Health Option Program (HOP)
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FIRST, from the HOP rate appropriate to the employees payroll percentage before the change to less than 50% to the HOP rate appropriate for the new lower payroll percentage. This will be effective as of the last day of the pay period in which the percentage change became effective. THEN, from the HOP rate for the new payroll percentage to the non-HOP rate for the new payroll percentage This will be effective as of the last day of the pay period following the pay period in which the last employee share premium was paid (i.e. two weeks after the last premium payment).
In the case of waiver of NYSHIP premiums during periods of LWOP, your accrual rate will change when you return to pay status and are again eligible to earn sick leave.
Can I participate in the HOP program if I am not a NYSHIP contract holder in either the Empire Plan or an HMO?
No.
If my spouse is enrolled in NYSHIP and carries our familys health insurance coverage, can we both participate in the Health Option Program and both apply our credits to reduce the cost of family health insurance coverage?
No. Only the contract holder may contribute to family health insurance premiums. However, if both you and your spouse carry individual coverage, you are both eligible to participate in HOP.
If I elect to participate and then cancel my insurance coverage at some point in the calendar year, can I discontinue my participation in the Health Option Program?
Employees who voluntarily cancel NYSHIP health insurance coverage are removed from the HOP program and return to earning sick leave at their normal rate of accrual. If they re-enroll in NYSHIP during the calendar year, they are ineligible to participate in HOP for the remainder of that calendar year. Employees enrolled in NYSHIP on a pre-tax basis can change coverage or health insurance plan or voluntarily cancel coverage ONLY: (1) in response to a qualifying event as defined by Section 125 of the Internal Revenue Code; OR (2) during the annual option transfer period.
Assuming I continue to be eligible to participate in HOP throughout a given calendar year, can I decide to withdraw from HOP and return to earning sick leave at my normal rate?
No. However, at the expiration of the calendar year, your participation in HOP automatically ends unless you have elected to participate in the following calendar year.
What happens if I move between individual and family coverage during any given year of participation?
Under HOP, employees can receive a health insurance premium credit of up to $310.50 (or the applicable part-time limit) or the annual cost of the employee share of their NYSHIP health insurance premium, whichever is less. Your health insurance premium credit will be adjusted upward or downward as appropriate if you move between individual and family coverage. The credit can never exceed $310.50. Employees enrolled in NYSHIP on a pre-tax basis can change coverage ONLY: (1) in response to a qualifying event as defined by Section 125 of the Internal Revenue Code; OR (2) during the annual option transfer period.
What are the tax implications of participating in HOP?
By participating in HOP you are reducing the amount deducted from your pay check each biweekly pay period to pay your share of your NYSHIP premium. If your share of your NYSHIP premium is withheld from your pay check on a pretax basis, and that amount is reduced by the HOP health insurance premium credit, the net effect is that the amount of income you pay taxes on increases. For example, assume that before enrolling in HOP, you had a $10 pretax deduction from each biweekly pay check to pay for your health insurance premium and that this was the only pretax deduction from you check. The amount of income you paid tax on was your gross biweekly salary minus that $10 pretax deduction. As the result of enrolling in HOP, you no longer have that $10 pretax deduction. Therefore, in this case, the amount of income you pay tax on in your gross biweekly salary will increase by $10 as a result of participation in HOP.
Enrollees who participate in the pre-tax premium contribution program (PTCP) and wish to make changes to their health insurance coverage are still governed by the PTCP rules regarding qualifying events. Reduction or elimination of the employee share premium under HOP does not in any way alter these regulations.
Can I enroll in both HOP and the Health Care Spending Account?
Yes. Employees eligible under the Health Care Spending Account (HCSAccount) guidelines may participate in that program by having money withheld from their paychecks to be applied against qualifying medical expenses.
How do I know if HOP is the right choice for me?
The decision to participate in HOP is a very personal one. There are a number of things you should take into consideration in making your decision. These include your daily rate of pay and the annual employee share cost of your NYSHIP premium. Other factors include your leave balances, your normal sick leave accrual rate, your anticipated need to use sick leave and your ability to forgo earning 3 days of sick leave during the calendar year. You should also keep in mind that at time of retirement, sick leave credits can be used, subject to certain limitations, for retirement service credit and to defray the cost of health insurance during retirement.
Who do I contact if I have further questions?
You should contact your agency State Administrators or Community College Administrators