End of school can jeopardize health coverage for students
By DEBORAH STAYMAN
If you have a child who is age 19 or older enrolled in the NYS Health Insurance
Program (NYSHIP), you may need to act quickly to ensure he or she remains
eligible for coverage.
If you are a NYSHIP enrollee, your unmarried dependent children who are 19 or
older, but less than 25, are eligible for coverage if they are full-time
students at an accredited educational institution and are otherwise not eligible
for employer group coverage. They continue to be eligible until the earlier of
the following dates:
the end of the third month following the month in which they complete course
requirements for graduation; or they reach age 25.
Students who want to continue health insurance coverage during the summer must
have been enrolled in the previous spring semester and must be enrolled as
full-time students for the fall semester.
If a dependent child who was a full-time student in the spring semester does not
enroll as a full-time student for the fall semester, coverage under the parent’s
policy will end on the last day of the month in which the student was a
full-time student attending classes.
Two ways to stay covered
If you want your child to continue to be covered without interruption, you must
act quickly in one of two ways:
• Continue coverage in NYSHIP under COBRA (federal Consolidated Omnibus Budget
Reconciliation Act); or
• Convert to a direct-pay contract.
Under provisions of COBRA, the employee or a family member is responsible for
informing the Employee Benefits Division of the state Department of Civil
Service of a child’s losing NYSHIP eligibility within 60 days from the date
coverage ends. To obtain a COBRA election form, send a written request to:
New York State Department of Civil Service
Employee Benefits Division
Attn.: COBRA Unit
State Office Building Campus
Albany, NY 12239
Include your Social Security number, the dependent’s name, the reason for the
request, the date coverage ended, and a telephone number where you can be
reached during the workday.
If you do not notify EBD within the required 60-day period, regardless of the
reason, the dependent will not be entitled to COBRA continuation coverage.
The health care benefits your child may continue under COBRA are the same
benefits you receive as an active employee enrolled in NYSHIP. COBRA requires
your child have the opportunity to continue coverage for up to 36 months. The
cost of COBRA coverage is the full premium (both the employer and employee
share) plus a 2 percent administrative fee.
If your child is seeking admission to a school over the summer, but has not yet
been accepted, coverage should be continued through COBRA. Once your child’s
enrolled for the fall semester, his or her dependent student status will be
reinstated back to the date he or she lost eligibility and the COBRA premium you
paid during the interim will be refunded.
Direct--pay option
In addition to continuation through COBRA, children losing eligibility are
entitled to convert to direct-pay contracts after their NYSHIP coverage ends.
Notification procedures and deadlines for applying for conversion coverage vary
among the NYSHIP health care plans.
The benefit package for direct-pay conversion contracts may differ from what
your child had under NYSHIP. To obtain premium information, contact the carrier
or HMO directly.
Additional information concerning COBRA and direct-pay conversion contracts is
in the NYSHIP General Information Book for Empire Plan enrollees dated June 1,
2002 and in the NYSHIP General Information Book for HMO Enrollees dated March 1,
2002, as well as in documents communicating changes made since then.
You may also contact your agency health benefits administrator, who is usually
located in your personnel office, for assistance.
The Communicator May 2007
Features
State
budget issues looking ok
Gov. signs
contract disclosure bill
Cost-benefit analysis bill fight...
Go Public: NY's taxpayers stuck...
Public-private battles battle-on
Fighting Medicare
costs...
Departments
President's Message: Go Public
You Said it: Letters ...
Member Mobilization
Health Notes
Retirees In Action:
Hevesi...
Legislative
Action
Membership Benefits &Travel
Union Matters
PEF nets 40 members
Nurses fine-tune campaign
Stutzman
nurses earn awards
Federal
budget battles coming
Albany
Housing Authority $..
Social Secuity
Admin. decides...
Native American
member helps...
Members' son:15 min.
of fame
Aaron Mair
earns Jefferson award
NYS's Promotion
Test Battery...
E. Board sends Oswego Co...
Privatization award
nomination...
Other Links
Professional Directory
Members' Classified
Member Communicator Feedback
Prefer The Online Edition?
How To Advertise Here
The Communicator Staff
Questions on this
site?
Email the
Webmaster