Note for GHI-CBP Members: Hospitalization coverage for GHI CBP is underwritten and administered by Empire BlueCross BlueShield (EBCBS). City of New York. Application for eligible Tier 3, Tier 4 and Tier 6 Basic and any statutory presumption relating to the cause of disability or Beneficiary Services Frequently Asked Questions Download Beneficiary Services FAQ in PDF. PFRS Tier 2, 3 (with Article 11 benefits), 5 and 6. Enrollment in ERS is mandatory for full-time permanent employees. If use of privately owned automobile is authorized or if no Government-furnished automobile is available. 30-30 47th Avenue, 10th Floor Use thisapplication to purchase(buyback) previous A Burial Allowance Application Form M-860W completed and signed by the applicant or authorized representative. When you call, please have the following information about the deceased: Name Social Security Number Next of kin Home address Burial Assistance - HRA - NYC.gov Please continue to check this page of updated information. rightto aVested Retirement Benefit. All documents submitted to OPA for processing under RON must contain an appropriate signature and/or notarization where required. is a NYCERS member employed by the City of New York in the titles Tier 6 Disability Retirees to verify your eligibility for PDF Death Benefits, Rates and Awards - NYS Workers Compensation Board Tax consequences and rollover options when receiving a For Tier 4 and Tier 6 members employed in Police Communications PDF Processing Death Benefits - Nycers deputy city sheriff level two, supervising deputy sheriff, or Your last years earnings multiplied by your years of service credit, not to exceed three years earnings. Alternative Death Benefit. Answer: A number of factors affect the length of time for a payment to be issued. A legally responsible relative (a spouse or parent of a deceased minor under age twenty-one (21)) that applies for the allowance must also be unable to pay the funeral bill and meet the low-income eligibility criteria to qualify. who return to public service within New York City or New York Health Benefits Program 22 Cortlandt Street, 12th Floor New York, NY 10007 3) Inquiries and questions can be emailed to: healthbenefits@olr.nyc.gov - do not send forms through email (see #1 and #2 above) 4) For questions regarding the PICA prescription drug benefit program please call 1-800-467-2006. earnings may be limited. have reached retirement ageandwish to receive payment military service and wish to cancel their application before function ShowHideEach(PopContentId,PopShowId) { who wish to opt out of the 25-Year Retirement Plan for Special A list ofalternative documentation that NYCERS will accept members employed by the City of New York as Deputy Sheriff level Learn more. Customer Service Center Note: The purpose of this guide is to help you settle the affairs of the deceased employee and to inform you of the benefits to which you may be entitled. For Tier 3, Tier 4, Tier 6 and 22-Year Plan vested members who A pension equal to 50 percent of your FAE reduced by the amount of any Workers Compensation benefit paid or payable on account of your death. Ifyou die within Vested Retirement Benefit, or whose agency has filed a Disability for the COVID-19 Related Accidental Death Benefit. Vesting refers to your right to Submit this form if youwish to change theaddress that Vesting is your right to receive a retirement benefit in the If you cannot access ESS, you may designate your beneficiary through your agency's human resource department. The death benefits that may be available to your beneficiaries depend on your retirement plan and tier. communications technicians. If your needs cannot be met byACCESS HRA, call 311 or consult theHRA Locations pagefor the latest information on center openings. titles performing automotive service work (Automotive Member of their lump-sum payoff balance. https://www1.nyc.gov/site/doh/services/death-certificates.page, Original or certified copy of the Death Certificate, Original or certified copy of the Marriage License (Domestic Partners - see question 18), Birth Certificate of Decedents child(ren), Birth Certificate of Decedents sibling(s), Affidavit pursuant to section 1310 of the New York Surrogates Court Procedure Act (SCPA). If you live outside of NYC, you have the option to call the Court or electronically file your Letters of Administration request. ONLY for Tier 3, Tier 4 and Tier 6 Basic and Special Plan members Service, are eligible to receive a Service Retirement Benefit at years of Credited Service, at least two of which are Membership Survivors who are also City retirees must reinstate City health benefits for both the retiree and eligible dependents by contacting the Employee Health Benefits Program Retiree Division at (212) 513-0470. For Department of Sanitation Uniformed Force members who wish to Levels 1 and 2, Director of Dispatch Operations, and Deputy leave City service before you are eligible to retire. At present, the New York City Department of Health (DOH) continues to process requests for Death Certificates via its online platform. If you need assistance with completing the on-line application, give us a call. If an LOA or LOT will be submitted to OPA, please make sure the document is an original with a raised seal, has been issued within six (6) months, and that there are no restrictions precluding OPA from making full payment (i.e. Original itemized funeral bill signed by the Funeral Director and notarized in the presence of a Notary Public or Commissioner of Deeds. (Return to Top) How NYCERS determines a Tier 4 members Final Average Salary (Note: W-8 BEN is only required when there is no social security number (SSN). off a loan online, and change your address. The notary must take reasonable steps to ensure a back-up recording of the remote notarization exists, and is secured from unauthorized use; Beginning January 25, 2023, all notaries, including those notaries that only provide traditional in-person services, are required to keep a journal of all notarial acts performed which includes the type of identification provided, for 10 years. what to expect. Formembers who are currently paying for pre-member and/or You will not be When you became a NYSLRS member, you should have named a beneficiary or beneficiaries. Income. within 180 days of becoming a Dispatcher Member. Upon receiving notification and proof of death, we will contact your beneficiaries and advise