Enrolling in a health plan as a result of loss of other coverage

If an employee has waived City benefits due to other health coverage, and then later loses that coverage, he or she can enroll in City benefits within 31 days of the loss of other coverage. Employees can use Employee Self-Service (ESS) to make this change.

To enroll in a health plan as a result of loss of other coverage

1. Determine if you received a NYCAPS health benefits enrollment form in the mail.
   
   
2. Select from below.
   
   
   • Yes, you received a NYCAPS health benefits enrollment form
     
     
     1. From the ESS navigation menu, do the following:
        
        
        1. Click the Employee Self-Service link.
           
           
        2. Click the Benefits link.
           
           
        3. Click the Health Benefits Enrollment link.
           
           
     2. Proceed to step 11.
        
        
   • No, you did not receive a NYCAPS Health benefits enrollment form
     
     
     1. Determine if the transfer period is open.
        
        
     2. Select from below.
        
        
        • Yes, the transfer period is open
          
          

          Important: Only one benefits event may be open at a time. During the transfer period, all employees automatically have an open benefits event, allowing them to make any change to their benefits. This event must be closed prior to making your change if you wish for the change to be effective immediately. Otherwise, changes made with the open benefits event will become effective in January.

          1. Contact your agency benefits representative or NYCAPS Central, whichever is applicable, and explain that you have a qualifying event and need to make a benefits change.
             
             
          2. Once the transfer period event is closed by, proceed to step 3.
             
             
        • No, the transfer period is not open
          
          
          1. Proceed to step 3.
             
             
        • No, the transfer period is not open but I made a change that is not yet effective
          
          

          During the transfer period or as a result of a qualifying event you made a change which has not yet gone into effect.

          1. Contact your agency benefits representative or NYCAPS Central, whichever is applicable, for assistance with this change.
             
             Important: If you proceed with this change without first contacting your agency benefits representative or NYCAPS Central, your changes may not be effective when the future dated event becomes effective.
             
             
3. From the ESS navigation menu, do the following:
   
   
   1. Click the Employee Self-Service link.
      
      
   2. Click the Benefits link.
      
      
   3. Click Life Event.
      
      
   4. Click Change Waiver Status.
      
      
4. In the Effective Date of Event field, enter the loss of coverage date.
   
   
5. From the Event Type drop-down menu, choose Enroll off Waiver.
   
   
6. Click the Submit My Event button.
   
   
7. Review your Event information carefully. Ensure that the Life Event type and Event effective date are accurate.
   
   
8. If necessary, change your selections and click the Edit my Enrollment Event button.
   
   
9. Click the Prepare my Enrollment Event button.
   
   The event is now ready for data entry.
   
   
10. Click the Go to my Enrollment Event button.
    
    The Health Benefits Enrollment page displays your event and status.
    
    Note: If you think you should have an open event and do not see it, contact your agency benefits representative or NYCAPS Central, whichever is applicable.
    
    
11. Click the Select button to the right of the Enroll Off Waiver event.
    
    The Enrollment Summary displays your current coverage.
    
    
12. Determine whether you will be adding any dependents.
    
    
13. Select from below.
    
    
    • Yes, you will be adding dependents
      
      
      1. Ensure that you have the following information for each dependent:
         
         
         • Full name
           
           
         • Social Security number (spouse only)
           
           
         • Date of birth
           
           
      2. Click the Add/Review Dependents button.
         
         
      The Enrollment Dependent Summary page appears.
      
      Note: If you have questions regarding who is eligible as a dependent, refer to the Summary Program Description (SPD).
      
      Note: If the dependent you plan to add is already listed, you do not need to add that dependent again now. You will be prompted in a later step to enroll the dependent in your plan.
      
      
      3. Click the Add a Dependent link.
         
         The Dependent Personal Information page appears.
         
         
      4. Enter all relevant information for the dependent.
         
         Note: Required fields are indicated by an asterisk (*).
         
         
      5. Click the Save button.
         
         A confirmation page appears.
         
         Important: Your dependents are only stored at this point, you must continue to add your new dependent(s) to your health plan.
         
         
      6. Click the OK button.
         
         
      7. On the Dependent Personal Information page, review your dependent's information.
         
         
      8. If changes are necessary, click the Edit button and make the appropriate changes.
         
         
      9. Click the Return to Enrollment Dependent Summary link.
         
         
      10. Repeat steps III - IX for all dependents.
          
          
      11. Click the Return to Event Selection link.
          
          The Health Benefits Enrollment page appears.
          
          
      12. Under Enroll, check the box to the left of each dependent you are enrolling.
          
          
      13. Click the Continue button.
          
          
      14. Proceed to step 14.
          
          
    • No, you will not be adding dependents
      
      
      1. Click the Continue button.
         
         
      2. Proceed to step 14.
         
         
14. Review the summary of your election.
    
    
15. If changes are required, click the Edit button and make the appropriate changes.
    
    
16. Click the OK button.
    
    Your new health plan coverage appears along with the new cost per pay period specific to your payroll cycle.
    
    
17. Click the Submit button to process your election.
    
    
18. Carefully read the Employee Certification in order to understand the terms and conditions of your health coverage.
    
    
19. Select from below.
    
    
    • You are ready to submit your elections
      
      
      1. Click the Submit button.
         
         Your benefit choices have now been successfully submitted.
         
         
      2. Click the OK button.
         
         
      3. Print the eBenefits coversheet.
         eBenefits coversheet
         
         
      4. Complete the coversheet and attach it to your required documentation.
         
         
      5. Ensure that you include your employee ID on all required documentation.
         
         
      6. Submit the coversheet and all required documentation to your agency benefits representative or NYCAPS Central, whichever is applicable.
         
         Your election will be placed in Pending status until your documentation is received.
         
         Once the required documentation is received and approved, the change will process overnight. The following day, a confirmation statement will be mailed to you.
         
         
    • You are not ready to submit your elections or you wish to make a change
      
      
      1. Click the Cancel button.
         
         No enrollment action will be taken.
         
         If you added dependents, the information will be stored but you will need to re-enter all other changes, including health plan elections.
         
         
      2. When you are ready to finalize your election and submit your changes, return to ESS and repeat this procedure.
         
         This event will remain open for 31 days from the date of the loss of other coverage.
         
         

---

Related topics
Adding a dependent to your health plan
Applying for a Buy-Out Waiver due to a qualifying event
Eligible dependents for health benefits
Waiving health benefits due to a qualifying event

2018

Last revised: March 9, 2009