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Compiled text through Jan 31, 2026Register checked through July 29, 2026/Vol. XLVIII, Issue 30 (2026-07-29)

All 12 displayed sections in this Part carry the same compiled date. Status and warnings stay on each section.

4 NYCRR 73.1 - Definitions

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Dates and status

Compiling agency: Department of Civil Service
Text status: Phase2b Dequote Reversal
Register checked through: July 29, 2026/Vol. XLVIII, Issue 30 (2026-07-29)
Activity status: No later Register activity identified in this check.
Source snapshot: May 19, 2026

(a)The term

plan or health insurance plan means the group hospitalization, surgical and medical insurance provided under the various contracts entered into pursuant to article XI of the Civil Service Law, and any amendments thereto, including all the benefits provided thereunder, and all conditions and limitations applicable thereto pursuant to such contracts or as prescribed by the President of the Civil Service Commission.

(b)The term

employer or an employer shall include the State of New York (in all its departments and agencies and those departments and agencies of the State maintained and financed from special or administrative funds) and any participating employer. The term participating employer shall mean any public authority, public benefit corporation, school district, district corporation, municipal corporation or other public agency, subdivision or quasi-public organization which elects, with the approval of the President of the Civil Service Commission, to include its employees and/or retired employees in the plan.

(c)The term

employee means any person in the service of an employer, except:

(1)any person whose regular work schedule is less than 20 hours a week, other than:

(i)a person paid on an annual salary basis whose salary rate is $2,000 per year or more; provided, however, that for purposes of this definition a participating employer may establish a minimum in excess of 20 hours per week and/or a salary basis higher than $2,000 per year for purposes of determining eligibility under the plan;

(ii)a paid elective official of the State or paid member of a public legislative body or other local elective official, including a publicly elected member of a school board; provided, however, that the determination of eligibility under the plan for such official or member and employer contributions, if any, shall be permissive for any participating employer, except that any unpaid local elective official who occupies a position which by statute, local law, ordinance or resolution is expressly prohibited from receiving compensation or school board member electing to participate by reason of such membership shall be required to pay both the employer and the employee contribution for any coverage elected under the plan;

(iii)a person whose major source of income is from his employment with the employer; or

(iv)an unpaid board member of a public authority, provided he or she has six months or more of service in such position;

(2)any person appointed or elected for a term of less than six payroll periods, or, in the case of a person paid other than biweekly, for less than three months; provided, however, that for the purposes of this definition a participating employer may require a higher anticipated employment requirement, not to exceed six months for seasonal and/or temporary, or all employees;

(3)any person whose employment is scheduled for termination, other than by retirement, within three months after the effective date of the extension of the plan to employees of a participating employer;

(4)any person who is employed by a public educational institution on other than full-time basis and who is a student therein enrolled for a degree; or

(5)any person who retired prior to the effective date of the plan or of the extension of the plan to employees of his participating employer and who is subsequently reemployed on a temporary, seasonal or occasional basis.

(d)The term

prior retiree means a person who has withdrawn from the active service of the employer prior to the effective date of the extension of the plan to employees of such employer and (1) was an employee of the employer as defined in subdivision (c) of this section for a total of not less than five years and (2) is receiving a retirement allowance or pension from any retirement or pension plan or system administered and operated by the State of New York, or a civil division thereof, including the New York State Teachers' Retirement System, but this last condition shall not serve to exclude from this definition any retired person whose retirement allowance is suspended by virtue of further government employment described in paragraph (5) of subdivision (c) of this section.

(e)The term

post retiree shall mean a person who has become enrolled in the plan as an employee and whose coverage is being continued after his withdrawal from the active service of the employer under the eligibility privileges of the plan and who either:

(1)has retired as a member of a retirement or pension plan or system administered and operated by the State of New York, or a civil division thereof, including the New York State Teachers' Retirement System;

(2)was not a member of a retirement or pension plan or system referred to in paragraph (1) of this subdivision, and is withdrawn or does withdraw from the active service of an employer after attaining such age as would have been required to retire as a member of the New York State and Local Employees' Retirement System;

(3)was an unpaid elective official, and is withdrawn or does withdraw from active service after attaining such age as would have been required to retire as a member of the New York State and Local Employees' Retirement System;

(4)was a publicly elected member of a school board with 20 years or more of service in such position with such participating employer that elects to permit enrollment for such members; or

(5)was an unpaid board member of a public authority with 20 years or more of service in such position.

(f)The term

retired employee shall include prior retiree and post retiree.

(g)The term

vested employee means a person who (1) while enrolled in the plan as an employee discontinues from the service of an employer, other than by death or retirement, on or after October 1, 1966, (2) is and remains entitled to receive at a future time a retirement allowance or pension from a retirement or pension plan or system administered and operated by the State of New York or a civil division thereof, including the New York State Teachers' Retirement System, the State University Optional Retirement Program established under article 8-B of the Education Law and the Education Department Optional Retirement Program established under article 3, part V, of the Education Law in which latter two cases such person must have had at least 10 years of State service, and (3) at the time of such discontinuance of service meets all conditions, including length of service with the employer and length of coverage under the plan, necessary under these regulations for the continuance of coverage after retirement, and (4) in the case of an employee who discontinues from the service of a participating employer, the participating employer may establish an additional requirement that the employee's discontinuance be within five years of their entitlement to receive such retirement allowance or pension. Such person shall remain a vested employee until his entitlement to such future retirement allowance or pension is terminated or until he commences to receive such retirement allowance or pension, in which latter case he shall become a post retiree.

