2025 Health Insurance Rates (effective 1/2/2025):

CSEA, M/C, NYSCOPBA, PBANYS, PEF, UUP
2025 Health Insurance Bi-weekly Rates
  For Classified employees in titles equal to SG-9 and below;
For UUP and M/C Professional Employees with annualized salaries less than $50,884		 For Classified employees in titles equal to SG-10 and above; For UUP M/C Professional Employees with annualized salaries of $50,884 or more
Health Plan Individual Family Individual Family
Empire Plan $60.23 $272.67 $80.31 $324.22
Highmark Blue Cross Blue Shield of WNY $53.93 $231.99 $71.91 $276.35
Independent Health $53.20 $226.04 $70.94 $269.39

2025 Option Transfer

Health Insurance Choices 2025
NYSHIP Rates and Deadlines for 2025
Planning for Option Transfer 2025
Option Transfer Guide 2025
NYSHIP Plan Comparison Tool
Health Insurance Transaction Form (PS-404)

Plans

Empire Plan:
Plan Details | Provider Directory | United Health Care (Group #030500)

HMO's:
Highmark Blue Cross Blue Shield of WNY
Independent Health

Summary of Benefits and Coverage
NYSHIP General Information Book
Prescription Drugs:  contact your health insurance plan for information
Pre-Tax Contribution Program
Health Insurance Transaction Form (PS-404)
Graduate Student Health Insurance
NYS Department of Civil Service Employee Benefits Division
Opt-Out Program
Union Benefit Funds: CSEA | UUP
COBRA
Health Insurance Market Place

Empire Plan members

Telehealth Benefit
The Empire Plan is doing all they can to support its enrollees through this unprecedented time and has introduced a new telehealth benefit to help them access health care services remotely. LiveHealth Online lets enrollees stay home and have a video visit with a board-certified doctor or licensed therapist on their smartphone, tablet or personal computer.

If enrollees are concerned about leaving their homes to receive medical care or their ability to access care, The Empire Plan will cover telehealth visits at no cost.  Additional information and step-by-step instructions to register are available. Enrollees who are already registered can login to www.empireblue.com/nys to get a coupon code to cover the full cost of their LiveHealth Online visit. For additional assistance, enrollees are encouraged to call The Empire Plan at 1-877-7-NYSHIP (1-877-769-7447) and select option 2 for the Hospital Program. Note: A postcard regarding this new benefit will also be mailed to enrollees in the coming week.

In addition, Empire Plan has coronavirus related benefits available for their members:

  • Cost-sharing, copay, coinsurance, and deductible waivers for COVID-19 testing (waivers apply to both active employees and retirees).
  • Early prescription refills (one emergency refill of up to a 30-day supply for three prescriptions and one refill of specialty medications, during a 90-day period).
  • Access to the  Empire Plan Nurseline (1-877-769-7447, option 5), which provides information on COVID-19 and can help members who suspect they may have contracted the virus.
  • Access to Beacon Lens,  the Beacon Health Options Blog which provides tips on managing stress and anxiety during the coronavirus crisis.

For additional information regarding any of these benefits, members can contact Empire Plan at 1-877-7-NYSHIP. 

Option Transfer Period

The annual option transfer period is the time in which you can make certain limited changes to your NYSHIP health insurance options. Any changes that are made during this period will be effective with the following calendar year.  The types of changes that are allowed during this option transfer period are:

  • change from one NYSHIP plan to another, e.g., the Empire Plan to a NYSHIP approved HMO or vice versa;
  • voluntarily cancel your insurance without a qualifying event;
  • remove otherwise eligible dependents from your plan without a qualifying event, resulting in a change from family to individual coverage.

No action is required to keep your current health insurance option.

Qualifying events for health insurance changes

  • change in family status (e.g., marriage, birth, death, legal separation, divorce, only dependent child attains the maximum age for coverage);
  • you no longer live or work within your HMO's NYSHIP service area and therefore you choose another NYSHIP HMO or the Empire Plan;
  • your spouse loses coverage due to termination of employment and you apply for coverage for your spouse under NYSHIP;
  • your spouse has a change in employment status, which results in acquiring or losing eligibility for health insurance coverage;
  • you first become eligible for health insurance coverage after the beginning of the tax year.
  • your employment with the State terminates or you retire.

Young Adult Option

The New York State Health Insurance Program allows a young adult child up to age 30 to purchase coverage through his or her parent's group health insurance policy. The Young Adult Option is for medical coverage only; dental and vision coverage is not included. Under the law, the young adult's coverage is subject to all terms of the group policy; however, premiums are to be paid by the young adult or his or her parent, not the employer. The premium is the full cost of individual coverage for the NYSHIP option selected.

 

Eligibility Criteria
The Young Adult Option is available to young adults who meet all of the following eligibility requirements:

  • Be a child, adopted child, or stepchild of a NYSHIP enrollee (including those enrolled under COBRA)
  • Be age 29 or younger
  • Be unmarried
  • Not be insured by or eligible for coverage through the young adult's own employer-sponsored health plan.
  • Live, work, or reside in New York State or the plan's service area
  • Not be covered under Medicare

In addition, the young adult does not need to live with the parent, be financially dependent on the parent, or be a student. A young adult's eligibility for health insurance coverage through a former employer under federal COBRA or state continuation coverage does not disqualify the young adult from electing this option under NYSHIP. Children of the young adult are not eligible for coverage under this option but may be eligible for health insurance coverage under other programs, such as the Child Health Plus Program. The young adult's parent does not need to have family coverage, nor is the young adult required to have been previously covered as a dependent under NYSHIP, to be eligible to enroll.

For more information or to enroll a young adult child, visit the Department of Civil Service.