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.
DAVID A. PATERSON
GOVERNOR
DEPARTMENT OF CIVIL SERVICE
ALBANY, NEW YORK 12239
www.cs.ny.gov
NANCY G. GROENWEGEN
COMMISSIONER
NY10-01
TO: State Agency Health Benefits Administrators
FROM: Employee Benefits Division
SUBJECT: 2010 Health Insurance Contribution Biweekly Rates 2010 Dental and Vision Rates for Leave without Pay
DATE: January 21, 2010
Attached are the 2010 New York State Health Insurance Program (NYSHIP) premium rates and Medicare Part "B" reimbursement rates effective January 1, 2010. The NYSHIP rates are presented in three basic groupings:
- Schedule I – Settled With Drug Coverage
- Schedule II – Unsettled With Drug Coverage
- Schedule III – CSEA and Courts
- Full Share Dental and Vision Rates
These schedules differentiate the rates applicable to employees in bargaining units whose contract negotiations have remained unsettled, from those that have reached agreement with the Governor’s Office of Employee Relations.
The Empire Plan rates, in aggregate, will increase 3.25%. The percentage changes for individual and family rates vary due to the separate rating of enrollee and dependent experience as well as the bargaining status of the respective groups.
Overall, the HMO rates have increased an average of 10.1%, with varying percentage changes for both individual HMOs and coverage types. The increase in the employee deduction by HMO can vary significantly due to the impact of the HMO capping formulas. The capping formula affects 18 of the 20 HMO option codes for individual coverage and 19 of the 20 HMO option codes for family coverage.
Questions may be directed to your processor.
Schedules & Rates:
SCHEDULE I - BIWEEKLY ENROLLEE SHARE PREMIUM WITH DRUG COVERAGE - SETTLED
SCHEDULE I - BIWEEKLY FULL SHARE PREMIUM WITH DRUG COVERAGE - SETTLED
SCHEDULE II - BIWEEKLY ENROLLEE SHARE PREMIUM WITH DRUG COVERAGE – UNSETTLED
SCHEDULE II - BIWEEKLY FULL SHARE PREMIUM WITH DRUG COVERAGE - UNSETTLED
SCHEDULE III - BIWEEKLY ENROLLEE SHARE PREMIUM WITH DRUG COVERAGE – CSEA & COURTS
SCHEDULE III - BIWEEKLY FULL SHARE PREMIUM WITH DRUG COVERAGE – CSEA & COURTS
NYSHIP Dental & Vision Rates