(h)The term

dependent shall include the spouse of an employee or retired employee. It shall also include such person's unmarried child under 19 years of age, any unmarried child 19 years of age or older who is incapable of self-support by reason of mental or physical disability and who became so incapable before reaching the age at which dependent coverage would otherwise terminate, and any student dependent as hereinafter defined. The term child shall be deemed to include any natural born child, any legally adopted child and any stepchild dependent upon the employee or retired employee, any child dependent upon the employee or retired employee during any waiting period prior to the finalization of the child's adoption by the employee or retired employee, and any child chiefly dependent on the employee or retired employee and permanently residing in the household of the employee or retired employee. Dependent shall not include, however:

(1)any person who is covered as an employee or retired employee or as a dependent of another employee or retired employee under the health insurance plan;

(2)any person who is in the armed forces of any country;

(3)any person for whom evidence of acceptability for coverage furnished in accordance with the provisions of the health insurance plan is not accepted as satisfactory.

(i)The term

student dependent means an employee's or retired employee's unmarried child 19 years of age or older but not yet 25 years of age; provided, however, that the time spent on military duty as defined in paragraph (b) of subdivision 1 of section 243 of the Military Law, not to exceed four years, shall be subtracted from the age of such child for purposes of determining the maximum age for eligibility as a student dependent who:

(1)receives more than half of his support from the employee or retired employee and is a full-time student at an accredited secondary or preparatory school or college; and

(2)is not otherwise eligible for employer group coverage.

4 NYCRR 73.2 - Eligibility

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Dates and status

Compiling agency: Department of Civil Service
Text status: Source receipt
Compiled text through: Jan 31, 2026
Register checked through: July 29, 2026/Vol. XLVIII, Issue 30 (2026-07-29)
Activity status: No later Register activity identified in this check.
Source snapshot: Jun 6, 2026

(a)Employees.

(1)An employee shall be eligible for coverage under the plan for himself and for his dependents, if any, subject to the provisions of this Part and of the appropriate contracts applicable to employees and their dependents.

(2)Coverage for any employee or any employee's dependents may be effective on the first day of employment. However, a participating employer may require the employee to complete up to six months of service before coverage for the employee and the employee's eligible dependents becomes effective.

(3)Coverage for any employee and his dependents shall cease without notice on the date of termination of his status as an employee as defined in section 73.1 of this Part. The status of any person as an employee shall be deemed to terminate upon his severance from the payroll, except that, for the purpose of continuing his coverage under the plan, the status of such person as an employee shall be deemed to continue:

(i)during any period of authorized leave without pay or while a vested employee;

(ii)during any period for which payment of benefits is made under a State income protection plan;

(iii)during any period, not to exceed one year or until reemployment by the State or reemployment by another employer, whichever first occurs, or such shorter period as may be established by collective negotiations, in which the employee is suspended and his name is placed on a preferred list for reinstatement; provided, however, that such continuance shall be permissive for any participating employer;

(iv)in the event of the employee's retirement, if the employee has completed at least five years of service with the employer from whose service the employee has retired if such employee was hired prior to April 1, 1975 and such employer elected to participate in the plan prior to March 1, 1972; provided further that an employer may establish a service requirement greater than five years for purposes of determining eligibility for retirement for any employee hired after April 1, 1975 and may elect not to provide continuance of coverage for any employee hired on or after April 1, 1977. An employer so electing shall agree to do so for all employees or all employees in a class or category who, on retirement, meet the conditions specified;

(v)in the event of the retirement of an employee who has met the conditions specified in subparagraph (iv) of this paragraph from the service of an employer which elected to participate in the plan on or after March 1, 1972, if such employer elects, at its option, to treat such retiree as an employee. An employer so electing shall agree to do so for all employees who, on retirement, meet the conditions specified in subparagraph (iv) of this paragraph;

(vi)in the event of the employee's retirement with less than five years of service with the employer from whose service the employee has retired, or less service than established by such employer, pursuant to subparagraph (iv) of this paragraph, such employer, at its option, may provide for the continuance of coverage for such employee, provided that the applicable period of required service has been met through employment with one or more public employers and such employee has served a minimum of one year with the employer from whose service the employee has retired. An employer so electing to provide continuance of coverage shall agree to do so for all employees or all employees in a class or category who, on retirement, meet the conditions specified;

(vii)in the event the employee is, or has been, granted a service-connected disability retirement by a retirement or pension plan or system administered and operated by the State of New York or a civil division thereof, including the New York State Teachers' Retirement System, regardless of the employee's service with the employer;

(viii)in the event of the retirement of an unpaid local elective official with 20 years or more service in such position with a participating employer that elects to permit enrollment for such officials, or an unpaid local elective official who has at least five or more years service with a participating employer and who also meets or exceeds a locally established service requirement which is not less than that established for other employees of that locality; or

(ix)in the event of the retirement of a publicly elected member of a school board with 20 years' or more service in such position with a participating employer that elects to permit enrollment for such members.

