2017 Local NYS Health Insurance Program (NYSHIP) Rates Employee Health Insurance Deduction per Paycheck To enroll and/or remain in an HMO, you must live or work in the HMO's service area. If you no longer live or work in the NYSHIP Service area of the HMO in which you are enrolled, you must change to another plan. NYS Empire Plan (001) -CSEA, PEF, NYSCOPBA, PBANYS, M/C (06) in titles SG-09 & below -M/C (13) & UUP with annualized salaries equal to $41,756 or less -CSEA, PEF, NYSCOPBA, PBANYS, M/C (06) in titles SG-10 & above -M/C (13) & UUP with annualized salaries equal to $41,757 or more Individual Coverage Family Coverage $39.91 $175.53 $53.21 $208.92 Blue Choice (066)* -CSEA, PEF, NYSCOPBA, PBANYS, M/C (06) in titles SG-09 & below -M/C (13) & UUP with annualized salaries equal to $41,756 or less -CSEA, PEF, NYSCOPBA, PBANYS, M/C (06) in titles SG-10 & above -M/C (13) & UUP with annualized salaries equal to $41,757 or more Individual Coverage Family Coverage $34.49 $148.86 $45.99 $177.31 BlueCross BlueShield of WNY (067)* -CSEA, PEF, NYSCOPBA, PBANYS, M/C (06) in titles SG-09 & below -M/C (13) & UUP with annualized salaries equal to $41,756 or less -CSEA, PEF, NYSCOPBA, PBANYS, M/C (06) in titles SG-10 & above -M/C (13) & UUP with annualized salaries equal to $41,757 or more Individual Coverage Family Coverage $36.12 $155.52 $48.16 $185.25 Independent Health (059)* -CSEA, PEF, NYSCOPBA, PBANYS, M/C (06) in titles SG-09 & below -M/C (13) & UUP with annualized salaries equal to $41,756 or less -CSEA, PEF, NYSCOPBA, PBANYS, M/C (06) in titles SG-10 & above -M/C (13) & UUP with annualized salaries equal to $41,757 or more Individual Coverage Family Coverage $36.33 $155.04 $48.44 $184.73 MVP of Rochester (058)* -CSEA, PEF, NYSCOPBA, PBANYS, M/C (06) in titles SG-09 & below -M/C (13) & UUP with annualized salaries equal to $41,756 or less -CSEA, PEF, NYSCOPBA, PBANYS, M/C (06) in titles SG-10 & above -M/C (13) & UUP with annualized salaries equal to $41,757 or more Individual Coverage Family Coverage $37.21 $144.40 $49.39 $172.58
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