"Nassau County - Long Island, New York"

A: The Smart Savings program ends the practice of providing two family health benefit policies to employees who are married to or partnered with another county employee or retiree. In Smart Savings, one spouse or partner is the primary person for health benefits coverage and the other spouse or partner is a dependent. The dependent spouse or partner receives the County’s health insurance buy back (currently $2,000) and the family is reimbursed should they have out of pocket expenses over the buy back amount that would have been covered if they had retained two family health benefit policies.

A: No. Participation is mandatory for members of the unions listed above, non-union employees of the County and the College

A: No. Smart Savings maintains the same level of benefits to the employees and their families.

Q: Who decides which spouse or partner is the primary person or who will be the dependent for health benefit purposes?

A: You decide. When your union first joins Smart Savings, you will receive a letter asking you which spouse or partner should become the primary person and which should receive the health insurance buy back, currently $2,000. If you do not make a choice within 30 days, the Comptroller’s Health Benefits Unit will follow standardized rules to determine which spouse will be primary, based on such factors as (1) whose union is covered by Smart Savings; (2) who is active and who is retired; (3) whose birth month and day falls earlier in the calendar year. If you have questions about this process, please contact the Comptroller’s Health Benefits Unit.

Q: Can my spouse and I switch who is the primary person and who is the dependent?

A: Yes. You may change which spouse or partner is primary and which is the dependent once a year during the open enrollment period. The change will be effective as of January 1 following the open enrollment period.

Q: What happens if I am the dependent for health benefits and my spouse dies or we get a divorce?

A: NYSHIP rules provide that as long as a member was continuously covered as a dependent, he or she can be provided health benefits as the primary person upon a change in status, such as a divorce or in the event the primary person dies. Under NYSHIP rules, the previous coverage continues automatically for 90 days after the change of status. Notify the Comptroller’s Health Benefits Unit of the change in status within the 90 days so that we can switch you to become the primary person in NYSHIP’s records.

Q: How will I receive my Smart Savings health insurance buy back reimbursement?

A: The buy back amount, currently $2,000, is paid to employees through a payroll check or direct deposit. Non-union County retirees can also receive the buy back amount. The buy back is taxable, and will be reported to the IRS in the W-2 for employees and in a 1099 for retirees.

Smart Savings Reimbursement Form
Smart Savings Reimbursement Procedures

Q: What happens if the health insurance buy back is not enough to cover my out-of-pocket medical expenses?

A: If a Smart Savings family has to pay more in out-of-pocket medical expenses than they would have with a second family

health benefits policy, the County will reimburse the family for any costs that exceed the gross buy back amount (currently $2,000)

if those costs would otherwise have been covered by the second family policy. This guarantee does not apply to County ordinance employees hired on or after January 1, 2007.

Q: How do I get reimbursed if I have out of pocket expenses over the buy back amount?

A: If your out-of-pocket medical expenses for a single year exceed the buy back amount, currently $2,000, you must send

a Reimbursement Form along with copies of your Explanation of Benefits (“EOB”) and receipts to the Plan Administrator. Once it is determined, based on the submitted receipts and EOBs, that you would have been reimbursed by a second family health insurance policy, you will be reimbursed for the amount in excess of the buy back.

The Reimbursement Form can be downloaded from http://www.nassaucountyny.gov/agencies/Comptroller/smart_savings.html

or will be sent to you on request to the Comptroller’s Health Benefits Unit.

Please mail your completed form(s) to the Plan Administrator listed below:

NASSAU COUNTY SMART SAVINGS PROGRAM

c/o Pamela D’Apuzzo

Complete Management Solutions, LLC.

55 Kennedy Drive, Suite 2

Hauppauge, New York 11788

Q: How do I enroll in the flexible spending account for medical expenses?
A: Enrollment forms for the flexible spending account can be obtained from Human Resources or your department’s HR representative during the open enrollment period.

Q: Is there a limit on how much I can put in my flexible spending account?

A: Yes. All Nassau County employees may contribute up to $5,000 to their flexible spending account. Employees in Smart Savings are eligible to put an extra $2,000 into a flexible spending account and may contribute up to $7,000.

Q: What if I have a hardship situation and need to keep two family health benefit policies?

A: You may apply for a hardship exemption from Smart Savings by sending a letter to the Office of Labor Relations.

Q: I am married to another Nassau County employee and we do not have any children. Can we get two individual health insurance policies instead of one family policy?
A: Yes. You may take two individual health insurance policies instead of one family policy. However, you will not receive the buy back or the reimbursement in excess of $2,000.

Q: If I am currently an active employee in Smart Savings and then retire, can I get my own policy back upon retirement?
A: No. If you were covered by Smart Savings as an employee, you continue in Smart Savings as a retiree.

Q: If I leave County employment before the end of the year, can I keep the entire buy back amount?

A: No, the buy back is a payment for a full calendar year. If you leave before the end of the year you will be notified of the pro-rated amount that you must return. If you do not repay the pro-rated amount, it will be deducted from your termination pay.

Q: If I have a dependent who is not my spouse’s dependent, and my spouse has a dependent who is not my dependent, can we keep two family health insurance policies?

A: You will probably not need two family policies. Under NYSHIP rules, stepchildren of the enrollee can be covered by his or her health insurance policy, so in most instances, the entire family can be covered by a single family plan. NYSHIP rules also provide

that where the dependent is not a child of the employee, upon proof of dependency, the child can be covered by the spouse of the responsible employee. In these situations, each individual case will be evaluated by NYSHIP, and you should consult with the Comptroller’s Health Benefits Unit to confirm eligibility for coverage of all dependents.

Q: What happens if my spouse or partner leaves the County and no longer has County health benefits?

A: You will be taken out of the Smart Savings program. If you were the dependent on your spouse or partner’s health benefits,

you will become the primary person. Please contact the Comptroller’s Health Benefits Unit as soon as you can so that we may process the change accurately.

If you have any further questions please contact the Nassau County Comptroller’s Office Health Benefits Unit