GENERAL BENEFIT QUESTIONS
1) Question: When is the “last day” that I can submit medical and/or dental plan changes that will be effective for January 1, 2024 to the MTA BSC?
Answer: The open enrollment period for active NYCT ATU Local 726 and ATU Local 1056 employees is October 15th through November 15th.
- To submit medical and/or dental coverage changes online (other than to add, change, or remove dependents):
o Sign on to the My MTA Portal at www.mymta.info
o On the home page, click the “My Benefits” tile, followed by clicking the “eBenefits – Open Enrollment” tile and submit your medical and/or dental enrollment or change request(s)
- To submit medical and/or dental changes via paper enrollment OR to add, change, or remove dependents, the open enrollment form and any required supporting documentation MUST be sent to the MTA BSC via email to bsc-benefits@mtabsc.org or via fax to 212-852-8700 by November 15, 2023.
- As a reminder, to submit changes to your dependent information (add a new dependent or make changes to or remove a current dependent), you MUST use the applicable open enrollment form(s) listed in the answer to question# 2 below. These changes can NOT be submitted online.
2) Question: How do I enroll my spouse or a dependent child?
Answer: To add a new dependent or make a change to or remove a current dependent, you need to complete, sign, and submit the following enrollment form:
- HR-BEN-810A 2024 Open Enrollment/Change Form for Active NYCT TWU Local 100 & MTA Bus TWU Local 100 Employees
- You will also need to submit copies of supporting documentation (if adding a new dependent), as noted in Section 6 of the HR-BEN-810A form (i.e., birth certificate, marriage certificate, etc.).
3) Question: How do I enroll my domestic partner?
Answer: If you would like to enroll a domestic partner, you will need to complete and submit the domestic partner application package (HR-BEN-065B), and all required supporting documentation to the MTA BSC via email to bsc-benefits@mtabsc.org or via fax to 212-852-8700.
- HR-BEN-065B can be obtained on the My MTA Portal, by contacting the MTA BSC via email at bscservice@mtabsc.org, or via phone at 646-376-0123.
- You will be required to submit supporting documents for the domestic partner process.
4) Question: Are routine examinations (i.e., mammograms, pap smears, immunizations, etc.) covered under the Aetna medical plans?
Answer: All of the three (3) Aetna plans offer coverage for these services, but you should view the Aetna plan design summaries available on the Aetna website at www.aetnanyct.com or contact Aetna directly at 855-824-5349 for more detailed information about these services.
5) Question: Can I enroll my spouse if he/she already has their own MTA-sponsored coverage?
Answer: The MTA does NOT allow dual coverage.
- As long as your spouse is not an MTA employee with coverage, you may enroll your spouse by submitting the enrollment form listed in the answer to question# 2, along with any required supporting documentation.
- If your spouse is an MTA employee who currently has their own MTA coverage, your spouse will need to terminate their coverage in order to be enrolled into your MTA-sponsored coverage.
- Once your spouse’s MTA-sponsored coverage is terminated, they will be eligible to participate in the MTA’s Medical Opt-Out program.
6) Question: Do I have to pay for my health coverage? I see a deduction on my check for health coverage.
Answer:
- If you are currently enrolled in or will be enrolling in the Aetna CPOS II High Option, there is a bi-weekly deduction of $13.17 for individual coverage and $26.34 for family coverage.
- The 2% deduction that you may see listed on your paycheck for health coverage is to help defray the cost of health benefits.
o The MTA and your respective union have contractually agreed to this deduction.
7) Question: I have an Autistic dependent child. Does Aetna offer any special services or coverage for this type of diagnosis under all three (3) Aetna plans available for me to select from?
Answer: Per the Collective Bargaining Agreement for TWU Local 100, Aetna offers enhanced coverage for Autism Spectrum Disorder (ASD), as behavioral, physical, occupational, and speech therapy as well as Applied Behavioral Analysis (ABA), is now covered under all three (3) Aetna plans offered (Aetna CPOS II Basic, Aetna CPOS II High Option, and Aetna Select).
- The Aetna plans provide for unlimited sessions for the above services for the treatment of ASD and at a $0 copay.
- If you have any questions or need additional details about this coverage, please contact Aetna directly at 855-824-5349.
8) Question: If I choose the Aetna Select plan, will I now be able to obtain medical and/or hospital services outside of New York?