(4)Notwithstanding the foregoing provisions, coverage under the plan for any person whose status as an employee terminates may continue for the period for which the required contributions of both the employee and the employer on account of such coverage were made, provided such contributions were payable to the Health Insurance Fund on or prior to the date of the termination of the status of such person as an employee. However, a participating employer may establish that coverage for any category of employees will cease on the last day of the month during which status as an employee terminates. In the event that no contributions are required of an employee for such coverage, coverage under the plan may continue, in the case of an employee paid on a biweekly basis, through the 28th day following the last day of the last payroll period during which the employee was employed and, in the case of an employee paid on a monthly basis, through the last day of the calendar month next following the last month during which the employee was employed, unless an earlier termination date for a particular category of employees has been established.

(5)Notwithstanding any of the foregoing provisions of this section, if the regular work schedule of an employee has been not less than 20 hours per week for at least one year and then is reduced to less than 20 hours per week under circumstances not expressly excepted under section 73.1(c)(1) of this Part, the president may, in his discretion and upon the request of the employer, deem such person's status as an employee to continue for a period not exceeding one year for the purpose of continuing his coverage under the plan. Thereafter, if the regular work schedule of such employee continues to be less than 20 hours per week, the president may, from time to time, review the case and, in his discretion, grant extensions not exceeding one year each during which such person's status as an employee may be deemed to continue.

(6)

(i)In the event both husband and wife elect coverage under the plan as employees as defined in section 73.1 of this Part, there shall be coordination of benefits.

(ii)No employee may elect coverage under the plan with more than one employer. A person having elected coverage with two or more employers shall terminate coverage with all but one of such employers. If the employee does not do so forthwith, the employee shall be deemed to terminate coverage with all but the employer with whom coverage was first acquired.

(7)Notwithstanding any other provisions of this Part for the purpose of determining an employee's eligibility to apply accumulated but unused sick leave credits against the employee's cost of health insurance in retirement, an employee whose services are terminated on account of the abolition of positions in the State service and who retires within one year following such termination, shall be deemed to have been on leave without pay and thus eligible to have such credits applied.

(b)Continued coverage of dependents on death of employee or retired employee.

(1)Notwithstanding any other provisions of this Part in the event of the death of an employee or retired employee for whom charges are paid on a biweekly basis, the coverage hereunder of his dependents shall continue, following the payroll period in which death occurs, for the payroll periods for which contributions were made by such employee for coverage of such dependents and, in addition, thereafter, for the five next succeeding payroll periods. If such coverage has been provided by the employer without cost to the employee or retired employee, the coverage of such dependents shall continue for the seven biweekly payroll periods next succeeding the payroll period in which the employee's death occurs. In the event of the death of an employee or retired employee for whom charges are paid on a monthly basis, the coverage hereunder of his dependents shall continue, following the month in which death occurs, for the month or months for which contributions were made by such employee or retired employee for coverage of such dependents and, in addition, thereafter for the two next succeeding months, but in no event shall coverage extended under this paragraph exceed the three-month period next succeeding the month in which the employee's or retired employee's death occurs. If such coverage has been provided by the employer without cost to the employee or retired employee, the coverage of such dependents shall continue for the three-month period next succeeding the month in which the employee's or retired employee's death occurs.

(2)Where the circumstances of death of the covered employee are such that an accidental death benefit from a retirement system or pension plan administered by the State or a civil division or a death benefit under the Workers' Compensation Law is payable, dependents shall be eligible for continued coverage, following expiration of the period of coverage provided in paragraph (1) of this subdivision, in accordance with and subject to the provisions of subdivision 2 of section 165 of the Civil Service Law. If an application or claim has been made for an accidental death benefit from a retirement system or pension plan or for death benefits under the Workers' Compensation Law, such dependents shall be eligible for continued coverage under this paragraph pending determination of such application or claim and provided the same is diligently prosecuted by the applicant or claimant. Coverage of dependents may be continued under this paragraph only if written application for such continued coverage is filed with the Department of Civil Service within 90 days after the death of the employee. In the case of dependents of an employee who died before July 1, 1964, such dependents who would otherwise be eligible for coverage under subdivision 2 of section 165 of the Civil Service Law if such section had been in effect at the time of such death shall be eligible for coverage under the plan, provided written application for such coverage is filed with the Department of Civil Service on or before December 31, 1964. Coverage of dependents of a deceased employee under this paragraph may be continued only for so long as such dependents would otherwise be eligible for coverage if the employee had lived and continued to be covered in the health insurance plan, and the surviving spouse for only so long as he or she remains unremarried.

(3)Notwithstanding any other provisions of this Part, in the event of the death of an employee or retired employee on or after September 1, 1968, who was an employee of the State and/or of a political subdivision thereof for not less than 10 years and who had been a participant in any of the health insurance plans, the unremarried spouse of such deceased employee or retired employee and/or the other qualified dependents, if any, may elect in writing to continue their present health insurance coverage, provided that the election to continue such coverage and tender of a premium payment equal to one quarter of the full share annual premium is made prior to the cessation of such coverage. If the spouse has remarried at the time of the election to continue coverage or remarries at any time after the election, he or she is ineligible to continue in the plan, but the other dependents, if any, may continue in the plan as provided by this Part.

