(b) Rate of contribution. The rate of
contribution of New York State on account of the coverage of its employees,
post retirees and their dependents shall be 100 percent of the charge on
account of individual coverage and 75 percent of the charge on account of
dependent coverage, except that for the health maintenance organization options
the State's contribution shall not exceed the same dollar amount as is paid by
the State under the basic benefit plan. Effective October 1, 2011, for those
employees employed in a title allocated or equated to salary grade 9 or below,
the State's rate of contribution for such employees and their dependents
enrolled in the Empire Plan or a health maintenance organization shall be 88
percent of the charge on account of individual coverage and 73 percent of the
charge on account of dependent coverage; provided, however, that for
hospital/medical/mental health and substance abuse coverage provided under a
health maintenance organization, the State's rate of contribution shall not
exceed 100 percent of its dollar contribution for such coverage under the
Empire Plan. For employees employed in a title allocated or equated to salary
grade 10 or above, the State's rate of contribution for such employees and
their dependents enrolled in the Empire Plan or a health maintenance
organization shall be 84 percent of the charge on account of individual
coverage and 69 percent of the charge on account of dependent coverage,
provided, however, that for hospital/medical/mental health and substance abuse
coverage provided under a health maintenance organization, the State's rate of
contribution shall not exceed 100 percent of its dollar contribution for such
coverage under the Empire Plan. Effective October 1, 2011, the rate of
contribution on account of the coverage of post retirees shall be as follows:
(1) for retirees who retired on or after
January 1, 1983, and employees retiring prior to January 1, 2012, New York
State shall contribute 88 percent of the charge on account of individual
coverage and 73 percent of the charge on account of dependent coverage,
provided, however, that for hospital/medical/mental health and substance abuse
coverage provided under a health maintenance organization, the State's rate of
contribution shall not exceed 100 percent of its dollar contribution for such
coverage under the Empire Plan;
(2)
for employees retiring on or after January 1, 2012, from a title allocated or
equated to salary grade 9 or below, New York State shall contribute 88 percent
of the charge on account of individual coverage and 73 percent of the charge on
account of dependent coverage, provided, however, that for
hospital/medical/mental health and substance abuse coverage provided under a
health maintenance organization, the State's rate of contribution shall not
exceed 100 percent of its dollar contribution for such coverage under the
Empire Plan;
(3) for employees
retiring on or after January 1, 2012, from a title allocated or equated to
salary grade 10 or above, New York State shall contribute 84 percent of the
charge on account of individual coverage and 69 percent of the charge on
account of dependent coverage, provided, however, that for
hospital/medical/mental health and substance abuse coverage provided under a
health maintenance organization, the State's rate of contribution shall not
exceed 100 percent of its dollar contribution for such coverage under the
Empire Plan.
The rate of contribution of a participating employer on
account of the coverage of its employees, post retirees and their dependents
shall be not less than 50 percent of the charge on account of individual
coverage and 35 percent of the charge on account of dependent coverage. A
participating employer may elect to pay higher rates of contribution for the
coverage of its employees, retired employees and their dependents; provided,
however, that if a participating employer so elects to pay a higher or lower
rate of contribution for its retired employees or their dependents, or both,
than that paid by the State for its retired employees or their dependents, or
both, amounts withheld from the retirement allowances of its retired employees
for their share of premium or subscription charges, if any, shall, if the
president so requires, be paid to such participating employer which shall pay
into the health insurance fund the full cost of premium or subscription charges
for the coverage of such retired employees and their dependents; and provided
that notice of such election shall be furnished to the Department of Civil
Service not less than 60 days prior to the date on which it is proposed to make
such higher rate of contribution effective. The contributions payable by a
prior retiree shall be equal to the contributions payable by active employees
and post retirees having similar coverages; the employer's contributions shall
be the difference between the contributions of the prior retiree and the total
charges on account of coverage for such prior retiree. Notwithstanding the
foregoing provisions:
(i) An employee
on leave without pay, an employee or former employee receiving long-term
disability payments from a State income protection plan, or a vested employee
whose coverage is continued pursuant to this Part shall be required to pay the
entire charge (both employee's and employer's contributions) on account of such
coverage for each full pay period of absence or while having the status of a
vested employee, as the case may be. Provided, however, any vested employee who
is currently entitled to, but defers receipt of, a retirement allowance or
pension from a retirement or pension plan or system administered and operated
by the State of New York, or a civil division thereof, including the New York
State Teachers' Retirement System or under the optional retirement programs
established under article 3, part V, and article 8-B of the Education Law shall
pay only the employee share of the charge. In addition, an employer may elect
to continue the employer share of health insurance premiums for employees in
authorized leave without pay status for periods aggregating not more than two
years provided such payment is available to all members of a class or category
of employee, and the employer provides written notice of such election to the
Department of Civil Service at least 60 days prior to the date on which it is
proposed to make such payment available. Such payment may be extended an
additional two years by the State Civil Service Commission for good cause shown
and where the interests of the government would be served. Where payment has
been made for a period which aggregates two years, or for an additional two
year period where extended under this paragraph, no further extensions shall be
granted unless the employee returns to his or her position and serves
continuously therein for the six month period immediately preceding the
subsequent leave of absence.
