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
COMMISSIONER
DANIEL E. WALL
EXECUTIVE
DEPUTY COMISSIONER
PA01-04
TO: Participating Agencies
FROM: Employee Benefits Division
SUBJECT: Correction to PA Fourth Quarter Report
DATE: March 8, 2001
The Empire Plan Quarterly Experience Report, PA 01-02, dated February 26, 2001, included an incorrect exhibit page. Exhibit II, page 3 is a duplicate of page 2. Attached are replacement pages 2 and 3 of Exhibit II. Please replace the corresponding pages in the reports sent to both the Chief Executive Officer and Health Benefits Administrator.
We are sorry for any inconvenience this error may have caused.
Empire Plan
Participating Agency Premium Rates
Comparison of 2001 and Projected 2002 Rates
CORE ONLY - Plan Prime
Individual | Gross Rates(1) | Gross Rates(1) | Gross Rates(1) | Net Rates(2) | Net Rates(2) | Net Rates(2) |
---|---|---|---|---|---|---|
Optimistic | 293.01 | 314.74 | 7.4% | 283.24 | 309.91 | 9.4% |
Best Estimate | 293.01 | 321.13 | 9.6% | 283.24 | 316.30 | 11.7% |
Pessimistic | 293.01 | 336.42 | 14.8% | 283.24 | 331.59 | 17.1% |
(1) Represents premiums charged by the carriers.
(2) Represents cost to a participating agency.
CORE ONLY - Plan Prime
Family | Gross Rates(1) | Gross Rates(1) | Gross Rates(1) | Net Rates(2) | Net Rates(2) | Net Rates(2) |
---|---|---|---|---|---|---|
Optimistic | 608.59 | 653.15 | 7.3% | 588.51 | 643.04 | 9.3% |
Best Estimate | 608.59 | 666.41 | 9.5% | 588.51 | 656.30 | 11.5% |
Pessimistic | 608.59 | 696.37 | 14.4% | 588.51 | 686.26 | 16.6% |
(1) Represents premiums charged by the carriers.
(2) Represents cost to a participating agency.
CORE ONLY - MediPrime
Individual | Gross Rates(1) | Gross Rates(1) | Gross Rates(1) | Net Rates(2) | Net Rates(2) | Net Rates(2) |
---|---|---|---|---|---|---|
Optimistic | 236.42 | 268.93 | 13.8% | 230.99 | 264.36 | 14.4% |
Best Estimate | 236.42 | 274.41 | 16.1% | 230.99 | 269.84 | 16.8% |
Pessimistic | 236.42 | 288.73 | 22.1% | 230.99 | 284.16 | 23.0% |
(1) Represents premiums charged by the carriers.
(2) Represents cost to a participating agency.
CORE ONLY - MediPrime
Family-1 | Gross Rates(1) | Gross Rates(1) | Gross Rates(1) | Net Rates(2) | Net Rates(2) | Net Rates(2) |
---|---|---|---|---|---|---|
Optimistic | 553.16 | 608.39 | 10.0% | 537.43 | 598.55 | 11.4% |
Best Estimate | 553.16 | 620.75 | 12.2% | 537.43 | 610.91 | 13.7% |
Pessimistic | 553.16 | 649.73 | 17.5% | 537.43 | 639.89 | 19.1% |
(1) Represents premiums charged by the carriers.
(2) Represents cost to a participating agency.
CORE ONLY - MediPrime
Family-2 | Gross Rates(1) | Gross Rates(1) | Gross Rates(1) | Net Rates(2) | Net Rates(2) | Net Rates(2) |
---|---|---|---|---|---|---|
Optimistic | 495.31 | 561.45 | 13.4% | 483.91 | 551.88 | 14.0% |
Best Estimate | 495.31 | 572.90 | 15.7% | 483.91 | 563.33 | 16.4% |
Pessimistic | 495.31 | 600.89 | 21.3% | 483.91 | 591.32 | 22.2% |
(1) Represents premiums charged by the carriers.
(2) Represents cost to a participating agency.