(c)Prior retirees.

Upon the extension of the plan to prior retirees of an employer, each such prior retiree shall be eligible for coverage under the plan for himself and his dependents, if any, subject to the provisions of this Part and of the appropriate contracts applicable to prior retirees and their dependents, provided he makes application for such coverage within the time specified therefor by the president.

(d)Cessation of eligibility upon termination of the plan or participation of employer.

Upon the termination of the plan by the State, or of the status of an employer as a participating employer by reason of default in the payment of charges, or by withdrawal or expulsion or otherwise, the coverage and eligibility for coverage of its employees and retired employees shall cease as of the end of the last period for which the required contributions of both employer and employee have been paid to the Health Insurance Fund.

(e)Disqualification.

The president may disqualify from participation in the health insurance plan and from receiving benefits thereunder any employee or retired employee or dependent of an employee or retired employee who has secured or attempted to secure participation in the health insurance plan or benefits under the plan for himself or another by fraud, deception or a false statement of a material fact, or who has accepted benefits for himself or another knowing he was not entitled thereto. No person shall be disqualified or denied benefits pursuant to this subdivision unless he is first given a written statement of the reasons therefor and afforded an opportunity to make an explanation and submit facts in opposition to such action. Such employee, retired employee or dependent of an employee or retired employee may be restored to eligibility for coverage under the plan only on approval of the president and subject to such conditions as may be imposed by the president, including repayment of sums expended for benefits obtained by fraud, deception or false statement of a material fact, or accepted by the employee with knowledge that he was not entitled thereto.

4 NYCRR 73.3 - Charges and contributions

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Dates and status

Compiling agency: Department of Civil Service
Text status: Phase2b Dequote Reversal
Register checked through: July 29, 2026/Vol. XLVIII, Issue 30 (2026-07-29)
Activity status: No later Register activity identified in this check.
Source snapshot: May 19, 2026

(a)Charges for coverage.

Charges for coverage of employees of the State whose salaries are paid on a biweekly basis shall be payable to the respective insurers on a corresponding biweekly basis. Charges for coverage of all other employees and for coverage of all retired employees shall be payable to the respective insurers on a monthly basis. All such charges are subject to change from time to time in accordance with the provisions of the respective contracts or otherwise upon amendment of any such contract.

(b)Rate of contribution.

The rate of contribution of New York State on account of the coverage of its employees, post retirees and their dependents shall be 100 percent of the charge on account of individual coverage and 75 percent of the charge on account of dependent coverage, except that for the health maintenance organization options the State's contribution shall not exceed the same dollar amount as is paid by the State under the basic benefit plan. Effective October 1, 2011, for those employees employed in a title allocated or equated to salary grade 9 or below, the State's rate of contribution for such employees and their dependents enrolled in the Empire Plan or a health maintenance organization shall be 88 percent of the charge on account of individual coverage and 73 percent of the charge on account of dependent coverage; provided, however, that for hospital/medical/mental health and substance abuse coverage provided under a health maintenance organization, the State's rate of contribution shall not exceed 100 percent of its dollar contribution for such coverage under the Empire Plan. For employees employed in a title allocated or equated to salary grade 10 or above, the State's rate of contribution for such employees and their dependents enrolled in the Empire Plan or a health maintenance organization shall be 84 percent of the charge on account of individual coverage and 69 percent of the charge on account of dependent coverage, provided, however, that for hospital/medical/mental health and substance abuse coverage provided under a health maintenance organization, the State's rate of contribution shall not exceed 100 percent of its dollar contribution for such coverage under the Empire Plan. Effective October 1, 2011, the rate of contribution on account of the coverage of post retirees shall be as follows:

(1)for retirees who retired on or after January 1, 1983, and employees retiring prior to January 1, 2012, New York State shall contribute 88 percent of the charge on account of individual coverage and 73 percent of the charge on account of dependent coverage, provided, however, that for hospital/medical/mental health and substance abuse coverage provided under a health maintenance organization, the State's rate of contribution shall not exceed 100 percent of its dollar contribution for such coverage under the Empire Plan;

(2)for employees retiring on or after January 1, 2012, from a title allocated or equated to salary grade 9 or below, New York State shall contribute 88 percent of the charge on account of individual coverage and 73 percent of the charge on account of dependent coverage, provided, however, that for hospital/medical/mental health and substance abuse coverage provided under a health maintenance organization, the State's rate of contribution shall not exceed 100 percent of its dollar contribution for such coverage under the Empire Plan;

(3)for employees retiring on or after January 1, 2012, from a title allocated or equated to salary grade 10 or above, New York State shall contribute 84 percent of the charge on account of individual coverage and 69 percent of the charge on account of dependent coverage, provided, however, that for hospital/medical/mental health and substance abuse coverage provided under a health maintenance organization, the State's rate of contribution shall not exceed 100 percent of its dollar contribution for such coverage under the Empire Plan.

