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NYC Health Benefits Program


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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 COVERAGE FOR EMPLOYEES HIRED ON OR AFTER JULY 1, 2019

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. 


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
Learn more about MetroPlus Gold for City Employees. Now available in all 5 boroughs! Play the video

 

  • DC 37 Med TeamDC 37 Med Team
  • 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

 

   
  • HIP HMOHIP HMO
Important Changes to the HIP HMO Plan Effective January 1, 2019. Learn More
 
  • 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.


24/7 Telemedicine Program with Teladoc

(For Those Covered Under the EmblemHealth GHI-CBP Plan)

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. The copay is $10 per consultation. 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


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 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.

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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