CORE PLUS MEDICAL ENHANCEMENT - Plan Prime
Individual | Gross Rates(1) | Gross Rates(1) | Gross Rates(1) | Net Rates(2) | Net Rates(2) | Net Rates(2) |
---|---|---|---|---|---|---|
Optimistic | 323.21 | 348.18 | 7.7% | 312.44 | 339.76 | 8.7% |
Best Estimate | 323.21 | 355.25 | 9.9% | 312.44 | 346.83 | 11.0% |
Pessimistic | 323.21 | 372.22 | 15.2% | 312.44 | 363.80 | 16.4% |
(1) Represents premiums charged by the carriers.
(2) Represents cost to a participating agency.
CORE PLUS MEDICAL ENHANCEMENT - Plan Prime
Family | Gross Rates(1) | Gross Rates(1) | Gross Rates(1) | Net Rates(2) | Net Rates(2) | Net Rates(2) |
---|---|---|---|---|---|---|
Optimistic | 668.99 | 720.03 | 7.6% | 646.91 | 702.76 | 8.6% |
Best Estimate | 668.99 | 734.66 | 9.8% | 646.91 | 717.39 | 10.9% |
Pessimistic | 668.99 | 767.97 | 14.8% | 646.91 | 750.70 | 16.0% |
(1) Represents premiums charged by the carriers.
(2) Represents cost to a participating agency.
CORE PLUS MEDICAL ENHANCEMENT - MediPrime
Individual | Gross Rates(1) | Gross Rates(1) | Gross Rates(1) | Net Rates(2) | Net Rates(2) | Net Rates(2) |
---|---|---|---|---|---|---|
Optimistic | 245.51 | 279.00 | 13.6% | 239.82 | 273.48 | 14.0% |
Best Estimate | 245.51 | 284.68 | 16.0% | 239.82 | 279.16 | 16.4% |
Pessimistic | 245.51 | 299.51 | 22.0% | 239.82 | 293.99 | 22.6% |
(1) Represents premiums charged by the carriers.
(2) Represents cost to a participating agency.
CORE PLUS MEDICAL ENHANCEMENT - MediPrime
Family-1 | Gross Rates(1) | Gross Rates(1) | Gross Rates(1) | Net Rates(2) | Net Rates(2) | Net Rates(2) |
---|---|---|---|---|---|---|
Optimistic | 592.45 | 651.90 | 10.0% | 575.44 | 637.52 | 10.8% |
Best Estimate | 592.45 | 665.15 | 12.3% | 575.44 | 650.77 | 13.1% |
Pessimistic | 592.45 | 696.31 | 17.5% | 575.44 | 681.93 | 18.5% |
(1) Represents premiums charged by the carriers.
(2) Represents cost to a participating agency.
CORE PLUS MEDICAL ENHANCEMENT - MediPrime
Family-2 | Gross Rates(1) | Gross Rates(1) | Gross Rates(1) | Net Rates(2) | Net Rates(2) | Net Rates(2) |
---|---|---|---|---|---|---|
Optimistic | 513.49 | 581.58 | 13.3% | 501.56 | 570.13 | 13.7% |
Best Estimate | 513.49 | 593.44 | 15.6% | 501.56 | 581.99 | 16.0% |
Pessimistic | 513.49 | 622.44 | 21.2% | 501.56 | 610.99 | 21.8% |
(1) Represents premiums charged by the carriers.
(2) Represents cost to a participating agency.
CORE PLUS MEDICAL & PSYCHIATRIC ENHANCEMENTS - Plan Prime
Individual | Gross Rates(1) | Gross Rates(1) | Gross Rates(1) | Net Rates(2) | Net Rates(2) | Net Rates(2) |
---|---|---|---|---|---|---|
Optimistic | 325.23 | 350.18 | 7.7% | 314.26 | 341.76 | 8.8% |
Best Estimate | 325.23 | 357.29 | 9.9% | 314.26 | 348.87 | 11.0% |
Pessimistic | 325.23 | 374.23 | 15.1% | 314.26 | 365.81 | 16.4% |
(1) Represents premiums charged by the carriers.
(2) Represents cost to a participating agency.
CORE PLUS MEDICAL & PSYCHIATRIC ENHANCEMENTS - Plan Prime
Family | Gross Rates(1) | Gross Rates(1) | Gross Rates(1) | Net Rates(2) | Net Rates(2) | Net Rates(2) |
---|---|---|---|---|---|---|
Optimistic | 673.67 | 724.66 | 7.6% | 651.09 | 707.37 | 8.6% |
Best Estimate | 673.67 | 739.39 | 9.8% | 651.09 | 722.10 | 10.9% |
Pessimistic | 673.67 | 772.61 | 14.7% | 651.09 | 755.32 | 16.0% |
(1) Represents premiums charged by the carriers.
