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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.

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ANDREW M. CUOMO
GOVERNOR

STATE OF NEW YORK
DEPARTMENT OF CIVIL SERVICE
ALBANY, NEW YORK 12239
www.cs.ny.gov

NY12-21

TO: New York State Agency Health Benefits Administrators
FROM: Employee Benefits Division
SUBJECT: NYSHIP Rate Change Effective July 1, 2012
DATE: May 23, 2012

As provided for in the 2012-2013 Executive Budget, Medicare Part B premium will be included as a component of the NYSHIP premiums effective April 1, 2012 for Participating Employers, which include public authorities and other quasi-public organizations of the State.A Previously, the Medicare Part B premium was only included as a component of the NYSHIP premiums for New York State enrollees. This will result in relatively minor changes to NYSHIP rates for State enrollees effective July 1, 2012.

Attached are rate charts which reflect the premium rates and Medicare Part B reimbursement rates effective July 1, 2012. These schedules differentiate the rates applicable to employees in bargaining units whose contract negotiations remain unsettled, from those that have reached agreement with the State.

The attached NYSHIP rates are presented as follows:

Empire Plan

All Other Groups

These rates reflect the cost of reimbursing Medicare Part B premiums to eligible State and Participating Employer enrollees from the effective date of this legislation April 1, through the end of 2012. Since the legislation was not passed until March 30, and the rate change required changes to NYBEAS, the rate change is effective July 1. Because the State contribution to the cost of HMO coverage is based on the cost of Empire Plan coverage, the decrease in Empire Plan premium results in a decrease in the State contribution to HMO coverage; therefore, in most cases the enrollee contribution for HMO coverage is increasing. This increase in the enrollee contribution for HMO coverage is not material, and will not trigger a Special Option Transfer Period

If you have any questions about this rate change, please contact the HBA Line at (518) 474-2780.

July 1, 2012 Premium Rate Change
NYS Health Insurance Program Biweekly Rates

Administrative Paycheck June 20, 2012 - Employees exempt from Lag Payroll
Administrative Paycheck July 3, 2012 - Employees subject to Lag Payroll
Administrative Paycheck July 12, 2012 - Employees subject to Extra Lag Payroll
Institution Paycheck June 14, 2012 - Employees exempt from Lag Payroll
Institution Paycheck June 28, 2012 - Employees subject to Lag Payroll

*Medicare: 45.86

Empire Plan

  Schedule I
Ratified (Settled Groups)
Benefit Programs:
A01, A02, A05, A06, A07, A13, A14, A15, A17, A19
A20, A28, A29, A33, A34, A35, A36, A37, A39, A41
A42, A43, A44, A46, A47, A48, A51, A60, A61, A62, A64, L19
  O
P
T		 C
O
V		 M
E
D		 Employee
<SG-9		 Employee
SG-10+		 Full Share
LWOP
Empire Plan
     Individual 001 1 0 32.77 43.69 273.05
     Medicare 001 1 1 (13.09) (2.17) 227.19
Family 001 4 0 132.07 157.70 640.83
       1 Medicare 001 4 1 86.21 111.84 594.97
       2 Medicares 001 4 2 40.35 65.98 549.11
  Schedule II
Non-Ratified Group (Unsettled Groups)
Benefit Program:
A03, A04, A09, A10, A11, A12, A25, A40, A50, A63
  O
P
T		 C
O
V		 M
E
D		 Employee Full Share LWOP
Empire Plan
     Individual 001 1 0 27.93 279.29
     Medicare 001 1 1 (17.93) 233.43
Family 001 4 0 121.77 654.66
       1 Medicare 001 4 1 75.91 608.80
       2 Medicares 001 4 2 30.05 562.94

*Medicare is income sensitive - this is the basic bi-weekly premium rate.

