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.
GOVERNOR
DEPARTMENT OF CIVIL SERVICE
ALBANY, NEW YORK 12239
www.cs.ny.gov
NY11-45
TO: New York State Agency Health Benefits Administrators
FROM: Employee Benefits Division
SUBJECT: 2012 New York State Health Insurance Rates
DATE: December 1, 2011
Attached are the 2012 New York State Health Insurance Program (NYSHIP) premium rates and Medicare Part B reimbursement rates that become effective January 1, 2012. The NYSHIP rates are presented in six groupings:
- Schedule I - Ratified (CSEA and Unrepresented Enrollees)
- Schedule II - Ratified (PEF and Courts Non-CSEA Represented Enrollees)
- Schedule III - Non-Ratified Group (Represented Enrollees Except CSEA, PEF, ALESU and UUP Lifeguards)
- Schedule IV - Non-Ratified Groups whose Agreements Expired on March 31, 2007 or earlier (ALESU and UUP Lifeguards)
- Schedule V - Student Employee Health Plan
- Full Share Dental and Vision Rates
These schedules reflect the rates applicable to employees in the various bargaining units based on the status and terms of each group's agreement with the State.
The Empire Plan rates, in aggregate, will increase 2.6%. The percentage changes for individuals and family rates vary due to the separate rating of enrollee and dependent experience as well as the collective bargaining agreements in effect for the respective groups.
Overall, the HMO rates have increased an average of 2.9%. The actual percentage change varies by HMO and coverage type (Individual v. Family). The change in the employee deduction for each HMO can vary due to the impact of the HMO capping formulas. The capping formula affects 15 of the 20 HMO option codes for individual coverage and 16 of the 20 HMO option codes for family coverage.
If you have any questions about this rate change, please contact the HBA Line at (518) 474-2780 and a processor will assist you.