Full Time and Civil Service
All full-time ECP, faculty, HEO, CLT and classified employees, and eligible part-time classified employees of the City University of New York-Brooklyn College are eligible for health coverage under the New York City Health Benefits Program (NYCHBP).
Those qualified for the NYCHBP may also enroll their dependents in the program. Dependents are eligible if their relationship to the eligible participant is one the following:
1. A legally married husband or wife, but never an ex-spouse.
2. A domestic partner at least 18 years of age, living together with the participant in a current continuous and committed relationship, although not related by blood to the participant in a manner that would bar marriage in New York State. More details concerning eligibility and tax consequences are available from your agency or the Office of Labor Relations Domestic Partnership Liaison Unit, 212.306.7605 (employees) or 212.513.0470 (retirees).
3. Children under age 26 (whether married or unmarried), except as provided below (relating to adult children eligible for other health coverage). Effective July 1, 2011, the term "children" means the following:
a. natural children;
b. children for whom a court has accepted a consent to adopt and for the support of whom an employee or retiree has entered into an agreement;
c. children required to be covered under a qualified medical child support order until the court order expires, at which time the child may continue to be eligible for coverage under (a) or (b) above;
d. children for whom a court of law has named the employee or retiree as legal guardian;
e. any other child who lives with an employee or retiree in a regular parent/child relationship and is the employee’s or retiree’s tax dependent (a child is the employee's or retiree's tax dependent if the employee or retiree claims the child on his or her income tax return as a dependent); or
f. unmarried children age 26 and older who cannot support themselves because of a disability, including mental illness, developmental disability, mental retardation or physical handicap. Such children are eligible for coverage if the disability occurred before the age at which the dependent coverage would otherwise terminate. Employees or retirees must provide medical evidence of the disability. The proof of disability must be submitted to the health plan within 31 days of the date the dependent reaches age 26. 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. Coverage will terminate for children reaching age 26 (other than eligible disabled children) at the end of the month in which the child reaches age 26.
To enroll, you must complete a health insurance application (Form ERB 2000), which may be obtained from the Benefits Office. You must also submit documentation to support the eligibility status of all persons you wish to cover under your health insurance.
Employees are eligible if they satisfy both of the following:
- You work on a regular schedule at least 20 hours per week; and
- Your appointment is expected to last for more than six months.
Effective Dates of Coverage
Coverage becomes effective according to the following:
For employees — For provisional employees, temporary employees (college assistants) and those non-competitive employees (hourly custodians) for whom there is no experience or education requirement for employment, coverage begins on the first day of the pay period following the completion of 90 days of continuous employment, provided that your Health Benefits Application has been submitted within that period.
For all other employees — For employees appointed from civil service lists, exempt employees and those non-competitive employees for whom there is an experience or education requirement, coverage begins on your appointment date, provided your Health Benefits Application has been received by your agency personnel or payroll office within 31 days of that date.
For eligible dependents — Coverage for eligible dependents listed on your Health Benefits Application will begin on the day that you become covered. Dependents acquired after you submit your application will be covered from the date of marriage, domestic partnership, birth or adoption, provided that you submit the required notification and documentation within 31 days of the event.
Selection of a Health Plan
Employees should consider a health plan that best meets their needs. Consider the following factors:
- Coverage — Services covered differ from plan to plan. For example, some plans provide preventive services, while others do not cover them at all; some plans cover routine foot care, while others do not.
- Choice of doctor — Some plans provide partial reimbursement when nonparticipating providers are used; other plans pay for or allow only the use of participating providers.
- Convenience of access — Certain plans have participating providers or centers that are more convenient to your home or workplace.
- Cost — Some plans require payroll deductions for basic coverage.
As an eligible participant of the NYC Health Benefits Program, you may choose from the plans listed below. These plans provide basic coverage, which may or may not require an additional premium by the employee. You cannot be covered by two health contracts for which the city pays into or which the city contributes.
- Aetna US Healthcare Healthcare Maintenance Organization
- Aetna US Healthcare Quality Point of Service
- CIGNA Healthcare
- DC 37 Med-Team/Choice (DC 37 titles only)
- Empire EPO
- Empire HMO New York
- GHI-CBP Empire Blue Cross/Blue Shield
- GHI HMO
- HIP Prime HMO
- HIP Prime POS
- Vytra Health Plans
To obtain further information about these benefit programs, please visit the Office of Labor Relations/NYC Health Benefits.
Coordination of Benefits
You may be covered by two or more group health benefit plans that may provide similar benefits. Should this occur, the city health plan will coordinate benefit payments with the other plan. The city program follows certain rules that have been established to determine which plan is primary; these rules apply whether or not you make a claim under both plans. The rules are as follows:
- The plan covering you as employee is primary before a plan covering you as a dependent.
- When two plans cover the same child as a dependent, the child's coverage will be as follows:
- The plan of the parent whose birthday falls earlier in the year provides primary coverage.
- If both parents have the same birthday, the plan that has been in effect the longest is primary.
- If the other plan has a gender rule, the rule of the other plan will determine which plan covers the child.
- When no other criteria apply, the plan covering you the longest is primary. However, the plan covering you as a laid-off or retired employee, or as a dependent of such person, is secondary, and the plan covering you as an active employee, or as a dependent of such a person, is primary, as long as the other plan has a COB provision similar to this one.
Special Rules for Dependents of Separated or Divorced Parents
If two or more plans cover a dependent child of divorced or separated parents, benefits are to be determined in the following order:
- The plan of the parent who has custody of the child is primary.
- If the parent with custody of a dependent child remarries, that parent's plan is primary. The step-parent plan is secondary, and the plan covering the parent without custody is third.
- If the specific decree of the court states one parent is responsible for the health care of the child, the benefits of that parent's plan are determined first. You must provide the appropriate plan with a copy of the portion of the court order showing responsibility for health care expenses of the child.
Termination of Coverage
- For an employee or retiree and covered dependents — when the retiree stops receiving a paycheck or pension check (with the exception of employees eligible for SLOAC or FMLA).
- For a spouse — when divorced from an employee or retiree.
- For a domestic partner — when partnership terminates.
- For a child — upon marriage or reaching an ineligible age, except for unmarried dependent full-time students, who are covered on all plans up to age 23.
- For all dependents, unless otherwise eligible — when the city employee or retiree dies.