The rate of contribution of a participating employer on account of the coverage of its employees, post retirees and their dependents shall be not less than 50 percent of the charge on account of individual coverage and 35 percent of the charge on account of dependent coverage. A participating employer may elect to pay higher rates of contribution for the coverage of its employees, retired employees and their dependents; provided, however, that if a participating employer so elects to pay a higher or lower rate of contribution for its retired employees or their dependents, or both, than that paid by the State for its retired employees or their dependents, or both, amounts withheld from the retirement allowances of its retired employees for their share of premium or subscription charges, if any, shall, if the president so requires, be paid to such participating employer which shall pay into the health insurance fund the full cost of premium or subscription charges for the coverage of such retired employees and their dependents; and provided that notice of such election shall be furnished to the Department of Civil Service not less than 60 days prior to the date on which it is proposed to make such higher rate of contribution effective. The contributions payable by a prior retiree shall be equal to the contributions payable by active employees and post retirees having similar coverages; the employer's contributions shall be the difference between the contributions of the prior retiree and the total charges on account of coverage for such prior retiree. Notwithstanding the foregoing provisions:

(i)An employee on leave without pay, an employee or former employee receiving long-term disability payments from a State income protection plan, or a vested employee whose coverage is continued pursuant to this Part shall be required to pay the entire charge (both employee's and employer's contributions) on account of such coverage for each full pay period of absence or while having the status of a vested employee, as the case may be. Provided, however, any vested employee who is currently entitled to, but defers receipt of, a retirement allowance or pension from a retirement or pension plan or system administered and operated by the State of New York, or a civil division thereof, including the New York State Teachers' Retirement System or under the optional retirement programs established under article 3, part V, and article 8-B of the Education Law shall pay only the employee share of the charge. In addition, an employer may elect to continue the employer share of health insurance premiums for employees in authorized leave without pay status for periods aggregating not more than two years provided such payment is available to all members of a class or category of employee, and the employer provides written notice of such election to the Department of Civil Service at least 60 days prior to the date on which it is proposed to make such payment available.

Such payment may be extended an additional two years by the State Civil Service Commission for good cause shown and where the interests of the government would be served. Where payment has been made for a period which aggregates two years, or for an additional two year period where extended under this paragraph, no further extensions shall be granted unless the employee returns to his or her position and serves continuously therein for the six month period immediately preceding the subsequent leave of absence.

(ii)A covered prior retiree whose retirement allowance is suspended by virtue of his further government employment in a capacity other than as an officer or employee of the employer from whose service he retired shall be required to pay the entire charge on account of such coverage for the period during which his retirement allowance is suspended. If further government service is as an officer or employee of the employer from whose service he retired, such employer shall pay the required employer's contributions.

(iii)The employer shall pay the entire charge for the coverage of dependents of a deceased employee for the period of continued coverage provided in section 73.2(b)(1) of this Part, following the period for which contributions for coverage of such dependents were made by the employee.

(iv)Dependents of a deceased employee for whom coverage is continued pursuant to section 73.2(b)(2) of this Part, shall be required to pay the entire charge on account of such coverage. The initial payment shall be required in advance of such coverage and, thereafter, advance payments shall be required at such intervals as may be prescribed by the President of the Civil Service Commission.

(v)Dependents of deceased State correction officers or civilian employees of a correctional facility whose death occurred as the result of injuries sustained during the period from September 9, 1971 to September 13, 1971 whose coverage is continued pursuant to section 73.2(b)(2) of this Part shall have the full cost of such coverage paid by the State; provided, however, that in the case of those enrolled in an optional benefit plan, the State shall contribute not more than the same dollar amount which would be paid if such unremarried spouse and dependents were enrolled in the basic Statewide health insurance plan and further provided that application for continuation of such coverage is made prior to September 1, 1972.

(vi)The employer shall pay an additional sum each month equal to the current monthly Federal Medicare charge as the employer's share of the cost of coverage for each employee and dependent covered under the health insurance plan who is 65 years of age or older.

(vii)The unremarried spouse and/or other dependents of a deceased employee who elect to continue coverage in the plan as provided in section 73.2(b)(3) of this Part shall be required to pay the entire charge (both employee's and employer's contributions) on account of such coverage.

(viii)No participating employer shall be required to pay the cost of premium or subscription charges for the coverage of unpaid local elective officials or their dependents. Provided however, in instances where there is no statute, local law, or ordinance or resolution which expressly prohibits an unpaid local elective official from receiving compensation and the participating employer elects to contribute toward such premium or subscription charges, the participating employer's rate of contribution shall be not less than 50 percent of the charge on account of individual coverage and 35 percent of the charge on account of dependent coverage.

Post-retirees who continue coverage in the plan by virtue of having served as unpaid local elective officials and who are expressly excluded from compensation by statute, local law, ordinance or resolution, shall be required to pay the entire charge (both the employee's and employer's contribution) on account of such coverage.

(ix)The post-retiree who continues coverage in the plan by virtue of 20 years' or more service as a publicly elected school board member with a participating employer shall be required to pay the entire charge (both employee's and employer' s contribution) on account of such coverage.

(c)Deduction of contributions.

