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The Health Coverage Option Transfer Period for employees funded by the State allows enrollees to change health insurance carriers, voluntarily cancel their insurance, or to delete dependents for 2013, begins now and ends December 31, 2012.
Premiums may be deducted as soon as the paycheck of January 2, 2013 depending on when paperwork is submitted to University Human Resources. Therefore due to the dates of the Option Transfer period, you may see the adjustments in deductions taken from your check(s) in January and/or February 2013.
No action is required if you wish to keep your current health insurance option.
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Open enrollment changes are effective January 3, 2013.
Changes MUST BE RECEIVED in University Human Resources by January 3, 2013.
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You may change your option online. Go to https://www.cs.ny.gov/. Click on Benefit Programs, then NYSHIP Online. Select your group if prompted, and then click on MyNYSHIP - Employee Self-Service. Or, you can go directly to https://www.cs.ny.gov/mynyship/welcome/. Note: you must register and receive an activation code by mail to use MyNYSHIP.
| Change Health Insurance Carriers |
Cancel Health Insurance Coverage |
Delete a Dependent |
- Complete sections 1 through 9 and 10-H (already completed) of the form below, as appropriate.
- Sign and date the form under “Authorization” on the second page.
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- Complete sections 1 through 9, and 10 (F) of the form below, as appropriate.
- Sign and date the form under “Authorization” on the second page.
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- Complete sections 1 through 10 (A - G) of the form below, as appropriate.
- Sign and date the form under “Authorization” on the second page.
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Choose the appropriate form:
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Click here for the appropriate form |
Click here for the appropriate form.
If changing from Family to Individual coverage, as you no longer have dependents on your insurance, click here for the appropriate form.
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Forward the completed form no later than January 3, 2013, to:
University Human Resources
120 Crofts Hall
North Campus
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or |
Scan and e-mail to:
Mary Wlodarczyk: A-J to mw76@buffalo.edu
Sharon Hassett: K-Z to shassett@buffalo.edu
or fax to 645-3830 |
Opt-out Program (CSEA, PBANYS (ALES), NYSCOPBA, and M/C Employees) allows eligible employees who have other employer-sponsored group health insurance, to opt out of their NYSHIP coverage in exchange for an annual incentive payment of $1,000 for waiving Individual coverage, or $3,000 for waiving Family coverage. In order to enroll, complete and submit the following forms to your campus HR office by Deceber 28, 2012, or upon subsequent qualifying event.PS-409 Opt-out Attestation Form
PS-404 Health Insurance Transaction Form
Data Sheet
2013 Health Insurance Rates
For 2013 Rates, please choose your bargaining unit.
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