The Empire Plan is a unique health insurance plan designed especially for public employees in New York State. Empire Plan benefits include inpatient and outpatient hospital coverage, medical/surgical coverage, Centers of Excellence for transplants, infertility and cancer, home care services, equipment and supplies, mental health and substance abuse coverage and prescription drug coverage.
2023 Participating Agency Monthly Empire Plan Premium Rates for Employers
PLAN PRIME
Individual $1,345.06
Family $3,175.87
MEDIPRIME
Individual Coverage (1 Medicare primary) $476.69
Family Coverage (1 Medicare primary) $1,362.01
Family Coverage (2 or more Medicare primary) $1,242.48
2023 Participating Agency Monthly Excelsior Plan Premium Rates for Employers
PLAN PRIME
Individual $1,097.75
Family $ 2,100.30
MEDIPRIME
Individual Coverage (1 Medicare primary) $72.02
Family Coverage (1 Medicare primary) $369.31
Family Coverage (2 or more Medicare primary) $249.90
Employers are required to contribute a minimum of 50% of the cost for individual coverage and 35% of the cost for dependent coverage (The dependent coverage cost is the difference between the family premium and the individual premium).
Family coverage for NYSHIP plans is for 2 or more covered members.
Plan Prime rates apply to active employees and retirees who are not Medicare primary.
The assessed administrative fee for the fiscal year ended March 31, 2022 equates to $16.95 per enrollee.
MediPrime rates apply to Medicare primary enrollees and/or their Medicare primary dependents.
Employers are required by Civil Service Law to reimburse Medicare primary enrollees and their enrolled Medicare primary dependents for their cost of the Medicare Part B Premium.