(1)The contributions required to be paid by an employee on account of coverage for himself and his dependents shall be deducted from his salary or wages by the chief fiscal officer of the employer. In the case of a retired employee his required contributions shall be deducted from his retirement allowance by the fiscal officer responsible for the payment of such allowance, but in the event that his retirement allowance is suspended by virtue of his further government employment as an officer or employee of the employer from whose service he retired his required contributions shall be deducted from his salary or wages. In the case of a retired employee of a participating agency which has elected to pay a higher rate of contribution for its retired employees or their dependents than is paid by the State for its retired employees and their dependents pursuant to subdivision (b) of this section, the amount deducted from his retirement allowance as his required contribution shall be paid by the fiscal officer responsible for the payment of such allowance to the chief fiscal officer of the participating employer. During any period when an employee or retired employee is not receiving a salary, wages or a retirement allowance and his coverage is continued pursuant to this Part, he shall make the payments required of him on account of such coverage directly to the chief fiscal officer of the participating employer or in the case of a State employee to the health insurance pending account.

(2)The sums to be deducted from salaries, wages or retirement allowances or otherwise paid by direct payment shall be as determined by the president or in the case of a participating employer by the appropriate fiscal officer, and shall be in sufficient amounts so that the full contributions of employees and retired employees due and payable to the health insurance fund as provided in section 73.8 of this Part will have been so deducted or otherwise paid on or before the appropriate due date.

(3)Payments required on account of coverage of surviving dependents, for whom coverage is continued pursuant to section 73.2(b)(2) of this Part, shall be made directly to the health insurance pending account or, upon written request of the surviving dependent, such contribution shall be deducted from any retirement allowance to which such survivor is entitled. In the case of surviving dependents of a deceased employee of a participating employer, such payments shall be made to the chief fiscal officer of such participating employer.

(4)Payments required on account of coverage of the unremarried surviving spouse and/or other dependents for whom coverage is continued pursuant to section 73.2(b)(3) of this Part shall be made on a quarterly basis directly to the health insurance pending account or, upon written request of the surviving dependent, such contribution shall be deducted from any retirement allowance to which such survivor is entitled.

In the case of a surviving unremarried spouse and/or other dependents of a deceased employee or retired employee of a participating employer, such payments shall be made to the chief fiscal officer of such participating employer.

4 NYCRR 73.4 - Administrative responsibilities of the employer

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Dates and status

Compiling agency: Department of Civil Service
Text status: Source receipt
Compiled text through: Jan 31, 2026
Register checked through: July 29, 2026/Vol. XLVIII, Issue 30 (2026-07-29)
Activity status: No later Register activity identified in this check.
Source snapshot: Jun 6, 2026

(a)The employer shall be responsible for performing the following administrative functions:

(1)enrollment of employees, retired employees, and their dependents;

(2)preparation and distribution of identification cards, and distribution of certificates for enrolled employees and retired employees, and such other materials as may be required in connection with the administration of the plan;

(3)maintenance of enrollment and up-to-date eligibility records for covered employees and retired employees;

(4)prompt certification to the insurers of eligibility or noneligibility for benefits for the employees and retired employees, and their dependents, claiming benefits and prompt notification to the carriers, as necessary, of the enrollment, change in status and termination of coverage of its covered employees;

(5)collection of any unpaid and past due employee contributions and refunding of any excess amounts contributed by employees;

(6)reporting such information and data concerning the administration and operation of the plan as the President of the Civil Service Commission may request.

(b)Such functions shall be carried out in conformity with standards and procedures approved by the President of the Civil Service Commission. Enrollment and eligibility records shall be maintained in a manner and form approved by the president.

4 NYCRR 73.5 - Assessment and payment of administrative expenses

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Dates and status

Compiling agency: Department of Civil Service
Text status: Source receipt
Compiled text through: Jan 31, 2026
Register checked through: July 29, 2026/Vol. XLVIII, Issue 30 (2026-07-29)
Activity status: No later Register activity identified in this check.
Source snapshot: Jun 6, 2026

Assessments of proportionate shares of expenses of administration of the plan pursuant to section 168 of the Civil Service Law shall be made annually on March 31st, in accordance with a formula approved by the president. A statement of each assessment shall be sent to the appropriate fiscal officer and shall show the formula used and the actual computation of the assessment. Such assessment shall be payable within 30 days after such statement is rendered, by check made payable to the State Commissioner of Taxation and Finance, and forwarded to the President of the Civil Service Commission. Failure to pay any such assessment promptly shall constitute cause for expulsion.

4 NYCRR 73.6 - Application for inclusion in the plan

No later Register activity identified in this check.

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Dates and status

Compiling agency: Department of Civil Service
Text status: Source receipt
Compiled text through: Jan 31, 2026
Register checked through: July 29, 2026/Vol. XLVIII, Issue 30 (2026-07-29)
Activity status: No later Register activity identified in this check.
Source snapshot: Jun 6, 2026

(a)Cost estimates.

