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RETIREE HEALTH INSURANCE COPAYMENT CLARIFICATION

We apologize for the confusion regarding the increase in health insurance copays outlined in the recent e-Communicator article.

PEF Retirees along with PEF and other organizations advocate for Retiree issues. Unfortunately, the State can change the Empire Plan copays for retirees without our consent. We will continue to advocate for everything that we think that we should receive, but we have little leverage to overturn the Governor’s decision on this.

The office visit copay for retirees is now $25. While active PEF-represented state employees are protected from copay increases by the 2016-2019 PS&T Contract, this is not the case for retirees.
Regrettably, the State chose to extend certain Empire Plan benefit changes negotiated by CSEA, UUP, DC37, and the PBA to all NYS agency retirees, vestees, dependent survivors and enrollees covered under preferred list provisions. In December, you should have received the Empire Plan At A Glance publication for state agency retirees. This publication notified retirees of all the benefit changes that were going to occur effective January 1, 2019. You can view or download this publication here: https://www.cs.ny.gov/employee-benefits/nyship/shared/publications/at-a-glance/2019/retiree-ny-aag-jan-2019.pdf.

As a result of the benefit changes the State implemented for retirees, the Empire Plan rates for those who retired on or after 1/1/12 in titles SG10 or higher only increased by 0.4% (53cents/month) for Individual coverage and 0.9% ($4.42/month) for Family coverage. The percentage increases of 0.4% and 0.9% are the same for those who retired between 1/1/83 and 12/31/11, regardless of salary grade. In other words, the premiums for retirees increased by a lower percentage than they would have increased had the benefit changes not been made.

While the copays for active PEF-represented state employees stayed the same, the premium increase from 2018 to 2019 was higher than it was for those bargaining units that agreed to the higher copays as well as for state agency retirees. The Empire Plan rates for active PEF-represented state employees increased by 1.7% for Individual coverage and 2.2% for Family.

To find the most up-to-date information about your health insurance coverage, go to www.cs.ny.gov and select Retirees and then Health Benefits. You may also call the NYS Dept. of Civil Service Employee Benefits Division Call Center at 518-457-5754 or 1-800-833-4344 (United States, Canada, Puerto Rico, Virgin Islands) Monday through Friday, between 9 a.m. and 4 p.m. Eastern time.