(ii) A
covered prior retiree whose retirement allowance is suspended by virtue of his
further government employment in a capacity other than as an officer or
employee of the employer from whose service he retired shall be required to pay
the entire charge on account of such coverage for the period during which his
retirement allowance is suspended. If further government service is as an
officer or employee of the employer from whose service he retired, such
employer shall pay the required employer's contributions.
(iii) The employer shall pay the entire
charge for the coverage of dependents of a deceased employee for the period of
continued coverage provided in section
73.2(b)(1)
of this Part, following the period for which contributions for coverage of such
dependents were made by the employee.
(iv) Dependents of a deceased employee for
whom coverage is continued pursuant to section
73.2(b)(2)
of this Part, shall be required to pay the entire charge on account of such
coverage. The initial payment shall be required in advance of such coverage
and, thereafter, advance payments shall be required at such intervals as may be
prescribed by the President of the Civil Service Commission.
(v) Dependents of deceased State correction
officers or civilian employees of a correctional facility whose death occurred
as the result of injuries sustained during the period from September 9, 1971 to
September 13, 1971 whose coverage is continued pursuant to section
73.2(b)(2)
of this Part shall have the full cost of such coverage paid by the State;
provided, however, that in the case of those enrolled in an optional benefit
plan, the State shall contribute not more than the same dollar amount which
would be paid if such unremarried spouse and dependents were enrolled in the
basic Statewide health insurance plan and further provided that application for
continuation of such coverage is made prior to September 1, 1972.
(vi) The employer shall pay an additional sum
each month equal to the current monthly Federal Medicare charge as the
employer's share of the cost of coverage for each employee and dependent
covered under the health insurance plan who is 65 years of age or
older.
(vii) The unremarried spouse
and/or other dependents of a deceased employee who elect to continue coverage
in the plan as provided in section
73.2(b)(3)
of this Part shall be required to pay the entire charge (both employee's and
employer's contributions) on account of such coverage.
(viii) No participating employer shall be
required to pay the cost of premium or subscription charges for the coverage of
unpaid local elective officials or their dependents. Provided however, in
instances where there is no statute, local law, or ordinance or resolution
which expressly prohibits an unpaid local elective official from receiving
compensation and the participating employer elects to contribute toward such
premium or subscription charges, the participating employer's rate of
contribution shall be not less than 50 percent of the charge on account of
individual coverage and 35 percent of the charge on account of dependent
coverage. Post-retirees who continue coverage in the plan by virtue of having
served as unpaid local elective officials and who are expressly excluded from
compensation by statute, local law, ordinance or resolution, shall be required
to pay the entire charge (both the employee's and employer's contribution) on
account of such coverage.
(ix) The
post-retiree who continues coverage in the plan by virtue of 20 years' or more
service as a publicly elected school board member with a participating employer
shall be required to pay the entire charge (both employee's and employer' s
contribution) on account of such coverage.