Upon the request of the governing body of any authority, corporation, district, agency, subdivision or organization eligible to become a participating employer pursuant to section 163 of the Civil Service Law, accompanied by a certificate of the chairman or other presiding officer thereof certifying as to the number of its employees and/or retired employees who would be eligible to participate in the plan, the President of the Civil Service Commission shall provide an estimate of the costs, including assessments for administrative expenses, based on current and anticipated charges at the time of the estimate, which would have to be paid by such authority, corporation, district, agency, subdivision or organization on account of the coverage of its employees and/or retired employees in the plan.

(b)Application for inclusion.

(1)Any such authority, corporation, district, agency, subdivision or organization may apply for the inclusion of its employees in the plan by submitting to the president the following: a certified copy of a resolution of its governing body electing such inclusion, duly adopted pursuant to subdivision 4 of section 163 of the Civil Service Law, which resolution shall be in a form approved by the president, and an appropriate certificate of the clerk, or if there be no clerk, the chairman or other presiding officer of such governing body certifying that a specified sum or sums of money have been appropriated for the purpose of paying the employer's contributions and expenses on account of the coverage of such employees and their dependents in the plan.

(2)Prior retirees of such authority, corporation, district, agency, subdivision or organization may also be included in such application, or separate application with respect to such prior retirees may be made at another time thereafter in the same manner.

(3)The president may request such further data, certificates or information in connection with any such application as he may deem necessary or desirable.

(4)No such application shall be approved unless it appears to the satisfaction of the president that sufficient sums have been appropriated to reasonably assure the availability of monies for the payment of anticipated employer's costs, including assessments for administrative expenses until the end of the employer's eligible fiscal year in which the expected effective date of the extension of the plan to such employees or prior retirees occurs.

4 NYCRR 73.7 - Effective date of coverage

No later Register activity identified in this check.

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Dates and status

Compiling agency: Department of Civil Service
Text status: Source receipt
Compiled text through: Jan 31, 2026
Register checked through: July 29, 2026/Vol. XLVIII, Issue 30 (2026-07-29)
Activity status: No later Register activity identified in this check.
Source snapshot: Jun 6, 2026

(a)Upon the approval of the application of any authority, corporation, district, agency, subdivision, or organization for the inclusion of its employees and/or prior retirees in the plan, it shall become a participating employer, and the president shall thereupon fix an effective date for the commencement of coverage of such employees and/or prior retirees, as the case may be. Such effective date shall be fixed with due regard to a reasonable time allowance needed for educational, promotional and enrollment purposes and other administrative requirements. The president may, in his discretion, fix a schedule of effective dates of coverage with respect to newly approved participating employers on a quarterly basis or at such other time intervals as he may deem appropriate.

(b)Notwithstanding such effective date for coverage as may be fixed by the president and except as provided in this subdivision, coverage shall not become effective with respect to the employees of a participating employer unless 75 percent of all persons eligible for coverage as employees of such participating employer shall enroll for such coverage. If a participating employer provides coverage for only a class of its employees designated by it in accordance with paragraph (a) of subdivision 2 of section 221 of the Insurance Law, the coverage shall not become effective until 75 percent of the class shall enroll for such coverage. If two or more classes of employees are covered simultaneously, the 75 percent requirement shall apply to the total of such two or more classes which shall be considered one group. If a class of employees not initially covered is subsequently extended the opportunity to enroll, then 75 percent of the employees of that class must enroll for coverage before such coverage can become effective for that class. If two or more classes not initially covered are subsequently and simultaneously extended the opportunity to enroll, then the 75 percent requirement shall apply to the total of such two or more classes which shall be considered one group. For the purposes of this subdivision, the prior retirees of a participating employer are deemed to be a class. The president shall make the final administrative determination whether any purported class set forth in an application for coverage is a class permitted by law. No coverage shall become effective until the employer and employee contributions therefor have been paid into the Health Insurance Fund.

4 NYCRR 73.8 - Payments to Health Insurance Fund

No later Register activity identified in this check.

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Dates and status

Compiling agency: Department of Civil Service
Text status: Source receipt
Compiled text through: Jan 31, 2026
Register checked through: July 29, 2026/Vol. XLVIII, Issue 30 (2026-07-29)
Activity status: No later Register activity identified in this check.
Source snapshot: Jun 6, 2026

(a)The total contributions required to insure covered employees and retired employees for any calendar month shall be due and payable to the Health Insurance Fund on the first day of the preceding calendar month.

(b)The chief fiscal officer of the participating employer shall, on the first day of each month, pay to the Health Insurance Fund the sum of:

(1)the contributions paid by covered employees and retired employees (except contributions deducted from retirement allowances other than as provided in paragraph [3] of this subdivision) required to insure them for the following calendar month;

(2)the contributions required to be paid by the participating employer for the coverage of all covered employees and retired employees of such participating employer for the following calendar month; and

(3)in the case of a participating employer electing to pay a higher rate of contribution for the coverage of its retired employees and their dependents, the contributions deducted from retirement allowances and paid to the chief fiscal officer of such participating employer pursuant to subdivision (b) of section 73.3 of this Part.

(c)Each such payment by a participating employer shall be accompanied by an accounting thereof to be set forth on an appropriate form prescribed by the president.