Answer: Yes, you can now see any “in-network” provider within the United States, however, this plan still does NOT allow for “out-of-network” providers.
9) Question: I would like to enroll in MTA-sponsored benefits with my family, but I have Medicaid. Can I have both coverage types?
Answer: No, you cannot be enrolled in both Medicaid and MTA-sponsored coverage. Once enrolled in MTA-sponsored coverage, you MUST notify Medicaid so they can terminate this coverage for you and your covered dependents.
10) Question: Are the Aetna plans accepted in all states?
Answer: All of the three (3) offered Aetna plans provide for “nationwide” coverage within the United States. For Aetna plan coverage details, please refer to the Aetna plan design summaries available on the Aetna website at www.aetnanyct.com.
11) Question: Can I be enrolled in both the EmblemHealth Preferred Dental plan, which is included with the Aetna CPOS II High Option plan as well as my union’s dental plan?
Answer: No, per the Collective Bargaining Agreement, you are eligible for only one (1) dental plan coverage. If you are currently enrolled in or will be enrolling in the Aetna CPOS II High Option plan, which includes the EmblemHealth Preferred Dental plan, you are INELIGIBLE to also be enrolled in your union’s dental plan coverage.
12) Question: If I change my plan, but then find out that the new plan will not work for me and my family, what should I do?
Answer: You should immediately contact the MTA Business Service Center at 646-376-0123 to create a Service Request. You will be contacted by a Benefits Analyst to discuss your case and you may be asked for proof of hardship.
13) Question: I have custody of my grandchildren. Can I enroll them in my MTA-sponsored coverage?
Answer: Yes, you can enroll your grandchildren into your MTA-sponsored coverage. You will be required to submit the regular health insurance enrollment/change form applicable to your respective group (available on the My MTA Portal) along with a copy of your grandchild’s birth certificate, social security card, and a copy of your legal guardianship or custody papers from the Court showing you are the named guardian or custodian of your grandchild(ren).
14) Question: I am currently covering my domestic partner under my MTA-sponsored coverage. My domestic partner is now Medicare-eligible. Does my domestic partner have to enroll in Medicare even though I am still working and in “Active” status? Will I still have to pay the imputed income tax if my domestic partner enrolls in Medicare?
Answer: Regardless of if you are in “Active” or “Retiree” status, your domestic partner MUST enroll in both Medicare Parts A and B once they become Medicare-eligible. You will continue to be charged imputed income tax despite your domestic partner being liable for paying the Medicare premiums.
15) Question: Are there any health benefit plan changes for 2024?
Answer:
- Per the Collective Bargaining Agreement for NYCT TWU Local 100 and MTA Bus TWU Local 100, Aetna offers enhanced coverage for Autism Spectrum Disorder (ASD), as behavioral, physical, occupational, and speech therapy as well as Applied Behavioral Analysis (ABA), are all now covered under the three (3) Aetna plans offered (Aetna CPOS II Basic, Aetna CPOS II High Option, and Aetna Select).
- The Aetna plans provide for unlimited sessions for the above services for the treatment of ASD and at a $0 copay.
- If you have any questions or need additional details about this coverage, please contact Aetna directly at 855-824-5349.
16) Question: I’m a kidney dialysis patient, but I am still working and in “Active” status. I received a Medicare ID card for Parts A and B, but I am too young for Medicare as I have not yet reached age 65. Why did I receive the Medicare ID Card and will Aetna still provide me with coverage?
Answer: If Medicare is offered to you as an “Active” employee who is also an End-Stage Renal Disease (ESRD) patient, you are required to enroll in both Medicare Parts A and B. It will now be your primary coverage and your MTA-sponsored Aetna plan will become your secondary coverage.
17) Question: Will I still be able to use my current doctor?
Answer:
- If you are looking to use your current doctor for an “in-network” only plan, you will first need to confirm if your physician is participating within the chosen plan.
- If you choose an Aetna plan that allows for both “in-network” and “out-of-network” coverage, but your current doctor is not participating within the chosen plan, you can still utilize the doctor for your medical services, but you will have to pay the provider up-front and then submit a claim to Aetna for reimbursement of your paid funds.
o The reimbursement will be processed in accordance with the schedule of allowances for the chosen plan and may be subject to a deductible and/or coinsurance.
o If you would like to utilize non-participating providers, you should enroll in either the Aetna CPOS II Basic or the Aetna CPOS II High Option plans as these plans provide for “in-network” and “out-of-network” benefits.