(2) Represents cost to a participating agency.
CORE PLUS MEDICAL & PSYCHIATRIC ENHANCEMENTS - MediPrime
Individual | Gross Rates(1) | Gross Rates(1) | Gross Rates(1) | Net Rates(2) | Net Rates(2) | Net Rates(2) |
---|---|---|---|---|---|---|
Optimistic | 245.64 | 279.13 | 13.6% | 239.94 | 273.61 | 14.0% |
Best Estimate | 245.64 | 284.81 | 15.9% | 239.94 | 279.29 | 16.4% |
Pessimistic | 245.64 | 299.64 | 22.0% | 239.94 | 294.12 | 22.6% |
(1) Represents premiums charged by the carriers.
(2) Represents cost to a participating agency.
CORE PLUS MEDICAL & PSYCHIATRIC ENHANCEMENTS - MediPrime
Family-1 | Gross Rates(1) | Gross Rates(1) | Gross Rates(1) | Net Rates(2) | Net Rates(2) | Net Rates(2) |
---|---|---|---|---|---|---|
Optimistic | 595.25 | 654.66 | 10.0% | 577.95 | 640.27 | 10.8% |
Best Estimate | 595.25 | 667.97 | 12.2% | 577.95 | 653.58 | 13.1% |
Pessimistic | 595.25 | 699.08 | 17.4% | 577.95 | 684.69 | 18.5% |
(1) Represents premiums charged by the carriers.
(2) Represents cost to a participating agency.
CORE PLUS MEDICAL & PSYCHIATRIC ENHANCEMENTS - MediPrime
Family-2 | Gross Rates(1) | Gross Rates(1) | Gross Rates(1) | Net Rates(2) | Net Rates(2) | Net Rates(2) |
---|---|---|---|---|---|---|
Optimistic | 514.40 | 582.48 | 13.2% | 502.37 | 571.03 | 13.7% |
Best Estimate | 514.40 | 594.35 | 15.5% | 502.37 | 582.90 | 16.0% |
Pessimistic | 514.40 | 623.34 | 21.2% | 502.37 | 611.89 | 21.8% |
(1) Represents premiums charged by the carriers.
(2) Represents cost to a participating agency.
Schedule I
New York State Health Insurance Program
Participating Agencies
Empire Rates - Projected for 2002
Best Estimate
Option 8 - Core Only - Plan Prime
Blue Cross Core | MetraHealth Core | MetraHealth PA Enh | MHSA Core | MHSA PA Enh | CIGNA Rx | EMS | Intra- Corp* | GROSS RATES | B/C Core | Met Core | Met PA Enh | MHSA Core | MHSA PA Enh | CIGNA | Med Adj | INTEREST REG* | INTEREST Spec | Net LWOP | EE ER | |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Individual | 98.87 | 130.28 | 7.60 | 82.66 | 0.33 | 1.39 | 321.13 | 2.72 | 0.00 | 0.46 | 1.10 | 0.00 | 0.99 | -0.44 | 316.30 | SEE PS 508 | ||||
Family | 205.94 | 270.08 | 18.41 | 168.37 | 0.75 | 2.86 | 666.41 | 5.61 | 0.00 | 1.13 | 2.22 | 0.00 | 2.05 | -0.90 | 656.30 | SEE PS 508 |
Option 8 - Core Only - MediPrime
Blue Cross Core | MetraHealth Core | MetraHealth PA Enh | MHSA Core | MHSA PA Enh | CIGNA Rx | EMS | Intra- Corp* | GROSS RATES | B/C Core | Met Core | Met PA Enh | MHSA Core | MHSA PA Enh | CIGNA | Med Adj | INTEREST REG* | INTEREST Spec | Net LWOP | EE ER | |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Individual | 68.42 | 37.39 | 0.73 | 167.54 | 0.33 | 0.00 | 274.41 | 1.82 | 0.00 | 0.04 | 2.23 | 0.00 | 0.80 | -0.32 | 269.84 | SEE PS 508 | ||||