(d)No monies in the Health Insurance Fund, other than the sums received therefor from the participating employer, shall be committed, encumbered or advanced to pay for the coverage of the employees and retired employees of such participating employer. The sums due on the first day of any month must be paid to the Health Insurance Fund promptly; and if not so received, the participating employer shall be in default and coverage of the employees and retired employees of such participating employer shall terminate at the end of the month for which payments have been made. However, upon application of any employer who has so defaulted, the president may authorize the reinstatement of such employer as a participating employer after a lapse of a minimum of two months following the cessation of the coverage of its employees and retired employees; provided, however, that the president may, in his discretion and for good cause shown, reduce or waive such two-month waiting period.

(e)If an employee is insured under an option under which he and his covered dependents, if any, are entitled to benefits on a continuing basis until such time as the participating employer notifies the insurer of the termination of his coverage, the participating employer shall guarantee and be liable for the payment to the Health Insurance Fund of all charges on account of the coverage of such employee and his covered dependents, if any, for all payroll periods preceding and the period within which the insurer is notified by the participating employer of the termination of such coverage.

4 NYCRR 73.9 - Inspection of records

No later Register activity identified in this check.

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Dates and status

Compiling agency: Department of Civil Service
Text status: Source receipt
Compiled text through: Jan 31, 2026
Register checked through: July 29, 2026/Vol. XLVIII, Issue 30 (2026-07-29)
Activity status: No later Register activity identified in this check.
Source snapshot: Jun 6, 2026

All records in the possession of the participating employer or its officers or agents which have a bearing on the participation of employees or retired employees in the health insurance plan, or which otherwise have any bearing on the administration or operation of the health insurance plan, shall be open to the inspection of representatives of the president and the insurers at all reasonable times.

4 NYCRR 73.10 - Withdrawal from the plan

No later Register activity identified in this check.

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Dates and status

Compiling agency: Department of Civil Service
Text status: Source receipt
Compiled text through: Jan 31, 2026
Register checked through: July 29, 2026/Vol. XLVIII, Issue 30 (2026-07-29)
Activity status: No later Register activity identified in this check.
Source snapshot: Jun 6, 2026

(a)A participating employer which intends to withdraw from the plan shall give notice of such intention to the president and to its covered employees and retired employees at least 90 days in advance of the last date for which coverage will be provided.

(b)A participating employer which withdraws from the plan shall not be eligible to rejoin the plan for one year following such withdrawal except with the consent of the president. The granting or denial of such consent shall be based on the extent to which the participating employer carried out its duties and responsibilities as required under the plan and this Part during the period of prior participation, with due consideration being given to:

(1)timely payment of premiums due;

(2)assignment of personnel to administer the plan;

(3)conformance in its assignment of effective dates and termination dates to permitted program options;

(4)compliance with plan Medicare reimbursement requirements;

(5)adherence to established eligibility requirements;

(6)proper distribution of certificates describing plan benefits, restrictions and penalties; and

(7)prior withdrawal(s).

(c)As a condition of rejoining the plan, the president shall require an employer to pay a charge for recoupment of deficits incurred during the period of prior participation which would have been reflected in the premium which would have been paid had such employer participated during the period of withdrawal. Charges for recoupment of deficits which are due by a participating employer shall be payable at a time and in a manner to be determined by the president.

4 NYCRR 73.11 - Expulsion from the plan

No later Register activity identified in this check.

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Dates and status

Compiling agency: Department of Civil Service
Text status: Source receipt
Compiled text through: Jan 31, 2026
Register checked through: July 29, 2026/Vol. XLVIII, Issue 30 (2026-07-29)
Activity status: No later Register activity identified in this check.
Source snapshot: Jun 6, 2026

(a)The president may expel a participating employer from the plan upon finding that fraud or abuses in the administration of the plan have been committed or permitted by the acts or neglect of its officers or agents, or that the participating employer has failed to carry out satisfactorily its duties and responsibilities as required under the plan and by this Part. Such expulsion shall be effective not sooner than two months after notice thereof has been given by the president to the governing body of the participating employer.

(b)A participating employer which is expelled from the plan shall not be eligible to rejoin the plan for one year following such expulsion.

4 NYCRR 73.12 - Negotiating units

No later Register activity identified in this check.

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Dates and status

Compiling agency: Department of Civil Service
Text status: Source receipt
Compiled text through: Jan 31, 2026
Register checked through: July 29, 2026/Vol. XLVIII, Issue 30 (2026-07-29)
Activity status: No later Register activity identified in this check.
Source snapshot: Jun 6, 2026

The provisions of this Chapter, insofar as they apply to employees in the negotiating units established pursuant to article 14 of the Civil Service Law and their dependents, shall be continued; provided, however, that during periods of time when there is in effect an agreement between the State and an employee organization reached pursuant to the provisions of said article 14, the provisions of such agreement and the provisions of this Chapter shall both be applicable. In the event the provisions of the agreement are different from the provisions of this Chapter, the provisions of the agreement shall be controlling. The president may, upon approval by the Director of the Budget, provide for the extension of the negotiated provisions of such agreement, in whole or in part, to officers and employees not in a negotiating unit within the meaning of article 14 of the Civil Service Law and may extend provisions regarding the modified State cost of premium or subscription charges to such employees or retirees.

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