18) Question: My physician does not participate with the Aetna CPOS II Basic, Aetna CPOS II High Option, or the Aetna Select plans, but I still want to utilize their services. What plan would be the best option for me to enroll in?
Answer: If you would like to utilize a non-participating provider, you should enroll in either the Aetna CPOS II Basic or the Aetna CPOS II High Option.
- These two (2) medical plans allow you to go “in-network” and “out-of-network”, but for non-participating providers, you will have to pay the provider up-front and then submit a claim to Aetna for reimbursement of your paid funds.
o The reimbursement will be processed in accordance with the schedule of allowances for the chosen plan and may be subject to a deductible and/or coinsurance.
o For additional information, please refer to the Aetna plan design summaries available under “Plan Overview” on the Aetna website at www.aetnanyct.com.
- If you choose the Aetna CPOS II High Option, there is a bi-weekly deduction of $13.17 for individual coverage and $26.34 for family coverage.
19) Question: What are the plan restrictions on “pre-existing” conditions?
Answer: You will need to contact Aetna directly for their guidelines on “pre-existing” conditions.
- Aetna Contact Information: 855-824-5349
20) Question: What is the deductible and/or out-of-network cost for each plan?
Answer: You will need to contact Aetna directly for a breakdown of the deductible and/or out-of-network costs based on the services you need.
- Aetna Contact Information: 855-824-5349
21) Question: Do the Aetna medical plans cover virtual care, urgent care visits, ambulance services, and preventative services?
Answer: All of the offered health plans under Aetna provide coverage for these services. You MUST call Aetna directly for more detailed information.
- Aetna Contact Information: 855-824-5349
MTA MEDICAL OPT-OUT PROGRAM QUESTIONS
1) Question: I will be opting-out of my medical coverage, but what if I lose my alternate coverage after the open enrollment period and need to return to my MTA-sponsored coverage?
Answer: You will be required to provide proof of your “loss of coverage”. This proof MUST be submitted to the MTA BSC with the corresponding enrollment/change form applicable to your employee group and any required supporting documentation, if enrolling in family coverage.
2) Question: How much money do I receive for opting-out of medical/hospital and prescription drug coverage for the entire year of 2024?
Answer: NYCT TWU Local 100 and MTA Bus TWU Local 100 opt-out enrollees will receive $550 for individual opt-out or $1,100 for family opt-out. There is NO pro-rated payment available.
3) Question: Am I able to put the opt-out incentive payment into my 401K, 457, or Roth Accounts?
Answer: Yes, you have the option to defer your opt-out incentive payment to your account(s) of choice by completing the “HR-DEFCOMP-075 Medical Opt-Out Deferred Compensation Lump Sum Deferral Form”. The HR-DEFCOMP-075 form MUST be submitted EVERY YEAR to the MTA BSC if you would like to defer your incentive payment while enrolled in the opt-out program.
4) Question: If I previously opted out for 2023 and would like to opt out for 2024 as well, do I have to complete a new opt-out form?
Answer: No, if you would like to maintain your current opt-out program status for the upcoming benefit year, you do NOT have to do anything.
- If you would like to defer the incentive payment to your 401K, 457, or Roth accounts, you MUST submit the HR-DEFCOMP-075 form EVERY YEAR to the MTA BSC.
5) Question: What is the deadline to submit the opt-out form?
Answer: The opt-out section on the “HR-BEN-810A 2024 Open Enrollment/Change Form for Active NYCT TWU Local 100 & MTA Bus TWU Local 100 Employees” MUST be completed and the form submitted to the MTA BSC by November 15, 2023.
6) Question: Do I have to provide proof of my alternate medical coverage?
Answer: Yes, you MUST provide proof of your alternate medical coverage. Additionally, you will be required to provide specific information such as the name of the other insurance carrier. If this information is NOT provided, the processing of your request will be delayed or denied.
7) Question: If I remain in the opt-out program for a full year, when should I anticipate receiving my financial incentive payment?
Answer: The payment of the lump-sum incentive will be made in December 2024 or pursuant to the represented employee's collective bargaining agreement.
- Please be advised that the payment will be subject to all applicable federal, state, and local taxes and is NOT considered pensionable income.
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