*Medicare: 45.86

All Other Groups

  Schedule I
Ratified (Settled Groups)
Benefit Programs:
A01, A02, A05, A06, A07, A13, A14, A15, A17, A19
A20, A28, A29, A33, A34, A35, A36, A37, A39, A41
A42, A43, A44, A46, A47, A48, A51, A60, A61, A62, A64, L19
  O
P
T		 C
O
V		 M
E
D		 Employee
<SG-9		 Employee
SG-10+		 Full Share
LWOP
HIP (050)
Individual 050 1 0 61.53 72.09 294.03
       Medicare 050 1 1 15.67 26.23 248.17
Family 050 4 0 197.03 223.01 710.80
       1 Medicare 050 4 1 151.17 177.15 664.94
       2 Medicares 050 4 2 105.31 131.29 619.08
MVP Health Care, Inc. - Rochester (058)
Individual 058 1 0 26.01 34.68 216.73
       Medicare 058 1 1 (19.85) (11.18) 170.87
Family 058 4 0 111.05 132.32 531.70
       1 Medicare 058 4 1 65.19 86.46 485.84
       2 Medicares 058 4 2 19.33 40.60 439.98
Independent Health - Western NY (059)
Individual 059 1 0 45.27 55.54 271.32
       Medicare 059 1 1 (0.59) 9.68 225.46
Family 059 4 0 165.91 191.28 667.45
       1 Medicare 059 4 1 120.05 145.42 621.59
       2 Medicares 059 4 2 74.19 99.56 575.73
MVP Health Care, Inc. - East Region (060)
Individual 060 1 0 28.28 37.70 235.63
       Medicare 060 1 1 (17.58) (8.16) 189.77
Family 060 4 0 120.91 144.05 578.69
       1 Medicare 060 4 1 75.05 98.19 532.83
       2 Medicares 060 4 2 29.19 52.33 486.97
Capital District PHP - Capital (063)
Individual 063 1 0 28.31 37.74 235.88
       Medicare 063 1 1 (17.55) (8.12) 190.02
Family 063 4 0 121.06 144.23 579.41
       1 Medicare 063 4 1 75.20 98.37 533.55
       2 Medicares 063 4 2 29.34 52.51 487.69
Blue Choice (066)
Individual 066 1 0 25.61 34.15 213.43
       Medicare 066 1 1 (20.25) (11.71) 167.57
Family 066 4 0 110.92 132.10 529.40
       1 Medicare 066 4 1 65.06 86.24 483.54
       2 Medicares 066 4 2 19.20 40.38 437.68
Community Blue (067)
Individual 067 1 0 32.13 42.84 267.73
       Medicare 067 1 1 (13.73) (3.02) 221.87
Family 067 4 0 168.11 195.08 700.41
       1 Medicare 067 4 1 122.25 149.22 654.55
       2 Medicares 067 4 2 76.39 103.36 608.69
HMO Blue - CNY (072)
Individual 072 1 0 84.66 94.68 305.03
       Medicare 072 1 1 38.80 48.82 259.17
Family 072 4 0 259.50 284.00 743.93
       1 Medicare 072 4 1 213.64 238.14 698.07
       2 Medicares 072 4 2 167.78 192.28 652.21
HMO Blue - Utica/Watertown (160)
Individual 160 1 0 96.38 106.28 314.17
       Medicare 160 1 1 50.52 60.42 268.31
Family 160 4 0 317.37 341.80 800.17
       1 Medicare 160 4 1 271.51 295.94 754.31
       2 Medicares 160 4 2 225.65 250.08 708.45
Aetna (210)
Individual 210 1 0 125.45 136.13 360.65
       Medicare 210 1 1 79.59 90.27 314.79
Family 210 4 0 508.96 534.62 1,017.49