Family-1 | 175.49 | 177.19 | 11.54 | 253.26 | 0.75 | 2.52 | 620.75 | 4.71 | 0.00 | 0.70 | 3.36 | 0.00 | 1.85 | -0.78 | 610.91 | SEE PS 508 | ||||
Family-2 | 145.04 | 84.29 | 4.67 | 338.15 | 0.75 | 0.00 | 572.90 | 3.81 | 0.00 | 0.27 | 4.50 | 0.00 | 1.66 | -0.67 | 563.33 | SEE PS 508 |
Option 7 - Core Plus All Enhancements - Plan Prime
Blue Cross Core | MetraHealth Core | MetraHealth PA Enh | MHSA Core | MHSA PA Enh | CIGNA Rx | EMS | Intra- Corp* | GROSS RATES | B/C Core | Met Core | Met PA Enh | MHSA Core | MHSA PA Enh | CIGNA | Med Adj | INTEREST REG* | INTEREST Spec | Net LWOP | EE ER | |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Individual | 98.87 | 130.28 | 34.12 | 7.60 | 2.04 | 82.66 | 0.33 | 1.39 | 357.29 | 2.72 | 0.00 | 3.48 | 0.46 | 0.00 | 1.10 | 0.00 | 1.10 | -0.44 | 348.87 | SEE PS 508 |
Family | 205.94 | 270.08 | 68.25 | 18.41 | 4.73 | 168.37 | 0.75 | 2.86 | 739.39 | 5.61 | 0.00 | 6.95 | 1.13 | 0.00 | 2.22 | 0.00 | 2.28 | -0.90 | 722.10 | SEE PS 508 |
Option 7 - Core Plus All Enhancements - MediPrime
Blue Cross Core | MetraHealth Core | MetraHealth PA Enh | MHSA Core | MHSA PA Enh | CIGNA Rx | EMS | Intra- Corp* | GROSS RATES | B/C Core | Met Core | Met PA Enh | MHSA Core | MHSA PA Enh | CIGNA | Med Adj | INTEREST REG* | INTEREST Spec | Net LWOP | EE ER | |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Individual | 68.42 | 37.39 | 10.27 | 0.73 | 0.13 | 167.54 | 0.33 | 0.00 | 284.81 | 1.82 | 0.00 | 0.92 | 0.04 | 0.00 | 2.23 | 0.00 | 0.83 | -0.32 | 279.29 | SEE PS 508 |
Family-1 | 175.49 | 177.19 | 44.40 | 11.54 | 2.82 | 253.26 | 0.75 | 2.52 | 667.97 | 4.71 | 0.00 | 4.39 | 0.70 | 0.00 | 3.36 | 0.00 | 2.01 | -0.78 | 653.58 | SEE PS 508 |
Family-2 | 145.04 | 84.29 | 20.54 | 4.67 | 0.91 | 338.15 | 0.75 | 0.00 | 594.35 | 3.81 | 0.00 | 1.82 | 0.27 | 0.00 | 4.50 | 0.00 | 1.72 | -0.67 | 582.90 | SEE PS 508 |
Option 6 - Core Plus Medical Enhancements - Plan Prime
Blue Cross Core | MetraHealth Core | MetraHealth PA Enh | MHSA Core | MHSA PA Enh | CIGNA Rx | EMS | Intra- Corp* | GROSS RATES | B/C Core | Met Core | Met PA Enh | MHSA Core | MHSA PA Enh | CIGNA | Med Adj | INTEREST REG* | INTEREST Spec | Net LWOP | EE ER | |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Individual | 98.87 | 130.28 | 34.12 | 7.60 | 82.66 | 0.33 | 1.39 | 355.25 | 2.72 | 0.00 | 3.48 | 0.46 | 1.10 | 0.00 | 1.10 | -0.44 | 346.83 | SEE PS 508 | ||
Family | 205.94 | 270.08 | 68.25 | 18.41 | 168.37 | 0.75 | 2.86 | 734.66 | 5.61 | 0.00 | 6.95 | 1.13 | 2.22 | 0.00 | 2.26 | -0.90 | 717.39 | SEE PS 508 |
Option 6 - Core Plus Medical Enhancements - MediPrime
