IMPORTANT NOTICE: Action Required to Maintain Health Insurance Coverage for Your Dependents.
PSC members and retirees who are eligible for employer-paid health insurance because of their employment at CUNY receive coverage from the City of New York, through the NYC Employee Benefits Program. For those who have “family” coverage, the City has decided to audit the eligibility of dependents (spouses and children) for that coverage. The last time such an audit was undertaken was in 2013/14, thousands of dependents were determined to be ineligible, saving the City nearly $100M a year. The City is again expecting significant savings from this audit. Eliminating ineligible dependents is a more acceptable approach than cutting benefits or raising members’ out-of-pocket costs.
The audit is being administered by an independent contractor, Health Management Systems, Inc. (HMS). HMS will be sending letters (not emails) to all employees/retirees with “family” coverage (which term includes spouse/domestic partner-only coverage) explaining what documents they need to submit to verify dependents’ eligibility and how to submit them. Here is a link to a sample letter.
For PSC members at CUNY, these mailings will be staggered according to the following proposed timelines:
- CUNY employees at community colleges, last name starting A-H: early October
- CUNY employees at community colleges, last name starting I-R: about Nov. 20
- CUNY employees at community colleges, last name starting S-Z, plus all CUNY employees at senior colleges: end of Dec.
- All pre-Medicare retirees (under 65): early Feb ‘27
- Medicare retirees, last name starting A-L: mid-March ‘27
- Medicare retirees, last name starting M-Z: early May ‘27
There is a verification form in each mailing (See page 3 of the sample letter) which must be signed and returned with the required documents (only send copies):
- For spouses, a government-issued marriage certificate PLUS a copy of the front page of your 2025 joint tax return or recurring household bills/statements within the last 90 days (not health care bills) to document that you and your spouse live in the same household.
- For domestic partners, a government-issued certificate of domestic partnership (For those who live in states that do not issue them, there are workarounds—contact HMS.) PLUS recurring household bills/statements within the last 90 days (not health care bills) to document that you and your partner live in the same household.
- For children up to age 26 and disabled children, a government-issued birth or adoption certificate with first and last names, naming you or your spouse/partner as the child’s parent OR a copy of a court order naming you or your spouse/partner as the child’s legal guardian. For a stepchild or child of domestic partner, documentation of your current relationship to your spouse or domestic partner must be included.
There are deadlines for submitting documents: approximately 3-4 weeks following the mailing date of your notice. For faster processing, the HMS verification form recommends that required documents may be submitted along with the verification form by uploading them via the secure web portal at www.VerifyOS.com or by faxing them to 877-223-8478. You may also submit by mail. Please DO NOT mail original documents as they will not be returned.
If you do not submit complete documentation for your dependents by the deadline, the affected dependent(s) for whom complete documentation has not been submitted will be removed from your City Health Benefits coverage. When the required documents are submitted and the dependent/s deemed eligible, coverage will be restored.
Questions and concerns should be addressed to HMS, not the City and not CUNY. Contact information is included in the mailing. Here is a link to pre-audit FAQs prepared by HMS: https://www.nyc.gov/site/olr/health/deva/deva-preaudit-faqs.page
To get ready:
- Make sure the NYC Employee Benefits Program has your correct mailing address. To check or update your address, contact your college HR Office.
- Watch for the NYC OLR/HMS mailing based on the dates above.
- Start locating and make copies of the required eligibility documents. (If you cannot find them, you will have to contact the appropriate government agency and that may take time.)
