News

Union legal action results in refunds and lower Empire Plan and HIP Individual Premium rates

As a result of a successful lawsuit by Local 1359, members who are enrolled in the Empire Plan will see lower co-premium rates effective in checks dated April 4, 2007. The new family premium will be $89.59 per pay period (a reduction of $2.95 from $92.54) and the new individual premium will be $21.30 per pay period (a reduction of $1.24 from $22.54). In addition, those members in HIP (HMO) will see their individual premiums reduced from $19.67 to $18.92 per pay period (a reduction of 75 cents).

Because the lower premium rates are effective retroactive to January 1, 2006 (a period of 15 months through March 31, 2007), refunds (due to overpayment) will be provided to all Empire Plan participants and HIP individual members later this year. Refund amounts will range from approximately $23 to $91 per member depending on your plan and participation category.

The reductions resulted from DC 37 Local 1359 successfully suing the state of New York for attempting to pass-along and include in the member premium rate base Medicare Part B costs that had always been borne by the employer.

Due to the complex nature of determining HMO premium rates and cost caps under NYSHIP rules, the HIP family rate is increasing slightly as a result of this recalculation. The new rate will be $89.42 per pay period, 45 cents above the old rate of $88.97. However, members affected by this increase have the right to change their plan selection to any other HMO or the Empire Plan during a transfer period comprising the entire month of March, 2007. Members in Aetna HMO and Downstate BlueCross/BlueShield who will also see rates increase can also transfer to a lower cost plan. However, any member in a plan which will see rates increase will only be charged prospectively if they remain in the plan. No retroactive charges will occur.

All affected members should have received a letter from the New York State Department of Civil Service concerning these plan changes and information concerning potential eligibility to transfer to another provider.