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Flexible Spending Program
Health Benefits Buy-Out > Eligibility and Enrollment


Eligibility
Employees eligible to participate in the Medical Spending Conversion (MSC) Health Benefits Buy-Out Waiver Program are those covered by:
  • New York City health insurance, and
  • The Citywide contract, or
  • The Management Benefits Fund.
Agencies include:
  • Mayoralty
  • Health and Hospitals Corporation (HHC)
  • Housing Authority
  • City University of New York (CUNY)
  • School Construction Authority (SCA)
  • Department of Education (DOE)
Employees of cultural institutions, libraries and DOE charter schools may be offered a Buy-Out Waiver Program through their individual institutions. Please contact your Benefits Manager for additional information.


Employees Eligible to Receive the Incentive Payment
Employees can waive coverage if insured under:

  • A spouse's/domestic partner's/parents' employer-provided non-City of New York group health plan; or
  • A group health plan available through other employment.
Exclusions
You are ineligible for participation in the Health Benefits Buy-Out Waiver Program if you are:
  • Waiving health coverage in order to be covered by a spouse, domestic partner or parent who works for the City of New York (or a City of New York-related agency), who is covered through the City of New York's Health Benefits Program;
  • Retired from the City of New York;
  • Covered by an individual direct payment health plan (not a group plan);
  • Covered by Medicaid;
  • Covered by Medicare;
  • On Worker's Compensation leave;
  • Covered by 1199; or
  • New York State Health Care Exchange.
How to Enroll
You may enroll in the Health Benefits Buy-Out Waiver Program during the annual Open Enrollment Period, which will be from September 22, 2014 through October 31, 2014.  Note: The Open Enrollment Period has been extended through November 14, 2014.

Once enrolled, you are in the program until you reinstate your City of New York health benefits. Therefore, you do not need to re-enroll every year.

To enroll, you must submit a Health Benefits Application and a Medical Spending Conversion (MSC) Health Benefits Buy-Out Waiver Program Enrollment/Change Form, which you can either download here or obtain from the FSA Program Administrative Office or your agency's benefits office.

You must complete a Health Benefits Application to waive your City of New York health benefits and an MSC Form in order to receive the annual incentive payment.

The completed forms should be returned to your agency's Human Resources Department or NYCAPS personnel, who will complete the benefits section and sign the forms and return them to the MSC Administrative Office for processing.

Newly eligible employees may participate as soon as they become eligible for City of New York health benefits. To participate, newly eligible employees must complete and submit both the Health Benefits Application and the MSC Health Benefits Buy-Out Waiver Program Enrollment/Change Form to their benefits or personnel officer for review and completion. The forms and legal/supporting documentation must be received by the MSC Administrative Office within 30 days after the employee becomes eligible for the program.

Enrollment after the initial 30-day period can only occur if you have a Qualifying Event. Any Qualifying Event that occurs in June will be effective after July 1st of that Plan Year. Any Qualifying Event that occurs in December will be effective after January 1st of the following Plan Year.

When covered for a portion of the benefit period, the amount of the incentive payment will be pro-rated by the number of days you are in the Health Benefits Buy-Out Waiver Program.


Note: Before deciding to waive City of New York health benefits coverage, make sure that your other coverage alone will meet your needs. Should you require assistance in completing the MSC Enrollment/Change Form, please call the MSC Administrative Office at (212) 306-7760 between 9:00 a.m. and 4:00 p.m., Monday through Friday. In-house counseling is by appointment only.

Download the Health Benefits Application (PDF)

Download FSA Program Forms and Brochures

Employees currently on waiver

Read the Health Benefits Buy-Out Waiver Program FAQ

 

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