Open Enrollment
Starting in December 2026, NYSHIP will offer Open Enrollment in place of the annual Option Transfer Period.
Open Enrollment may allow you to:
- 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)
The exact options available to you depend on your plan type.
Already enrolled? See what's available.
If you're already enrolled in NYSHIP, select your plan type to see the available NYSHIP health insurance plan options.
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.
Compare Plans
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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
- For active employees: Changes made during Open Enrollment are typically effective at the starts of the next plan year
- For retirees: Changes can be made once in a 12-month period
- Any NYSHIP enrollee: Changes due to a qualifying life event follow specific effective date rules
Refer to your specific plan documents for more information.
- Covered services
- Provider networks
- Your out-of-pocket costs
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 in 2026 or Grade 13 and below in 2027 (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 in 2026 or Grade 14 and above in 2027 (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.