2027 NYSHIP Information Coming Soon!
This page reflects information for the 2026 calendar year.
Information for the 2027 calendar year will be provided once it is released.
Compare Plans
Save money by generating a comparison of the benefits provided by the NYSHIP plans in your area.
Coverage Options
The Empire Plan vs. NYSHIP HMOs
NYSHIP offers two types of health insurance options: The Empire Plan and NYSHIP-approved Health Maintenance Organizations (HMOs).
The Empire Plan provides worldwide coverage and access to a broad network of providers. Benefits are collectively bargained. HMOs provide regional coverage and typically require you to use network providers.
The Opt-Out Program
If you are eligible and have other employer-sponsored group health insurance, you can opt out of NYSHIP coverage in exchange for an incentive payment. You must meet eligibility requirements and provide proof of other coverage.
Open Enrollment
Starting in December 2026, NYSHIP will offer Open Enrollment in place of the annual Option Transfer Period.
During Open Enrollment you can:
- Enroll in NYSHIP with no waiting period
- Change between The Empire Plan, a NYSHIP HMO or the Opt-Out Program
- Switch to Individual or Family coverage
- Change your Pre-Tax Contribution Program (PTCP) status or deduction
- Enroll in the Productivity Enhancement Program (PEP) for the upcoming year
- Enroll in the Young Adult Option (YAO)
Changing Your Option
Before you make a change, consider:
- Confirm that your plan is available where you live or work
- HMO availability varies by county
- Changes made during Open Enrollment are typically effective at the starts of the next plan year
- Changes due to a qualifying life event follow specific effective date rules
- Covered services
- Provider networks
- Your out-of-pocket costs
Forms You'll Need:
Cost of Coverage
Costs to Consider
New York State helps to pay for your health insurance coverage. After the State's contribution, you are responsible for paying the balance of your premium, usually through biweekly deductions from your paycheck. Whether you enroll in The Empire Plan or a NYSHIP HMO, the State's share and your share of the cost of coverage are based on the following:
If you are a Grade 9 and below (or salary equivalent):
Your Individual Coverage State Share is 88%, Employee Share is 12%
Your Dependent Coverage State Share is 73%, Employee Share is 27%
If you are a Grade 10 and above (or salary equivalent):
Your Individual Coverage State Share is 84%, Employee Share is 16%
Your Dependent Coverage State Share is 69%, Employee Share is 31%
If you enroll in a NYSHIP HMO, the State's dollar contribution for the hospital, medical/surgical and mental health and substance use components of your HMO premium will not exceed its dollar contribution for those components of The Empire Plan premium. For the prescription drug component of your HMO premium, the State pays the share noted in the table; the dollar amount is not limited by the cost of Empire Plan drug coverage.
This information does not apply to COBRA enrollees, Young Adult Option enrollees or enrollees in leave without pay status (who pay the full cost of coverage).
What They Are
The amount of money you are expected to pay upon receiving covered services under your health insurance plan is referred to as either a copayment or coinsurance.
A copayment is a fixed dollar amount that has been set for the service being received, regardless of the total cost of the service.
Coinsurance is a fixed percentage of the cost of the service being received.
Copayment and coinsurance amounts for The Empire Plan and all NYSHIP HMOs may be viewed in Health Insurance Choices.
What It Is
The dollar amount you are required to pay before a health plan begins to reimburse for covered services received from non-network providers.
2026 Deductible Amounts
The 2026 Empire Plan deductible amounts may be viewed in Health Insurance Choices.
NYSHIP HMOs do not have annual deductibles.
What It Is
The maximum out-of-pocket (OOP) limit is the most you will pay out of your own pocket in a given plan year for covered health care services delivered by in-network providers under your plan. Once you reach this limit, your copayments will be reimbursed by your plan for the remainder of the plan year. Additional information about the annual maximum OOP limit can be found in Health Insurance Choices.
Benefit Programs
Pre-Tax Contribution Program
The Pre-Tax Contribution Program allows you to pay your share of NYSHIP premiums with pre-tax dollars, which can lower your taxable income.
Productivity Enhancement Program
The Productivity Enhancement Program allows eligible employees to exchange annual leave for a credit toward their NYSHIP premium. If eligible, you may enroll in PEP during Open Enrollment.