Requires reviews of dependent eligibility provisions pertaining to dependents of enrollees in the New York state health insurance plan

BILL NUMBER:S4270C

Title of bill

An act to amend the civil service law, in relation to requiring reviews of dependent eligibility provisions pertaining to dependents of enrollees in the New York state health insurance plan

Summary of specific provisions

Section 1 of NYS Civil Service Law is amended by adding a new section 164-a that allows the civil service department to conduct ongoing reviews of dependent eligibility audits for all newly hired New York State Health Insurance plan enrollee dependents through a qualified verification vendor.

Section 2 Subdivision 2 of section 164 of the civil service law as added by section 1 of part W of chapter 56 of the laws of 2008, "...is amended to state that during the fiscal period of two thousand eleven through two thousand twelve a sixty day amnesty period similar to a sixty day amnesty period established in 2013 shall be included."

Justification

The New York State Health Insurance Program (NYSHIP) was established by the State Legislature in 1957 to provide health insurance coverage to New York State (NYS or State) employees, retirees and their eligible dependents. Public authorities, public benefit corporations, and other quasi-public entities, such as the NYS Thruway Authority and the Dormitory Authority may choose to participate in the NYSHIP Health Plan; those that do are called Participating Employers (PEs). Article XI of the NYS Civil Service Law also allows local units of government such as school districts, special districts, and municipal corporations to participate in NYSHIP; those local government units which choose to participate in NYSHIP are called Participating Agencies (PAs). At present there are approximately 368 NYS agencies, 92 Participating Employers, and 800 participating Agencies in NYSHIP. NYSHIP is administered by the Department's Employee Benefits Division.

This bill mandates the Division of Civil Service to contract out for an on-going dependent eligibility audit for new hires, those employees with family status changes, and those employees that add dependents during "open enrollment."

The last time a dependent eligibility audit for NYSHIP was conducted the net savings to the state was in excess of $25 million.

Prior legislative history

This is a new bill.

Fiscal implications

There is no fiscal impact to the state, but a potential cost savings to the state.

Effective date

This act shall take effect immediately.