{"id":11637,"date":"2024-12-04T13:23:12","date_gmt":"2024-12-04T18:23:12","guid":{"rendered":"https:\/\/www.pef.org\/?p=11637"},"modified":"2024-12-04T13:23:12","modified_gmt":"2024-12-04T18:23:12","slug":"empire-plan-hmo-premium-rates-for-2025","status":"publish","type":"post","link":"https:\/\/www.pef.org\/articles\/news\/empire-plan-hmo-premium-rates-for-2025\/","title":{"rendered":"Empire Plan, HMO premium rates for 2025"},"content":{"rendered":"

December 4, 2024 \u2014<\/em>\u00a0The Empire Plan and HMO premium rates for 2025 have been finalized by the Department of Civil Service. Plan rates are adjusted annually based on enrollee utilization and projected costs. Rates are not negotiated by PEF \u2013 the union negotiates the employee\/state premium percentage\u00a0<\/span>cost share<\/span><\/i>, which has not changed from 2024 to 2025.<\/span>\u00a0<\/span><\/p>\n

For titles equal or below Salary Grade 9, the state will pay 88% of the cost of the premium for individual coverage and 73% for the additional cost of family coverage. For titles equal to Salary Grade 10 and above, the state will pay 84% of the cost of premium for individual coverage and 69% for the additional cost of family coverage.<\/span>\u00a0<\/span><\/p>\n

The Option Transfer Period runs through the last day of the calendar year \u2014 December 31, 2024.<\/span>\u00a0<\/span><\/p>\n

The 2025 Empire Plan premium rates for PEF-represented active employees and all other applicable ratified unions are indicated below. HMO rates, as well as more information on plans and benefits, can be found on\u00a0<\/span>PEF\u2019s Health Benefits webpage<\/span><\/a>.<\/span>\u00a0<\/span><\/p>\n

For SG 9 and Below:<\/span>\u00a0<\/span><\/p>\n

\n\n\n\n\n\n
Type of Coverage<\/span>\u00a0<\/span><\/td>\n2024 Biweekly Premium Deduction<\/span>\u00a0<\/span><\/td>\n2025 Biweekly Premium Deduction<\/span>\u00a0<\/span><\/td>\n$ Change from 2024 to 2025<\/span>\u00a0<\/span><\/td>\n% Change from 2024 to 2025<\/span>\u00a0<\/span><\/td>\n<\/tr>\n
Individual<\/span>\u00a0<\/span><\/td>\n$60.07<\/span>\u00a0<\/span><\/td>\n$60.23<\/span>\u00a0<\/span><\/td>\n$0.16<\/span>\u00a0<\/span><\/td>\n0.3%<\/span>\u00a0<\/span><\/td>\n<\/tr>\n
Family<\/span>\u00a0<\/span><\/td>\n$271.92<\/span>\u00a0<\/span><\/td>\n$272.67<\/span>\u00a0<\/span><\/td>\n$0.75<\/span>\u00a0<\/span><\/td>\n0.3%<\/span>\u00a0<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n

\u00a0<\/span><\/p>\n

For SG 10 and Above:<\/span>\u00a0<\/span><\/p>\n

\n\n\n\n\n\n
Type of Coverage<\/span>\u00a0<\/span><\/td>\n2024 Biweekly Premium Deduction<\/span>\u00a0<\/span><\/td>\n2025 Biweekly Premium Deduction<\/span>\u00a0<\/span><\/td>\n$ Change from 2024 to 2025<\/span>\u00a0<\/span><\/td>\n% Change from 2024 to 2025<\/span>\u00a0<\/span><\/td>\n<\/tr>\n
Individual<\/span>\u00a0<\/span><\/td>\n$80.09<\/span>\u00a0<\/span><\/td>\n$80.21<\/span>\u00a0<\/span><\/td>\n$0.22<\/span>\u00a0<\/span><\/td>\n0.3%<\/span>\u00a0<\/span><\/td>\n<\/tr>\n
Family<\/span>\u00a0<\/span><\/td>\n$323.33<\/span>\u00a0<\/span><\/td>\n$324.22<\/span>\u00a0<\/span><\/td>\n$0.89<\/span>\u00a0<\/span><\/td>\n0.3%<\/span>\u00a0<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n

\u00a0<\/span><\/p>\n

Enrollment, Changes, and Informational Pieces<\/span><\/b>\u00a0<\/span><\/p>\n

Active employees can submit and make changes to all health benefits online using\u00a0<\/span>MyNYSHIP<\/span><\/a>. If employees do not participate online, they must complete PS-404 form in order to enroll or make changes. Changes must be submitted online or to your agency\u2019s Health Benefits Administrator no later than December 31, 2024.<\/span>\u00a0<\/span><\/p>\n

Young Adult Option (YAO)<\/span><\/b>\u00a0<\/span><\/p>\n

The open enrollment period for the YAO will coincide with the annual Option Transfer Period. YAO provides coverage to children of NYSHIP enrollees, up to age 30. For more information, click\u00a0<\/span>here<\/span><\/a>.<\/span>\u00a0<\/span><\/p>\n

HMOs<\/span><\/b>\u00a0<\/span><\/p>\n

It is important to look at more than premium rates when selecting an HMO. PEF and other unions only negotiate the benefit level with the Empire Plan and do not negotiate the benefits provided by HMOs.<\/span>\u00a0<\/span><\/p>\n

HMOs are allowed to change benefit levels annually, independent of the negotiated Empire Plan benefits. PEF recommends HMO enrollees review their plan options carefully during the Option Transfer Period.<\/span>\u00a0<\/span><\/p>\n

The actual percentage of rate change for HMOs varies by plan and coverage type and the change in the employee deduction for each can vary due to the impact of the HMO premium \u201ccapping\u201d formula.\u00a0<\/span>\u00a0<\/span><\/p>\n

If a PEF member enrolls in an HMO, the state\u2019s dollar amount contribution for non-prescription drug components of the HMO premium will not exceed the state\u2019s dollar contribution for the non-prescription drug components of the Empire Plan premium. Employees must pay 100% of the premium exceeding the cap.<\/span>\u00a0<\/span><\/p>\n

If you have questions, contact a PEF Health Benefits representative in the Contract Administration Department at 518-785-1900, ext. 283.<\/span>\u00a0<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

December 4, 2024 \u2014\u00a0The Empire Plan and HMO premium rates for 2025 have been finalized by the Department of Civil Service. Plan rates are adjusted annually based on enrollee utilization…<\/p>\n","protected":false},"author":13,"featured_media":11638,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[482,6],"tags":[],"class_list":["post-11637","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health-benefits","category-news"],"acf":[],"yoast_head":"\nEmpire Plan, HMO premium rates for 2025 - PEF<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.pef.org\/articles\/news\/empire-plan-hmo-premium-rates-for-2025\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Empire Plan, HMO premium rates for 2025\" \/>\n<meta property=\"og:description\" content=\"December 4, 2024 \u2014\u00a0The Empire Plan and HMO premium rates for 2025 have been finalized by the Department of Civil Service. 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