| To enroll in an HMO, you must live or work in the HMO's service area. If you no longer live or work in the NYSHIP service area of the HMO in which you are enrolled, you must change to another option. Service areas may change from year to year. Refer to the NYSHIP Options by County list to see which options are available to you for the 2025 plan year.
|
Biweekly Costs Schedule for employees of the State of New York who are Management/Confidential; represented by C-82, CSEA, DC-37, NYSCOPBA, PBANYS, PEF or UUP; justices, judges and nonjudicial employees of the Unified Court System (UCS) and Legislature |
Biweekly Costs Schedule for employees of the State of New York who are represented by PBA or PIA |
| For Employees in the groups listed above and in titles allocated or equated to Salary Grade 9 and below* |
For Employees in the groups listed above and in titles allocated or equated to Salary Grade 10 and above* |
For Employees in the groups listed above and in titles allocated or equated to Salary Grade 9 and below |
For Employees in the groups listed above and in titles allocated or equated to Salary Grade 10 and above |
| Code |
Plan |
Individual |
Family |
Individual |
Family |
Individual |
Family |
Individual |
Family |
| 001 |
The Empire Plan |
60.23 |
272.67 |
80.31 |
324.22 |
63.83 |
289.34 |
85.10 |
344.02 |
| 066 |
Blue Choice |
49.93 |
214.37 |
66.58 |
255.38 |
49.93 |
214.37 |
66.58 |
255.38 |
| 063 |
Capital District Physicians' Health Plan (CDPHP) (Capital) |
66.53 |
228.97 |
85.52 |
273.66 |
58.12 |
228.97 |
77.50 |
273.66 |
| 300 |
Capital District Physicians' Health Plan (CDPHP) (Central) |
98.03 |
248.45 |
117.29 |
296.86 |
71.64 |
248.45 |
92.10 |
296.86 |
| 310 |
Capital District Physicians' Health Plan (CDPHP) (Hudson Valley) |
162.11 |
368.80 |
181.40 |
419.00 |
135.73 |
307.00 |
156.21 |
360.33 |
| 050 |
EmblemHealth – HIP (Downstate) |
173.20 |
458.53 |
195.00 |
515.22 |
146.82 |
396.73 |
169.81 |
456.55 |
| 220 |
EmblemHealth – HIP (Capital) |
280.97 |
597.60 |
300.92 |
656.06 |
254.59 |
535.80 |
275.73 |
597.39 |
| 350 |
EmblemHealth – HIP (Hudson Valley) |
270.78 |
669.54 |
287.41 |
713.59 |
244.39 |
607.74 |
262.22 |
654.93 |
| 067 |
Highmark Blue Cross Blue Shield |
53.93 |
231.99 |
71.91 |
276.35 |
53.93 |
231.99 |
71.91 |
276.35 |
| 069 |
Highmark Blue Shield |
55.34 |
238.57 |
73.78 |
284.15 |
55.34 |
238.57 |
73.78 |
284.15 |
| 072 |
HMOBlue (Central New York Region) |
58.77 |
248.57 |
78.36 |
296.28 |
58.77 |
248.57 |
78.36 |
296.28 |
| 160 |
HMOBlue (Utica Region) |
82.98 |
291.46 |
103.18 |
344.91 |
63.28 |
283.44 |
84.38 |
337.15 |
| 059 |
Independent Health |
53.20 |
226.04 |
70.94 |
269.39 |
53.20 |
226.04 |
70.94 |
269.39 |
| 058 |
MVP Health Care (Rochester) |
51.70 |
203.12 |
68.93 |
242.78 |
51.70 |
203.12 |
68.93 |
242.78 |
| 060 |
MVP Health Care (East) |
54.92 |
216.03 |
73.22 |
258.20 |
54.92 |
216.03 |
73.22 |
258.20 |
| 330 |
MVP Health Care (Central) |
87.54 |
245.35 |
107.07 |
293.19 |
62.07 |
245.35 |
82.76 |
293.19 |
| 340 |
MVP Health Care (Mid-Hudson) |
94.72 |
247.48 |
114.01 |
295.68 |
68.34 |
247.48 |
88.82 |
295.68 |
| 360 |
MVP Health Care (North) |
73.33 |
236.58 |
92.72 |
282.74 |
59.98 |
236.58 |
79.98 |
282.74 |
| * UUP Employees with an annualized salary of less than $50,885 are considered to be salary grade 9 and below while UUP employees with an annualized salary of $50,885 or more are considered to be salary grade 10 and above. |