Got questions about health benefits?  Ask for help

Confused about where to turn for help with health-benefit questions or problems? For active PS&T employees, both your employer and your union offer help (Retirees see side bar).  Each state agency has a health benefits administrator (HBA) to help its employees with these matters. In addition, PEF has health benefits staff in the Contract Administration Department to help active PS&T employees.  Understanding their different roles could save you time and frustration and get your problems resolved quickly and effectively.

What HBAs do

If you have questions about your health, dental and/or your vision care coverage, you should first contact your agency HBA, usually located in the Personnel Office.  Your employer administers all of your health benefits, including dental and vision.  An online telephone directory for agency HBAs can be found using the NYS Department of Civil Service web site at www.cs.state.ny.us.  Select “Benefit Programs,” follow the instructions to access “NYSHIP Online,” and then click on “Using Your Benefits.”  NYSHIP Online is a complete resource for information regarding the New York State Health Insurance Program (NYSHIP) and related benefits.

HBA services for employees include:

• Distributing health-benefit informational materials including publications that provide details of your insurance benefits and plan requirements (also available at NYSHIP Online);

• Determining the eligibility of an employee and his or her family for coverage;

• Maintaining files which document the employee's personal and job data, dependent data, and making necessary enrollment changes;

• Informing an employee of the procedures for continuing coverage when his or her employment/payroll status changes (e.g. termination, retirement, authorized leave without pay);

• Providing eligible employees with the forms necessary to take advantage of special program features such as requests for a waiver of premium due to disability, dual-annuitant sick leave credit, and coverage for a disabled dependent (forms also available at NYSHIP Online); and

• For questions on specific benefits or claims, your HBA may refer you to the appropriate insurer or your HMO for assistance.

How PEF can help

Through the Joint Committee on Health Benefits, PEF works with Civil Service, the Governor's Office of Employee Relations, and the Division of the Budget to review and

oversee the various health plans, including dental and vision, available to active PS&T employees.

If you are an active PS&T employee who has contacted your agency HBA but are not satisfied with the outcome, call PEF’s health benefits staff in Albany at 1-800-342-4306, ext. 283.  You should also call if you have any health benefit complaints or suggestions for improvements.

PEF also provides benefits information on the PEF web site at www.pef.org.  Use the link for “Health Benefits” on the left side of the home page.