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  • Ny Ps-404 2017

Get Ny Ps-404 2017

NNUAL OPTION TRANSFER REQUEST(S) BELOW Change NYSHIP Option Change to: HMO Code Individual Opt-out Elect Opt-out (if eligible) Change Pre-Tax Status Empire Plan HMO Name Family Opt-out If choosing Opt-out, you must also complete the PS-409 Opt-out Attestation Form. Change to: 14. Pre-Tax Post-Tax Submit during the Pre-Tax Contribution Selection Period (November 1-30) LEAVE WITHOUT PAY AND RETIREMENT STATUS LEAVE WITHOUT PAY RETIREMENT I wish to continue coverage while I am on a.

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How to fill out the NY PS-404 online

The NY PS-404 is a vital form used for health insurance transactions for employees in New York State. This guide provides step-by-step instructions on how to accurately complete the form online, ensuring you can enroll in health insurance coverage effectively.

Follow the steps to successfully complete the NY PS-404 online.

  1. Use the 'Get Form' button to obtain the NY PS-404 and open it in your preferred online editor.
  2. Begin by filling out the employee information section in boxes 1-9. Provide your first name, last name, middle initial, date of birth, sex, social security number, street address, city, state, zip code, and telephone numbers. Make sure all information is entered accurately.
  3. In box 10, check the appropriate boxes to add, delete, or change dependent information. Fill out all required fields for each dependent including their last name, first name, middle initial, relationship, date of birth, sex, and any special coverage requirements.
  4. For new or newly eligible employees, complete box 11 (A-C). Select options for medical, dental, and vision coverage. Specify whether you are opting for individual or family enrollment and indicate your preference for pre-tax or post-tax contributions.
  5. In box 12, indicate any changes or cancellations to your coverage. Specify whether you are changing from individual to family coverage, or cancelling coverage altogether, and include the date of the event that prompted the change.
  6. Box 13 is for annual option transfer requests. Use this box to indicate if you are changing your NYSHIP option or your pre-tax status during the designated time period.
  7. In box 14, provide information regarding your status during a leave without pay or if you are retiring. Specify whether you wish to continue or cancel your health coverage.
  8. Finally, review all entries for accuracy. Ensure you’re providing any required documentation, and sign and date the authorization section at the end of the form.
  9. Once completed, you can save your changes, download, print, or share the completed form as necessary.

Complete your health insurance transactions online by filling out the NY PS-404 today.

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Empire insurance is often referred to as the Empire Plan or the New York State Empire Plan. This plan provides comprehensive health coverage for New York state employees and their eligible dependents. Being familiar with the alternative names helps in navigating insurance documents and services more efficiently. For detailed insights into this plan, resources related to NY PS-404 would be beneficial.

NYSHIP and the Empire Plan are closely related, but they are not identical. NYSHIP is a collection of health insurance options available to New York state employees, whereas the Empire Plan is a specific type of insurance plan offered under NYSHIP. Knowing the distinction can assist you in selecting the best coverage for your health care needs. For more details on your options, consult resources like NY PS-404.

No, NYSHIP and the Empire Plan are not the same; however, the Empire Plan is one of the health insurance options available through NYSHIP. NYSHIP offers a variety of plans to cover different needs, while the Empire Plan specifically serves state employees. Understanding the differences between these programs can help you choose the right health coverage for yourself or your family. You can find relevant information about these plans in the context of NY PS-404.

The Empire Plan has recently been rebranded as the 'New York State Health Insurance Program – Empire Plan.' This name change reflects broader efforts to standardize and enhance health benefits for New York state employees. While the name has changed, the core services and benefits remain the same. To understand how these services fit into your health insurance options, refer to NY PS-404 details.

Yes, New York state employers are generally required to offer health insurance to their employees. Under the New York ACA mandates, businesses must provide coverage if they have a certain number of employees. This ensures that workers have access to essential health services, contributing to overall well-being. For an in-depth overview of health insurance obligations, consider checking out resources related to NY PS-404.

NYSHIP, or the New York State Health Insurance Program, is not the same as UnitedHealthcare. While UnitedHealthcare is one of the private insurance providers that offer health plans under NYSHIP, NYSHIP itself encompasses a variety of health insurance plans available to New York state employees. When considering health coverage options, it's essential to understand the benefits and services each plan provides. For more specific information regarding your coverage, you can explore NY PS-404 solutions.

In New York City, the minimum hours to qualify for health insurance generally align with the state regulations, requiring employees to work at least 30 hours per week. However, employers may offer plans with varying criteria for part-time workers. It’s essential to communicate with your employer about their specific health benefits policies. You can also find valuable resources on this topic by exploring uslegalforms.

The opt-out program for NYSHIP allows eligible employees to reject health insurance coverage offered by their employers and receive a payment in exchange. This program benefits those who may have alternate health coverage. It’s important to apply for this opt-out program during the designated enrollment period. For detailed steps and requirements, visit the NYSHIP website or consult with uslegalforms for helpful resources.

In New York, employers with four or more employees must offer health insurance coverage under state laws. These covers must include minimum essential benefits as outlined in the Affordable Care Act. Additionally, employers need to inform employees about their health insurance options clearly. Using uslegalforms can help you ensure compliance with regulations while setting up health benefits for your employees.

The least amount of hours you need to work to qualify for health insurance in New York often depends on your employer's specific policies. Most commonly, working 30 hours per week qualifies you for health benefits. Some employers, however, may offer plans to part-time employees working as few as 20 hours. It's crucial to verify with your employer to understand your eligibility for health benefits.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Help Portal
Legal Resources
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
NY PS-404
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