Human Resource Services News and Events

« Back to All News & Events

Spousal Eligibility for Health Insurance

Stony Brook University Logo
MEMORANDUM

To: State Employees on West Campus and HSC
From: Human Resource Services
Date: August 29th, 2007

Effective May 1, 2007, the New York State Department of Civil Service has revised its New York State Health Insurance Program (NYSHIP) policy to recognize any same-sex marriage that is legal in the jurisdiction where it was performed, for the purposes of providing spousal benefits. This revision covers all the NYSHIP and all other benefit programs, such as the vision and dental programs (including the Retiree Dental Plan) administered by GHI, the New York Public Employee and Retiree Long-Term Care Program (NYPERL) and the M/C Life Insurance Program.

At this time, a same-sex marriage from the following jurisdictions will be recognized if it is legal in the jurisdiction itself: Massachusetts, Canada, including all of its provinces, Spain, South Africa, the Netherlands, and Belgium. The New York State Department of Civil Service will assume that the possession of a marriage certificate from the jurisdiction is proof that the marriage is legally recognized there.

Civil Unions will continue to be acceptable as part of the proof required for domestic partner coverage.

Special Health Insurance Enrollment Period and Tax Implications

To implement this change there is a special enrollment period from now until May 31, 2007 during which current enrollees may enroll same-sex spouses in their medical, dental and vision coverage effective May 1, 2007, if the legal marriage took place prior to May 1, 2007.

Applications signed after May 31, 2007 will be subject to the usual effective date rules used for spouse benefit eligibility. For employees who currently do not have health insurance with Stony Brook the usual waiting periods for effective dates of enrollment will apply for the employee and the dependents.

The revised program allows a spouse and children to be covered for benefits on a pre-tax basis. Enrollees may still be subject to imputed income in the same way as domestic partners.

However, if the spouse is a federally qualified dependent for tax purposes, the employee should complete a Dependent Tax Affidavit in order for the imputed income to be waived. Contact Debbie Giacopelli at 632-6165 for this form.

Health Insurance Enrollment Process

In order to add a spouse, or change the status of a domestic partner to a spouse for health insurance, the employee must complete a NYS Health Insurance Transaction Form (PS404) and provide documentation as follows: a copy of the marriage certificate and a copy of the spouse’s social security card. Links to form PS404 will be provided in the section titled forms at the end of the memo.

Enrollment of children of the same-sex spouse will no longer be based on the program’s eligibility for “other children,” but will now be subject to the eligibility criteria for stepchildren. To add a stepchild to the benefits program, the employee must complete a NYS Health Insurance Transaction Form (PS404) and provide a copy of the child’s birth certificate and social security card.

Dental and Vision Coverage

In order to add a same-sex spouse or stepchild, or change the status of a domestic partner to a spouse, for dental and vision coverage:

M/C, PEF, ALES, and NYCOPBA: Complete the NYS Health Insurance Transaction Form (PS404) and in Dependent Information, Section G, check “D” and “V” for dental and vision and forward to HRS.

UUP: Complete the Change Form and send to UUP:
http://www.uupinfo.org/benefits/btfchangestatus.pdf

CSEA: Contact the CSEA Benefits Trust Fund at 1-800-323-2732.

GSEU: Complete the NYS Health Insurance Transaction Form (PS404G) and in Dependent Information, Section G, check “D” and “V” for dental and vision and forward to HRS.

M/C Life Insurance

To add a same-sex spouse to M/C Life Insurance without medical underwriting, the employee must complete a PS-934 form which can be requested by calling Sandy White 631- 632-6167. If the marriage occurred before May 1, 2007 the employee has until July 11, 2007 to add a spouse. If married prior to May 1, 2007 and applying after July 11, 2007, the employee will be required to have a Statement of Health form completed for the spouse. For forms or any questions regarding M/C Life Insurance for a same-sex spouse please contact Sandy White 631- 632-6167.

New York Public Employee and Retiree Long Term Care Program (NYPERL)

Please contact NYPERL at 1-866-474-5824 or http://www.nyperl.net.

Forms

To add a spouse or stepchild for health insurance, dental and vision coverage:
NYS Health Insurance Transaction Form (form PS-404).

Graduate and Teaching Assistants enrolled in the Student Employee Health Plan: To add a spouse or stepchild to health insurance, dental and vision coverage, complete the NYS Health Insurance Transaction Form (form PS-404).

All forms should be sent to Human Resources Services, Room 390, Benefits Unit. For further information, please contact Debbie Giacopelli 631- 632-6165 or Ellen Krause at 631-632-6213.