Blue Cross Core | MetraHealth Core | MetraHealth PA Enh | MHSA Core | MHSA PA Enh | CIGNA Rx | EMS | Intra- Corp* | GROSS RATES | B/C Core | Met Core | Met PA Enh | MHSA Core | MHSA PA Enh | CIGNA | Med Adj | INTEREST REG* | INTEREST Spec | Net LWOP | EE ER | |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Individual | 68.42 | 37.39 | 10.27 | 0.73 | 167.54 | 0.33 | 0.00 | 284.68 | 1.82 | 0.00 | 0.92 | 0.04 | 2.23 | 0.00 | 0.83 | -0.32 | 279.16 | SEE PS 508 | ||
Family-1 | 175.49 | 177.19 | 44.40 | 11.54 | 253.26 | 0.75 | 2.52 | 665.15 | 4.71 | 0.00 | 4.39 | 0.70 | 3.36 | 0.00 | 2.00 | -0.78 | 650.77 | SEE PS 508 | ||
Family-2 | 145.04 | 84.29 | 20.54 | 4.67 | 338.15 | 0.75 | 0.00 | 593.44 | 3.81 | 0.00 | 1.82 | 0.27 | 4.50 | 0.00 | 1.72 | -0.67 | 581.99 | SEE PS 508 |
*79.9% of 2001 Rate
New York State Health Insurance Program
Participating Agencies
Empire Rates - Projected for 2002
Optimistic
Option 8 - Core Only - Plan Prime
Blue Cross Core | MetraHealth Core | MetraHealth PA Enh | MHSA Core | MHSA PA Enh | CIGNA Rx | EMS | Intra- Corp* | GROSS RATES | B/C Core | Met Core | Met PA Enh | MHSA Core | MHSA PA Enh | CIGNA | Med Adj | INTEREST REG* | INTEREST Spec | Net LWOP | EE ER | |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Individual | 96.89 | 127.68 | 7.45 | 81.00 | 0.33 | 1.39 | 314.74 | 2.72 | 0.00 | 0.46 | 1.10 | 0.00 | 0.99 | -0.44 | 309.91 | SEE PS 508 | ||||
Family | 201.82 | 264.68 | 18.04 | 165.00 | 0.75 | 2.86 | 653.15 | 5.61 | 0.00 | 1.13 | 2.22 | 0.00 | 2.05 | -0.90 | 643.04 | SEE PS 508 |
Option 8 - Core Only - MediPrime
Blue Cross Core | MetraHealth Core | MetraHealth PA Enh | MHSA Core | MHSA PA Enh | CIGNA Rx | EMS | Intra- Corp* | GROSS RATES | B/C Core | Met Core | Met PA Enh | MHSA Core | MHSA PA Enh | CIGNA | Med Adj | INTEREST REG* | INTEREST Spec | Net LWOP | EE ER | |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Individual | 67.05 | 36.64 | 0.72 | 164.19 | 0.33 | 0.00 | 268.93 | 1.82 | 0.00 | 0.04 | 2.23 | 0.00 | 0.80 | -0.32 | 264.36 | SEE PS 508 | ||||
Family-1 | 171.98 | 173.64 | 11.31 | 248.19 | 0.75 | 2.52 | 608.39 | 4.71 | 0.00 | 0.70 | 3.36 | 0.00 | 1.85 | -0.78 | 598.55 | SEE PS 508 | ||||
Family-2 | 142.14 | 82.61 | 4.57 | 331.38 | 0.75 | 0.00 | 561.45 | 3.81 | 0.00 | 0.27 | 4.50 | 0.00 | 1.66 | -0.67 | 551.88 | SEE PS 508 |
Option 7 - Core Plus All Enhancements - Plan Prime
Blue Cross Core | MetraHealth Core | MetraHealth PA Enh | MHSA Core | MHSA PA Enh | CIGNA Rx | EMS | Intra- Corp* | GROSS RATES | B/C Core | Met Core | Met PA Enh | MHSA Core | MHSA PA Enh | CIGNA | Med Adj | INTEREST REG* | INTEREST Spec | Net LWOP | EE ER | |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Individual | 96.89 | 127.68 | 33.44 | 7.45 | 2.00 | 81.00 | 0.33 | 1.39 | 350.18 | 2.72 | 0.00 | 3.48 | 0.46 | 0.00 | 1.10 | 0.00 | 1.10 | -0.44 | 341.76 | SEE PS 508 |
Family | 201.82 | 264.68 | 66.88 | 18.04 | 4.63 | 165.00 | 0.75 | 2.86 | 724.66 | 5.61 | 0.00 |