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Medicare lawsuit causes mid-year shift in NYSHIP
premium rates
By SHERRY HALBROOK
As reported in February, the courts have forced the state to stop adding the
expense for Medicare Part B premium reimbursements to the NYS Health Insurance
Program premium rates and to reimburse the NYSHIP enrollees for that improper
expense they incurred last year.
As a result, the state is changing the 2007 NYSHIP premium rates effective April
1 of this year. These rate changes will be reflected in paycheck deductions
processed March 29 for employees on the Institution payroll and April 4 for
those on the administration payroll.
For most PS&T unit employees, including those enrolled in the Empire Plan, their
biweekly premium contribution will decrease. And later this year, these
individuals will be reimbursed up to $91 for their overpayments during 2006 and
the first quarter of 2007.
However, for employees enrolled in HMOs with premiums more costly than those of
the Empire Plan the biweekly premium contribution will increase. That’s because
the state’s payment share of HMO premiums cannot be greater than its share of
the Empire Plan’s premium.
Since the premium rates established late last year for 2007 included the cost of
the Medicare Part B component, the premium for the Empire Plan was higher than
it should have been. That resulted in the state paying too large a share of the
premium for employees enrolled in those HMOs that cost more than the Empire
Plan.
If you are in that group now faced with higher rates than you bargained for, the
state sent you a letter in late February alerting you of an opportunity to
change health plans, but you had to do it by March 30.
And you will not have to pay the state back for the money it spent picking up
too large a share of your premiums last year.
PEF, and others in the coalition that brought the lawsuit, successfully argued
that would not be fair, since it was not your fault. The state was responsible
for the error.
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The Communicator April
2007
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