       1 Medicare 210 4 1 463.10 488.76 971.63
       2 Medicares 210 4 2 417.24 442.90 925.77
GHI HMO Albany Region (220)
Individual 220 1 0 115.89 126.78 355.40
       Medicare 220 1 1 70.03 80.92 309.54
Family 220 4 0 388.38 415.44 922.92
       1 Medicare 220 4 1 342.52 369.58 877.06
       2 Medicares 220 4 2 296.66 323.72 831.20
Empire BlueCross BlueShield HMO - Upstate (280)
Individual 280 1 0 42.40 53.78 292.74
       Medicare 280 1 1 (3.46) 7.92 246.88
Family 280 4 0 189.93 218.42 752.43
       1 Medicare 280 4 1 144.07 172.56 706.57
       2 Medicares 280 4 2 98.21 126.70 660.71
Empire BlueCross BlueShield HMO - Downstate (290)
Individual 290 1 0 123.30 134.96 379.90
       Medicare 290 1 1 77.44 89.10 334.04
Family 290 4 0 403.03 432.25 980.07
       1 Medicare 290 4 1 357.17 386.39 934.21
       2 Medicares 290 4 2 311.31 340.53 888.35
Capital District PHP - Central (300)
Individual 300 1 0 57.28 67.21 275.87
       Medicare 300 1 1 11.42 21.35 230.01
Family 300 4 0 194.59 219.12 679.52
       1 Medicare 300 4 1 148.73 173.26 633.66
       2 Medicares 300 4 2 102.87 127.40 587.80
Capital District PHP - W. Hudson Valley (310)
Individual 310 1 0 62.06 71.94 279.40
       Medicare 310 1 1 16.20 26.08 233.54
Family 310 4 0 206.22 230.61 688.36
       1 Medicare 310 4 1 160.36 184.75 642.50
       2 Medicares 310 4 2 114.50 138.89 596.64
Empire BlueCross BlueShield HMO - Mid-Hudson (320)
Individual 320 1 0 112.85 124.43 367.67
       Medicare 320 1 1 66.99 78.57 321.81
Family 320 4 0 372.95 401.97 945.83
       1 Medicare 320 4 1 327.09 356.11 899.97
       2 Medicares 320 4 2 281.23 310.25 854.11
MVP Health Care, Inc. - Central Region (330)
Individual 330 1 0 50.28 59.97 263.56
       Medicare 330 1 1 4.42 14.11 217.70
Family 330 4 0 175.68 199.61 648.73
       1 Medicare 330 4 1 129.82 153.75 602.87
       2 Medicares 330 4 2 83.96 107.89 557.01
MVP Health Care, Inc. - Mid-Hudson (340)
Individual 340 1 0 55.00 64.70 268.46
       Medicare 340 1 1 9.14 18.84 222.60
Family 340 4 0 187.17 211.12 660.59
       1 Medicare 340 4 1 141.31 165.26 614.73
       2 Medicares 340 4 2 95.45 119.40 568.87
GHI HMO - HV & Ulster Regions (350)
Individual 350 1 0 142.13 153.02 381.64
       Medicare 350 1 1 96.27 107.16 335.78
Family 350 4 0 466.55 493.61 1,001.10
       1 Medicare 350 4 1 420.69 447.75 955.24
       2 Medicares 350 4 2 374.83 401.89 909.38
MVP HMO - North Region (360)
Individual 350 1 0 90.99 100.87 308.36
       Medicare 350 1 1 45.13 55.01 262.50
Family 350 4 0 278.57 302.96 760.76
       1 Medicare 350 4 1 232.71 257.10 714.90
       2 Medicares 350 4 2 186.85 211.24 669.04