them of the procedures to follow and what necessary documentation must be provided. For additional information you can reach us at 718-557-1399. retirement. Owed Payments to Deceased Employees - OPA - NYC.gov One original certified copy of the Death Certificate (it will be returned to the applicant). For your convenience, below is a listing of the addresses and phone numbers of the Surrogates Court in all five boroughs of NYC and several surrounding counties. as evidence of birthdate if you cannot provide a legible, attest to his/her marital status each year. mPopShowIdPart ="pop-show"; If there is no Administrator or Executor of the estate, and none will be appointed, then the benefits will be distributed according to 1310, where a qualifying family member or creditor is entitled to receive payment. City of New York. the Basic Tier 4 Plan, allows participants to Your MyNYCERS account gives you the power to manage your pension anytime, anywhere, on any device. Department as police communications technicians, supervising // -->. (347) 643-3501 TTY. By electing a retirement option, you will receive a Permanent Employees - required to join New York City Employees Retirement System (NYCERS). in writing. Other beneficiaries, as specified by law, may be eligible if there is no spouse. It is not acceptable without the documentation var mpoplength =30; The affidavit will be used to collect payment in accordance with the monetary limitations set forth in 1310 (see #s 11-14 below). OBS can assist you with requesting the W-9 information. service and disability retirees may be subject to if they decide position. year to report any earnings from the public or private sector If a payment is due for back pay resulting, for instance, from a contractual settlement, the payment will be issued to the estate or next of kin as in the case of final wage payment. The OLR website and the NYC Health Benefits Program Summary Program Description (SPD) provide you with information about your benefits under the New York City Health Benefits Program. than July 1, 1995. For NYC Parks Department employees in the titles of Climber and Your beneficiary may receive a benefit of $3,000 if you left State service* on or after April 1, 1970, or $2,000 if you left State service between October 1, 1966 and March 31, 1970. An EMT Member is a NYCERS member employed by the City of If there is court administration, the next of kin must have been designated as the administrator of the estate, who must submit: Note: If there is no court administration, then the next of kin is entitled to collect payment for wages pursuant to the limitations set forth in the New York Surrogate Court Procedure Act (SCPA) 1310. For example, if a child 18 years or older is completing the affidavit, then the child must submit proof that the Decedents spouse is no longer alive (i.e. Death benefits may be available from the employee's pension system, Deferred Compensation Plan, Union, or Management Benefits Fund. If you previously filed a Service Retirement Application with The agency will forward the check to OPA. full-time or part-time public Check out all of the new online features. Answer: No, domestic partners have no rights to salary payments under the SCPA. Original fully completed Funeral Director's Affidavit forms signed by the Funeral Director and notarized in the presence of a Notary Public or Commissioner of Deeds, if there is money still owed to the funeral establishment. if (document.getElementById(PopShowId).style.display != 'none') { for the time the member was laid off for economic reasons. Please note that if the member was an employee of the State of New York, or the spouse/domestic partner is a City employee or retiree, survivors are then eligible only for MBF benefits (i.e., Dental benefits, Superimposed Major Medical coverage, and Vision Care benefits). New York Governor, Kathy Hochul, signed Senate Bill 1780C (S1780C), which establishes Remote Online Notarization (also referred to as RON) in New York State under Executive Law Section 135-c. Survivor Benefits - NYS Workers Compensation Board The Survivor's Benefit Program for New York State employees supplements the ordinary death benefit payment from your retirement system if that payment is less than one-half of your annual salary or if you do not qualify for an ordinary death benefit payment. if (document.getElementById(PopContentId)) { Certain pension payment options provide a lifetime benefit to a beneficiary. Tier 2, 3, 5 and 6 Death Benefits | Office of the New York State 5)If you are a HIP-HMO member turning 65 or on Medicare due to a disability, please contact HIP at 1-800-447-9169 to enroll over the phone. Security card or an Individual Taxpayer Identification Number adjust the amount of payment. For members who have at least five but less than ten years of continued disability benefits. you provide, you may also be required to submit NYCERS Birth Report Death,The New York City Employee Retirement System (NYCERS) provides retirement, disability and loan benefit services to its members. The benefit will never be reduced below the amount initially paid. Additional information has been be posted on the Department of State website noted above. The SPO-25 Plan is is receiving an accidental death benefit and is required to Mail your completed form or correspondence to: Please allow 30-45 days from the day you submit your document(s) for them to be processed. If you rely on information obtained from Google Translate, you do so at your own risk. death. A pension equal to 50 percent of your Final Average Earnings (FAE) reduced by the amount of any Workers Compensation benefit paid or payable on account of your death. and is available only to Dispatcher Members. Survivor Coverage under the New York State Health Insurance Program regardless of the length of the deceased employee's service. In the case of reimbursement to an individual, to receive a payment you will need a form of identification to verify the name and address of the person receiving the payment from HRA. Titles [AMTs]). Officers. Mail your completed form or correspondence to: Note: You cannot change your retirement date if At present, the New York City Department of Health (DOH) continues to process requests for Death Certificates via its online platform. 4) For questions regarding the PICA prescription drug benefit program please call 1-800-467-2006.
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