"SMART SAVINGS" Coverage when both spouses, or partners, work for the County
Coverage when both spouses work for the County
Q: What is the Smart Savings Program?
A: The Smart Savings program ends the practice of providing two family medical, dental and optical 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 medical, dental and optical health benefits coverage and the other spouse or partner is a dependent. The dependent spouse receives from the County a medical insurance Buyback (currently $2,000) and the family is reimbursed should they have out of pocket expenses over the buyback amount that would have been covered if they had retained two family medical benefits policies.
Q: Who is covered by Smart Savings?
A: Smart Savings covers all County and College employees. County non-union retirees are also covered. All other retirees are covered if they retired on or after:
September 1, 2007 for PBA members
June 1, 2008 for ShOA members
June 1, 2008 for DAI members
February 1, 2009 for CSEA members
February 1, 2009 for NCC non-union employees
September 1, 2009 for NCCFT members
Q: May I opt-out of Smart Savings?
A: You cannot opt out of the program voluntarily. However, under current County rules, you and your spouse may choose to have two individual health insurance policies instead of one family policy.
Q: Will Smart Savings result in a reduction in health benefits?
A: No. Smart Savings maintains the same level of benefits to the employees/retirees and their families.
Q: I am married to another Nassau County employee and we do not have any children. Can we get two individual health, dental and optical insurance policies instead of one family policy?
A: Yes. You may take two individual health, dental and optical insurance policies instead of one family policy. However, you will not receive the Smart Saving Buyback check or reimbursement for out of pocket expenses.
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 on the policy and my spouse dies or we get a divorce?
A: If you are an active employee or a retiree you and your eligible dependents will be covered under your own policy should your spouse pre-decease you.
Q: How will I receive my Smart Savings health insurance Buyback check?
A: The Buyback amount, currently $2,000, is paid to employees through a payroll check. Retirees enrolled in the Smart Savings program also receive the Buyback amount. For these retirees, checks will be issued in the beginning of the year for which the coverage is being declined. The Buyback amount is taxable and will be reported to the IRS in the W-2 for active employees and on a MISC-1099 for retired employees.
Q: What happens if the health insurance Smart Saving Buyback amount is not enough to cover my out-of-pocket medical expenses?
A: If a Smart Savings enrollee has to pay more out-of-pocket medical expenses above the buyback amount, the County will reimburse the enrollee for any costs that exceed the buyback amount if those costs would otherwise have been covered by the second family policy.
Q: How do I get reimbursed if I have out of pocket expenses over the Buyback amount?
A: If your out-of-pocket medical expenses for a single year exceed the Buyback amount, currently $2,000, you must send a Reimbursement Form along with copies of your Explanation of Benefits (“EOB”) or receipts to the Plan Administrator (VMG Health). Once it is determined, based on the submitted receipts and EOBs, that the expenses would have been covered by a second family health insurance policy, you will be reimbursed for the amount in excess of the buy back
The Smart Savings Reimbursement Form is available in the Forms section of this website.
Please mail your completed form(s) to the Plan Administrator listed below:
NASSAU COUNTY SMART SAVINGS PROGRAM
VMG Health
Attn: Pam D'Apuzzo
PO Box 136 Lindenhurst, NY 11757
Q: Can I put the Buyback amount in the flexible spending account for medical expenses?
A: No. The IRS requires that deposits into a flexible spending program be made directly from your paycheck, therefore you will receive the Buyback as a separate payment and it cannot be directly deposited into your flexible spending account. You can, however, enroll in the flexible spending account program and have an equivalent amount deducted from your pay check. Enrollment forms can be obtained from Human Resources or your department’s Human Resources Representative during the open enrollment period.
Q: What if I have a hardship situation and need to keep two family health benefits policies?
A: County employees may apply for a hardship exemption from Smart Savings by sending a letter to the Office of Labor Relations. College employees may apply to the College President.
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 Buyback amount?
A: No, the Buyback 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.
Q: If I have a dependent that is not my spouse’s dependent, and my spouse has a dependent that is not my dependent, can we keep two family health insurance policies?
A: Yes, however, in most circumstances you will probably not need two family policies. If this situation applies to you, please contact the Comptroller’s Office Health Benefits at the number below to discuss your options to ensure that participating in Smart Savings would be beneficial to you and your family.
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 Us at the Nassau County Comptroller's Office Health Benefits Unit or call (516) 571-2369.