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Young Adult Health Benefits Coverage Eligibility Certification form - schools nyc

Young Adult Health Benefits Coverage Eligibility Certification form - schools nyc 2025

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The document provides instructions for City of New York employees on how to enroll their Young Adult dependents in health benefits coverage up to age 26. It outlines the steps for completing eligibility certification, enrollment through Employee Self Service (ESS) or application forms, and submitting required documentation to prove dependent eligibility. The document also includes a Frequently Asked Questions section addressing common concerns regarding eligibility, enrollment processes, and necessary documentation.

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Click ‘Get Form’ to open it in the editor.
Begin by reviewing the eligibility requirements outlined on page 3 of the Summary Program Description. Ensure you understand if your Young Adult dependent qualifies.
Answer each question on the Young Adult Health Benefits Coverage Eligibility Certification form carefully. Check one box for each question, ensuring accuracy.
If eligible, proceed to complete the certification statement at the bottom of the form. Sign and date it, providing your Employee Social Security Number and Employee ID if applicable.
Once completed, submit this form along with any required documentation (like a birth certificate) to your agency's Health Benefits Representative or through Employee Self Service if available.

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What is the highest income to qualify for ACA?

Eligibility and Cost Family ContributionsMonthly Income by Family Size* (Effective for applications received on or after 2/15/2025) 12 Free Insurance $2,896 $3,913 $15 Per Child Per Month (Maximum of $45 per family) $3,261 $4,407 $30 Per Child Per Month (Maximum of $90 per family) $3,913 $5,2883 more rows

Which of the following groups is not eligible for Healthy New York program?

The Healthy NY program, in partnership with CDPHP and other insurance companies in New York State, provides comprehensive and affordable health insurance to small businesses. Individuals and sole proprietors are no longer eligible for Healthy NY. Instead, get information about CDPHP individual insurance plans.

What is the young adult option in NY?

The Young Adult Option is available to young adults who meet all of the following eligibility requirements: Be a child, adopted child, or stepchild of a NYSHIP enrollee (including those enrolled under COBRA) Be age 29 or younger. Be unmarried.

Do NYC teachers get free health insurance?

Teachers can choose from a variety of health insurance plans, several of which require no employee contributions. Coverage for teachers and their families begins on the first day of employment.

How can I enroll in ACA?

There are several ways to apply for and enroll in Marketplace health coverage: Use HealthCare.gov to apply online. Fastest way to apply. Enroll over the phone. Find help in your area. Use a certified enrollment partner. Fill out and mail in a paper application.

How to apply for ACA in New York?

Apply online through the NY State of Health website. By phone at 1-855-355-5777 (TTY: 1-800-662-1220) With the free help of a trained and certified Enrollment Assistor or Broker.

What is the income limit for the Essential Plan in NY?

The maximum income to qualify for Obamacare in 2025 on healthcare.gov is $60,240 for an individual on their taxes, while for two people it is $81,760, for three people it is $103,280, and for four people it is $124,800.

Young Adult Health Benefits Coverage Eligibility Certification form - schools nyc 2025

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