NYSHIP Update

On Thursday, November 8, 2018, an ASBO New York representative attended the Participating Agency Advisory Council meeting to review the third quarter experience and other changes relative to NYSHIP. ASBO is happy to report that calendar year 2019 aggregate increases are expected to be 0.7% (that’s not a typo) for the Empire Plan and 2.6% for the Excelsior Plan. It is important to stress that these are aggregate increases. Actual premiums for each of the different categories of coverage have been submitted to the Division of Budget for approval and are expected to be out within the next couple of weeks. In addition, business officials are reminded that the NYSHIP premiums are based on a calendar year, so do not forget to account for an increase for the 2020 calendar year when preparing your budget. 

The lower than anticipated increases are largely due to four factors:

1. Lower rates for prescription medicines – NYSHIP recently issued an RFP for pharmacy benefit managers and CVS Caremark submitted a proposal which was very favorable and included better pricing for medicines and greater rebates

2. Programmatic benefit changes related to an increase in copays, deductibles and maximum out of pocket expenses

3. Better than expected trend projections for future cost increases

4. The final reconciliation of prior year accruals verses actual expenses – 2017 actual expenses were lower than the projected accruals for incurred but not reported claims thereby resulting in a return of funds as a dividend

It is very important to note that Empire Blue Cross Blue Shield is currently in contract negotiations with NY Presbyterian Hospitals (there are many hospitals in the NY area which are affiliated with NY Presbyterian).  The current contract is set to expire on December 31, 2018.  Notifications will be sent out by NYSHIP to members in the event that the negotiations do not result in the renewal of a contract.