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.
ANDREW M. CUOMO
GOVERNOR
DEPARTMENT OF CIVIL SERVICE
ALBANY, NEW YORK 12239
www.cs.ny.gov
NY11-20
TO: M/C Group Life Insurance Benefits Administrators
FROM: Employee Benefits Division
SUBJECT: M/C Group Life Insurance Plan Annual Update Enrollment Listing
DATE: August 10, 2011
Enclosed is the 2011 NYS Management/Confidential (M/C) Group Life Insurance Plan (Plan) annual update listing for employees of your agency enrolled in the Plan.
Personal life insurance premium rates have decreased 14.4% for the plan year September 1, 2011 through August 31, 2012. There has been an increase to the administrative charges for the plan which has resulted in a slight increase in the dependent and spouse rates. The rates for Accidental Death and Dismemberment, as well as the Accident and Sickness benefit have been reduced to zero.
The bi-weekly rate sheet can be printed from the Civil Service website at www.cs.ny.gov/ebdonline.
Individual update letters describing coverage choices, premium costs and a flyer containing general information about their coverage were mailed to all Plan participants.
The life insurance annual update was processed through NYBEAS. We ask that you review the listing and report any discrepancies to the M/C Life Unit as soon as possible, as any salary corrections that are made may affect the enrollees' deductions. You may reference our July 15, 2010 memo, NY11-16, if you have any questions or call the M/C Life Insurance Unit at (518) 473-3496.
Attachment
MANAGEMENT/CONFIDENTIAL GROUP LIFE INSURANCE
BIWEEKLY RATE SCHEDULE
Rates Effective September 8, 2011 Institution
Rates Effective September 1, 2011 Administration
| ENROLLEE'S AGE | LIFE INSURANCE NON-SMOKER RATE PER $1,000 | LIFE INSURANCE SMOKER RATE PER $1,000 | AD&D RATE PER $1,000* | SPOUSE'S LIFE PER $1,000** Employee's Age | Children*** |
|---|---|---|---|---|---|
| Under age 25 | 0.014 | 0.017 | 0.000 | 0.017 | 0.23 |
| 25 TO 29 | 0.017 | 0.021 | 0.000 | 0.017 | 0.23 |
| 30 TO 34 | 0.023 | 0.028 | 0.000 | 0.034 | 0.23 |
| 35 TO 39 | 0.026 | 0.032 | 0.000 | 0.043 | 0.23 |
| 40 TO 44 | 0.028 | 0.035 | 0.000 | 0.059 | 0.23 |
| 45 TO 49 | 0.042 | 0.053 | 0.000 | 0.093 | 0.23 |
| 50 TO 54 | 0.064 | 0.080 | 0.000 | 0.144 | 0.23 |
| 55 TO 59 | 0.120 | 0.150 | 0.000 | 0.228 | 0.23 |
| 60 TO 64 | 0.184 | 0.230 | 0.000 | 0.329 | 0.23 |
| 65 TO 69 | 0.355 | 0.443 | 0.000 | 0.482 | 0.23 |
| 70 and over | 0.576 | 0.719 | 0.000 | 0.600 | 0.23 |
* Maximum AD&D Benefit is $250,000
** Limited to one half the enrollee's coverage to a maximum of $20,000 and based on enrollee's age
*** This $0.23 premium cost provides $4,000 coverage for each eligible child
MANAGEMENT/CONFIDENTIAL GROUP ACCIDENT AND SICKNESS INSURANCE
LIMITED TO CURRENT ACCIDENT AND SICKNESS ENROLLEES AS OF JANUARY 1, 1986
| COVERAGE | BASIC MONTHLY BENEFIT | EXTRA IN-HOSPITAL MONTHLY BENEFIT | EXTRA MONTHLY INCOME BENEFIT | |
|---|---|---|---|---|
| $75 | 0.00 | 0.00 | 0.00 | |
| 100 | 0.00 | 0.00 | ||
| 125 | 0.00 | 0.00 | ||
| 150 | 0.00 | 0.00 | ADDITIONAL LOSS LIFE AND LIMB |
|
| 200 | 0.00 | 0.00 | $10,000 | $25,000 |
| 250 | 0.00 | 0.00 | ||
| 300 | 0.00 | 0.00 | 0.00 | 0.00 |
| 400 | 0.00 | 0.00 | ||
To determine Total Bi-weekly Cost, each calculation is rounded separately.