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Form PS-425.4 Termination of Domestic Partnership for Nyship - New York
What Is Form PS-425.4?
This is a legal form that was released by the New York State Department of Civil Service - a government authority operating within New York. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form PS-425.4?
A: Form PS-425.4 is a form used for terminating a domestic partnership under NYSHIP in New York.
Q: What is NYSHIP?
A: NYSHIP stands for New York State Health Insurance Program, which provides health insurance coverage for eligible state and local government employees in New York.
Q: Who can use Form PS-425.4?
A: Form PS-425.4 can be used by individuals who have a domestic partnership recognized by NYSHIP and wish to terminate that partnership.
Q: What information is required on Form PS-425.4?
A: Form PS-425.4 requires information about both parties in the domestic partnership, the reason for termination, and any dependent children.
Q: Are there any fees associated with filing Form PS-425.4?
A: There are no fees associated with filing Form PS-425.4.
Q: What should I do after completing Form PS-425.4?
A: After completing Form PS-425.4, you should submit it to your employer's benefits office for processing.
Q: How long does it take for the termination to be processed?
A: The processing time for the termination of a domestic partnership may vary, so it's best to check with your employer's benefits office for more information.
Q: Can I appeal the decision if my application for termination is denied?
A: Yes, you may have the right to appeal the decision if your application for termination is denied. Contact your employer's benefits office for more information on the appeals process.
Q: What happens to my health insurance coverage after the termination is processed?
A: Your health insurance coverage will be adjusted based on the termination of your domestic partnership. Check with your employer's benefits office for details on how this will impact your coverage.
Form Details:
- Released on March 1, 2017;
- The latest edition provided by the New York State Department of Civil Service;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form PS-425.4 by clicking the link below or browse more documents and templates provided by the New York State Department of Civil Service.
