NYSHIP 2024 Rates for Retirees, Vestees, Dependent Survivors and Enrollees covered under Preferred List Provisions of Participating Employers and their Enrolled Dependents
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Not all Participating Employers use the contribution rates reflected in this flyer. If you have questions regarding whether any of these rates apply to you or what your NYSHIP rates will be for the upcoming plan year, contact your former employer. To enroll in an HMO or to remain enrolled in your current HMO, you must live or work in the HMO's NYSHIP service area. Service areas may change from year to year. Refer to the NYSHIP Options by County list to see which options are available to you for the 2024 plan year. |
These rates reflect the monthly cost for NYSHIP retiree, Dependent Survivor and Vestee coverage. Rates for retirees do not reflect sick leave credits. | ||||||||
| Retirees of Employers that contribute 100% Individual/ 75% Dependent |
Retirees and Dependent Survivors of Employers that contribute 90% Individual/ 75% Dependent |
Amended Dependent Survivors (25% Dependent contribution) |
Vestees and all other Dependent Survivors (full-share premium) |
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| Code | Plan | Individual | Family | Individual | Family | Individual | Family | Individual | Family |
| 001 | The Empire Plan | 0.00 | 427.35 | 109.05 | 536.40 | 427.35 | 427.35 | 1,090.54 | 2,799.94 |
| 066 | Blue Choice | 0.00 | 298.57 | 81.89 | 380.46 | 298.57 | 298.57 | 818.86 | 2,013.14 |
| 063 | Capital District Physicians' Health Plan (CDPHP) (Capital) | 0.00 | 304.94 | 93.68 | 398.62 | 304.94 | 304.94 | 936.76 | 2,156.53 |
| 300 | Capital District Physicians' Health Plan (CDPHP) (Central) | 38.10 | 338.88 | 138.14 | 442.73 | 338.88 | 338.88 | 1,038.44 | 2,393.96 |
| 310 | Capital District Physicians' Health Plan (CDPHP) (Hudson Valley) | 197.09 | 552.27 | 297.26 | 652.44 | 393.35 | 393.35 | 1,198.71 | 2,772.11 |
| 050 | EmblemHealth – HIP (Downstate) | 166.58 | 622.67 | 279.20 | 735.29 | 455.71 | 455.71 | 1,292.73 | 3,115.56 |
| 220 | EmblemHealth – HIP (Capital) | 356.94 | 778.56 | 457.09 | 878.71 | 479.51 | 479.51 | 1,358.42 | 3,276.47 |
| 350 | EmblemHealth – HIP (Hudson Valley) | 357.12 | 1,022.19 | 451.18 | 1,116.25 | 457.48 | 457.48 | 1,297.64 | 3,127.58 |
| 067 | Highmark Blue Cross Blue Shield | 0.00 | 323.42 | 88.68 | 412.10 | 323.42 | 323.42 | 886.84 | 2,180.53 |
| 069 | Highmark Blue Shield | 0.00 | 341.93 | 93.32 | 435.25 | 341.93 | 341.93 | 933.17 | 2,300.91 |
| 072 | HMOBlue (Central New York Region) | 0.00 | 343.27 | 95.95 | 439.22 | 343.27 | 343.27 | 959.50 | 2,332.58 |
| 160 | HMOBlue (Utica Region) | 0.00 | 386.56 | 100.42 | 486.98 | 386.56 | 386.56 | 1,004.18 | 2,550.43 |
| 059 | Independent Health | 0.00 | 325.30 | 90.27 | 415.57 | 325.30 | 325.30 | 902.74 | 2,203.93 |
| 058 | MVP Health Care (Rochester) | 0.00 | 282.70 | 87.09 | 369.79 | 282.70 | 282.70 | 870.86 | 2,001.67 |
| 060 | MVP Health Care (East) | 0.00 | 297.67 | 91.63 | 389.30 | 297.67 | 297.67 | 916.35 | 2,107.03 |
| 330 | MVP Health Care (Central) | 15.79 | 337.12 | 117.02 | 439.93 | 337.12 | 337.12 | 1,028.05 | 2,376.54 |
| 340 | MVP Health Care (Mid-Hudson) | 36.16 | 340.84 | 136.31 | 444.61 | 340.84 | 340.84 | 1,037.62 | 2,400.99 |
| 360 | MVP Health Care (North) | 0.00 | 326.68 | 100.12 | 426.80 | 326.68 | 326.68 | 1,001.16 | 2,307.89 |