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NYC Health Benefits Program
Browse Coronavirus-Related Information
- For information on the coronavirus, including how and where to get tested for Covid-19, visit https://www1.nyc.gov/site/coronavirus/index.page
- Learn more about Coronavirus (COVID-19) testing at AdvantageCare Physicians (ACPNY) locations.
Important Notice
The Health Benefits Retiree client service walk-in center is closed.
Due to the closure of the office, retirees who mailed or faxed forms or correspondence March 11, 2020 or after, we cannot access or process that form. Please resubmit inquiries and documents as follows:
1) healthbenefits@olr.nyc.gov - email inquiries and questions
2) NYCRetireesHBP@emblemhealth.com - Forms/documents
Please do NOT include your Social Security number, include your Employee ID or pension number only.
Also, please do NOT submit your form/document more than once. This will only delay processing.
3) For questions regarding the PICA prescription drug benefit program please call 1-800-467-2006.
4) If you are a HIP-HMO member turning 65 or on Medicare due to a disability, please contact HIP at (800) 447-9169 to enroll over the phone. Please identify yourself as a City of New York retiree or dependent of a retiree. For all other members enrolled in a HMO plan, please contact your health plan at the customer service numbers on the back of your ID card.
Please note that active employees can contact NYCAPS Central by:
1) Phone - 212-487-0500
2) Email - nycapscentral@dcas.nyc.gov Or HealthBenefits@dcas.nyc.gov
Please check our website periodically for updates.
Download Adobe Scan to convert your documents into PDFs. Use your smart phone or tablet camera to take a picture of your paper form and Adobe Scan will convert it to a PDF. Adobe Scan mobile app is available for iPhone and Android.
Health Benefits Fall Transfer Period for Employees
Employees who do not wish to make any changes to their current health plan do not need to do anything during the Transfer Period.
During the Annual Transfer Period, you may:
- Transfer into any health plan listed in this notice for which they are eligible,
- Add or drop the Optional Rider, or
- Add or drop dependent(s).
Employees who do not have access to ESS can make changes to their health benefits by completing the Health Benefits application. Completed applications should be submitted to your agency HR/Personnel Office for processing.
If you are making changes to your health benefits plan/option, please review the following Health Benefits Program materials:
- Health Plan Rate Chart for Employees
- Summary Program Description (SPD)
- Summary of Benefits and Coverage (SBC)
- Links to the Health Plans’ websites for additional health plan and contact information (links provided below)
- Employee Notice
Informational Webinars
The following health plans are offering informational webinars for employees to learn more about their health plan offering (click on the link below for webinar dates and registration information):
New ID Cards for GHI-CBP and GHI Senior Care Members
EmblemHealth will be mailing new member ID cards to GHI-CBP and GHI Senior Care members throughout June. The new ID cards are effective beginning July 1, 2020. Your new member ID card will have a different ID number for you, and each eligible dependent will receive their own card and ID number.
Visit the EmblemHealth Website for more information:
Important Changes for your health coverage - New State Mandates effective July 1, 2020
Expanded IVF Coverage
The New York City Health Benefits Program will cover three cycles of IVF for employees and non-Medicare retirees and their dependents, including in-vitro fertilization (IVF) prescription drugs. New York State law now requires coverage for three cycles of IVF per lifetime, prescription drugs in connection with IVF services, and fertility preservation services.
Use the Health Plan Website links below to contact your health plan for additional information.
View the HBP Summary Plan Description for more information
PrEP
The New York City Health Benefits Program will cover the cost of health care services and medicines for employees and non-Medicare retirees and their dependents, for the detection and prevention of HIV, including screenings and pre-exposure prophylaxis (PrEP).
Use the Health Plan Website links below to contact the applicable non-grandfathered health plan for additional information.
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.
Coverage for Employees 65+
If you're over 65, still working for the City and enrolled in the NYC Health Benefits Program, do not use your Medicare card when you visit your doctor's office. Instead, be sure to use the member ID card provided to you by your current HBP health plan.
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.
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.
| Learn more about MetroPlus Gold for City Employees. Now available in all 5 boroughs! Play the video |
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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* |
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*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. |
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24/7 Telemedicine Program with Teladoc
(For Those Covered Under the EmblemHealth GHI-CBP, GHI HMO, HIP HMO, HIP POS, and VYTRA plans)
With Teladoc, you can talk with a doctor within minutes rather than days or hours. Teladoc doctors can diagnose, treat and prescribe medication (when medically necessary) for non-emergency medications. This includes treatments for the flu, sore throat, allergies, stomach aches, eye infections, bronchitis, and much more. Copays are waived during the COVID outbreak. To set up your account now so you can talk with one of Teladoc’s board-certified doctors anytime when you don't feel well, call 1-800-Teladoc (1-800-835-2362) or visit Teladoc.com/emblemhealth
View the Teledoc Registration Guide for instructions on setting up your account on Teladoc’s website or mobile app.
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
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 Gated EPO Plan with Prescription Drugs
Empire BlueCross BlueShield Gated EPO Plan without Prescription Dugs
Empire BlueCross BlueShield
Empire BlueCross BlueShield HMO without Prescription Drugs
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 for Calendar Year 2019
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 is distributed to all full-time employees working an average of 30 hours or more per week, for all or part of the calendar year. For information about Form 1095-B, please contact your health care provider directly. The 1095-B will include all dependent information.
Please note that the 1095-C for the calendar year 2019 will be available for employees in February 2020. Please check Employee Self-Service (ESS), if applicable, in February 2020 in order to obtain the Form 1095-C, or contact your payroll department.
