The Empire Plan for
Public Employers
The Empire Plan has a proven record of serving local governments and public employers throughout New York State. It provides cost-effective, comprehensive health insurance coverage to the employees and families of almost 900 public employers.
Eligible public employers include local and county governments and agencies, schools and school districts, libraries, utilities, fire districts, parks and more.
A Plan as Great as the Empire State
Eligible public employers include local and county governments and agencies, schools and school districts, libraries, utilities, fire districts, parks and more.
If you are a public employer, The Empire Plan is specially designed for you. Its size, comprehensive coverage, dependability and almost 70 years of experience make it easy to understand why New York State public employers and their employees benefit from choosing The Empire Plan.
Health care coverages and other benefits under The Empire Plan include:
- Inpatient and outpatient hospital coverage for medical, surgical and maternity care paid in full when in-network
- Medical and surgical coverage with network and non-network providers
- Home care services, diabetic supplies, durable medical equipment and certain other medical supplies paid in full
- Chiropractic and physical therapy
- Protheses and orthotic devices paid in full through network providers
- Programs for managing conditions including cardiovascular disease, asthma, depression, diabetes, chronic kidney disease, eating disorders and ADHD
- Access to Centers of Excellence for transplants, infertility, substance abuse and cancer
- A managed mental health and substance abuse program
- A prescription drug program
- The toll-free Empire Plan NurseLineSM for health information and support 24 hours a day, 365 days a year
Related Topics
To learn more about The Empire Plan programs and services, access popular publications, contact the program administrators, and more:
Empire Plan Programs and Services
Learn more about some of the benefits your employees will enjoy if your agency participates in The Empire Plan.
Publications
NYSHIP communicates program information directly to enrollees through a variety of publications.
Frequently Asked Questions
Review commonly asked questions about NYSHIP and The Empire Plan.
Contact Information
For direct questions about The Empire Plan, please contact us.
Rates for PA and PE
Participating Agencies
A Participating Agency (PA) is a local government agency in New York State such as a County, City, Town, Village, School District or other municipal entity.
| Plan Prime | |
|---|---|
| Individual Coverage: | $1,611.46 |
| Family Coverage: | $3,663.79 |
Plan Prime rates apply to active employees and retirees who are not Medicare-primary.
| Mediprime | |
|---|---|
| Individual Coverage (one Medicare-primary individual): | $596.38 |
| Family Coverage (one Medicare-primary individual): | $2,261.97 |
| Family Coverage (two or more Medicare-primary individuals): | $1,633.33 |
Employer Contribution and Medicare Reimbursement
Employers are required by the New York State Civil Service Law to reimburse Medicare-primary enrollees and their enrolled Medicare-primary dependents for their cost of the Medicare Part B premium.
Employers are required to contribute a minimum of 50% of the cost for individual coverage and 35% of the cost for dependent coverage (i.e., the difference between the Family premium and the Individual premium). Family coverage under NYSHIP is for two or more covered members.
Participating Employers
A Participating Employer (PE) is a quasi-governmental agency in New York that is maintained and financed from special administrative funds.
| Rates for PE | |
|---|---|
| Individual Coverage: | $1,194.83 |
| Family Coverage: | $3,067.83 |
Employer Contribution
Employers are required to contribute a minimum of 50% of the cost for individual coverage and 35% of the cost for dependent coverage (i.e., the difference between the Family premium and the Individual premium). Family coverage under NYSHIP is for two or more covered members.
Financial Reports
Under the Government Accounting Standards Board’s (GASB) Statement 75/45, government employers need to value their obligations for “other postemployment benefits” (OPEB). These are the benefits other than pensions that a state or local government employee receives as part of their retirement benefits package.
To help Participating Agencies value their OPEB obligation under GASB 75/45, the Department of Civil Service has made available actuarial assumption reports that present assumptions and rationale used in the development of New York State and SUNY GASB valuations.
Onboarding Procedures
This document outlines the onboarding procedures for public employers requesting to join NYSHIP.