Learn about eligibility requirements for participation in the HBP.Read More
To be eligible for participation in the City Health Benefits Program, employees must meet all of the following criteria:
Dependents are eligible if their relationship to the eligible participant is one of the following:
Coverage will terminate for children (other than eligible disabled children) at the end of the month in which the child reaches age 26.
Exception: Unmarried, disabled children age 26 and older, who cannot support themselves, are eligible for continued coverage if the following criteria are met:
NOTE - The eligibility for such dependents only applies to current employees whose disabled dependent children reach the age limitation while covered by a City health plan. New employees with disabled dependent children, already over the age limitation, may not include such children as dependents on their City health plan coverage. In addition, employees may not add disabled dependent children to their health plan coverage, if the child is already over age 26.
City of New York employees, and employees of Participating Employers, hired on or after July 1, 2019, and their eligible dependents, will only be eligible to enroll in the EmblemHealth HIP HMO Preferred Plan, and must remain in the HIP HMO Preferred Plan for the first year (365 days) of employment.
After 365 days of employment, the employee will have the option of either remaining in the HIP HMO Preferred Plan or selecting a different health plan within 30 days before the end of the 365 day period. If a new health plan is selected, the new plan will be effective on the 366th day.
Only after the 365th day can the employee participate in any Annual Fall Transfer Period.
An employee who needs to request an exemption from the required enrollment in the HIP HMO Preferred Plan can do so by submitting an Opt-Out Request Form to EmblemHealth. An employee, or eligible dependent, must meet certain criteria and the request must be approved by EmblemHealth before the exemption is granted. The Opt-Out Request Form is available on the EmblemHealth website.
Find out how to enroll as an active employee.Read More
1. As an Employee
To enroll, you must obtain and file a Health Benefits Application at your payroll or personnel office or NYCAPS Central. The form must be filed within 30 days of your appointment date (for exceptions, see Effective Dates of Coverage section). If you do not file the form on time, the start of your coverage will be delayed and you may be subject to loss of benefits.
New employees, employees enrolling for the first time or current employees requesting to add dependents are required to provide acceptable documentation to support the eligibility status of all persons to be covered on their City health plan coverage.
Find out how to enroll at retirement.Read More
2. At Retirement
You must file a Health Benefits Application at your payroll or personnel office prior to retirement to continue your coverage into retirement. If you are Medicare-eligible and are enrolling in an HMO you must complete an additional application form, which must be obtained directly from the health plan. If you are retired from a cultural institution, library, or the Fashion Institute of Technology, or if you receive a TIAA/CREF pension and are eligible for City health coverage, you must file a Health Benefits Application with your former employer.
Find out how to add your domestic partner to your health benefits coverage. Read more
Every employee or retiree eligible for City health benefits must either enroll for coverage or waive membership.Read More
Every employee or retiree eligible for City health benefits must either enroll for coverage or waive membership by completing the appropriate sections of the Health Benefits Application. Those who waive or cancel City health plan coverage and subsequently wish to enroll or reinstate benefits will not have coverage until the beginning of the first payroll period 90 days after the submission of a Health Benefits Application, unless the participant has lost other coverage.
Allows eligible employees who can obtain non-City group health benefits to waive their New York City health benefits in return for an annual cash incentive payment. Learn More