company of Empire Blue Cross and Blue Shield, one of the City’s health insurance providers, was the victim of a highly-sophisticated cyber-attack in 2015. Visit the Anthem website – www.anthemfacts.com, or call their hotline, 1-877-263-7995, for updated information.


 

 

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