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
LOLA W. BRABHAM
Commissioner
NY20-23
TO: New York State Agency Health Benefit Administrators
FROM: Employee Benefits Division
SUBJECT: Accessing Direct Pay Rates Online
DATE: September 18, 2020
The current NYSHIP Rates & Information for Direct Pay Enrollees publication is available on both HBA Online and NYSHIP Online. This publication provides premium rates under the New York State Health Insurance Program (NYSHIP) for those enrolled, or enrolling, in the following:
Health Insurance
- COBRA
- Young Adult Option (YAO)
- Leave Without Pay (Leaves without an employer contribution)
Dental and Vision*
- Leave Without Pay (Leaves without an employer contribution)
- Retirees (COBRA)
*Enrollees who receive Dental and/or Vision coverage through an Employee Benefit Fund (CSEA, UUP, UCS and DC-37) would need to contact their Benefit Fund for current year COBRA rates.
Health Benefits Administrators (HBAs) may access this publication on HBA Online by selecting Easy Reference on the left-hand menu.
Select NYSHIP Rates & Information for Direct Pay Enrollees under the subheader [current year] Rates.
HBAs can also direct enrollees to access the Department of Civil Service website at www.cs.ny.gov. The enrollee would select State Employees and choose Health Benefits.
The enrollee would then be asked to provide their current employment information, including group, and current health insurance option. Note that if this has been visited previously on your computer, it will default to the last group you entered. The banner at the top of the page will indicate the group you are currently viewing. You can also Change Your Group through this banner (See below).
Once you’ve selected the group, select Health Benefits & Option Transfer.
Select Rates and Health Plan Choices.
Scroll down the page to access the current year’s Rates & Information for Direct Pay Enrollees on the right-hand panel.
HBAs should be referring to these readily available resources and can assist enrollees by helping them navigate NYSHIP Online. HBAs should refrain from directing enrollees to EBD for direct pay premium information. This publication is mailed annually to direct pay enrollees in December and posted online along with the other rate flyers. It cannot be ordered through HBA Online.
If you have any questions after reviewing this memo and the HBA Manual, please contact the Employee Benefits Division HBA Help Line at (518) 474-2780. Representatives are available Monday through Friday between 9 a.m. and 4 p.m. Eastern time.