*Medicare is income sensitive - this is the basic bi-weekly premium rate.

  Schedule II
Non-Ratified Group (Unsettled Groups)
Benefit Program:
A03, A04, A09, A10, A11, A12, A25, A40, A50, A63
  O
P
T		 C
O
V		 M
E
D		 Employee Full Share LWOP
Empire Plan
     Individual 001 1 0 27.93 279.29
     Medicare 001 1 1 (17.93) 233.43
Family 001 4 0 121.77 654.66
       1 Medicare 001 4 1 75.91 608.80
       2 Medicares 001 4 2 30.05 562.94
HIP (050)
Individual 050 1 0 54.26 294.03
       Medicare 050 1 1 8.40 248.17
Family 050 4 0 179.51 710.80
       1 Medicare 050 4 1 133.65 664.94
       2 Medicares 050 4 2 87.79 619.08
MVP Health Care, Inc. - Rochester (058)
Individual 058 1 0 21.67 216.73
       Medicare 058 1 1 (24.19) 170.87
Family 058 4 0 100.41 531.70
       1 Medicare 058 4 1 54.55 485.84
       2 Medicares 058 4 2 8.69 439.98
Independent Health - Western NY (059)
Individual 059 1 0 38.15 271.32
       Medicare 059 1 1 (7.71) 225.46
Family 059 4 0 148.70 667.45
       1 Medicare 059 4 1 102.84 621.59
       2 Medicares 059 4 2 56.98 575.73
MVP Health Care, Inc. - East Region (060)
Individual 060 1 0 23.56 235.63
       Medicare 060 1 1 (22.30) 189.77
Family 060 4 0 109.32 578.69
       1 Medicare 060 4 1 63.46 532.83
       2 Medicares 060 4 2 17.60 486.97
Capital District PHP - Capital (063)
Individual 063 1 0 23.59 235.88
       Medicare 063 1 1 (22.27) 190.02
Family 063 4 0 109.47 579.41
       1 Medicare 063 4 1 63.61 533.55
       2 Medicares 063 4 2 17.75 487.69
Blue Choice (066)
Individual 066 1 0 21.34 213.43
       Medicare 066 1 1 (24.52) 167.57
Family 066 4 0 100.33 529.40
       1 Medicare 066 4 1 54.47 483.54
       2 Medicares 066 4 2 8.61 437.68
Community Blue (067)
Individual 067 1 0 26.77 267.73
       Medicare 067 1 1 (19.09) 221.87
Family 067 4 0 150.11 700.41
       1 Medicare 067 4 1 104.25 654.55
       2 Medicares 067 4 2 58.39 608.69
HMO Blue - CNY (072)
Individual 072 1 0 77.67 305.03
       Medicare 072 1 1 31.81 259.17
Family 072 4 0 242.74 743.93
       1 Medicare 072 4 1 196.88 698.07
       2 Medicares 072 4 2 151.02 652.21
HMO Blue - Utica/Watertown (160)
Individual 160 1 0 89.45 314.17
       Medicare 160 1 1 43.59 268.31
Family 160 4 0 300.64 800.17
       1 Medicare 160 4 1 254.78 754.31
       2 Medicares 160 4 2 208.92 708.45
Aetna (210)
Individual 210 1 0 118.12 360.65
       Medicare 210 1 1 72.26 314.79
Family 210 4 0 491.60 1,017.49
       1 Medicare 210 4 1 445.74 971.63
       2 Medicares 210 4 2 399.88 925.77
GHI HMO Albany Region (220)
Individual 220 1 0 108.47 355.40
       Medicare 220 1 1 62.61 309.54
Family 220 4 0 370.34 922.92
       1 Medicare 220 4 1 324.48 877.06
       2 Medicares 220 4 2 278.62 831.20
Empire BlueCross BlueShield HMO - Upstate (280)
Individual 280 1 0 34.73 292.74
       Medicare 280 1 1 (11.13) 246.88
Family 280 4 0 171.17 752.43
       1 Medicare 280 4 1 125.31 706.57
       2 Medicares 280 4 2 79.45 660.71
Empire BlueCross BlueShield HMO - Downstate (290)
Individual 290 1 0 115.49 379.90
       Medicare 290 1 1 69.63 334.04
Family 290 4 0 383.90 980.07
       1 Medicare 290 4 1 338.04 934.21
       2 Medicares 290 4 2 292.18 888.35
Capital District PHP - Central (300)
Individual 300 1 0 50.33 275.87
       Medicare 300 1 1 4.47 230.01
Family 300 4 0 177.80 679.52
       1 Medicare 300 4 1 131.94 633.66
       2 Medicares 300 4 2 86.08 587.80
Capital District PHP - W. Hudson Valley (310)
Individual 310 1 0 55.14 279.40
       Medicare 310 1 1 9.28 233.54
Family 310 4 0 189.50 688.36
       1 Medicare 310 4 1 143.64 642.50
       2 Medicares 310 4 2 97.78 596.64
Empire BlueCross BlueShield HMO - Mid-Hudson (320)
Individual 320 1 0 105.08 367.67
       Medicare 320 1 1 59.22 321.81
Family 320 4 0 353.93 945.83
       1 Medicare 320 4 1 308.07 899.97
       2 Medicares 320 4 2 262.21 854.11
MVP Health Care, Inc. - Central Region (330)
Individual 330 1 0 43.45 263.56
       Medicare 330 1 1 (2.41) 217.70
Family 330 4 0 159.20 648.73
       1 Medicare 330 4 1 113.34 602.87
       2 Medicares 330 4 2 67.48 557.01
MVP Health Care, Inc. - Mid-Hudson (340)
Individual 340 1 0 48.17 268.46
       Medicare 340 1 1 2.31 222.60
Family 340 4 0 170.68 660.59
       1 Medicare 340 4 1 124.82 614.73
       2 Medicares 340 4 2 78.96 568.87
GHI HMO - HV & Ulster Regions (350)
Individual 350 1 0 134.71 381.64
       Medicare 350 1 1 88.85 335.78
Family 350 4 0 448.51 1,001.10
       1 Medicare 350 4 1 402.65 955.24
       2 Medicares 350 4 2 356.79 909.38
MVP HMO - North Region (360)
Individual 350 1 0 84.07 308.36
       Medicare 350 1 1 38.21 262.50
Family 350 4 0 261.85 760.76
       1 Medicare 350 4 1 215.99 714.90
       2 Medicares 350 4 2 170.13 669.04

*Medicare is income sensitive - this is the basic bi-weekly premium rate.

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