EMPLOYEE BENEFITS DIVISION Eligibility for a Waiver of Empire 2025

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The document is an application form (PS-452) for a waiver of Empire Plan premium for New York State employees on Leave of Absence due to total disability. It outlines eligibility criteria, including being enrolled in The Empire Plan, having a total disability, and being on authorized unpaid leave. The process for completing the application involves the enrollee, treating physician, and plan administrator. It also includes privacy notifications and instructions for submission.

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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.

Can an employee waive health insurance?

Employees who choose to decline one or more lines of coverage offered by a company for themselves or their dependents must sign a waiver and provide a reason for declining. The waiver that the employee will be required to sign can include the following: Name. Social Security number.

Can legally required benefits be waived?

In general, legally required benefits cannot be waived as they are mandated by law. However, there are certain exceptions. For instance, an employee may choose to waive health insurance coverage if they can provide proof of coverage from another source, such as a spouses insurance plan.

Who qualifies for NYSHIP?

The New York State Health Insurance Program (NYSHIP) covers New York State public employees and their dependents. Other public sector employees and their dependents can be eligible for NYSHIP through their agency or employers. Overall, we cover 1.2 million enrollees throughout the country.

Can I ask for money instead of health insurance?

It is legal to offer employees cash in lieu of health plan benefits, but it has to be done appropriately through a cafeteria plan that includes a cash-in-lieu agreement. If they opt out for cash in the agreement, they will be taxed on those funds as if they were wages.

Can an employee waive benefits?

Employees who choose to decline one or more lines of coverage offered by a company for themselves or their dependents must sign a waiver and provide a reason for declining.

ps 452 form

Employee benefits division eligibility for a waiver of empire plan Employee benefits division eligibility for a waiver of empire form

Can I deny benefits from my employer?

Employers typically offer health insurance as part of their benefits package, but they usually dont require employees to enroll in it. You can decline or waive this benefit and get your own insurance.

What is waiver of benefits?

Employee Benefits Areas Typically, a waiver of premium policy allows a person to avoid paying premiums on their life or health insurance policies for as long as they qualify for long-term disability benefits.

Is the Empire Plan the same as Nyship?

The Empire Plan is a health insurance plan for eligible employees in the state of New York. It is the primary plan for the New York State Health Insurance Program (NYSHIP). NYSHIP is administered by the Department of Civil Service.