Page 17 - Work Force December 2025

NYSHIP health plan choices for 2026
Now is the time for New York state
employees to compare NYSHIP
health plans if you are considering
changing your health insurance
option for the 2026 plan year.
Consider your choices carefully.
During the annual option transfer
period, health insurance
options may be changed
for any reason.
Changes may be
made outside
the designated
option transfer
period only
under certain
circumstances,
described in the
NYSHIP General
Information Book.
The NYSHIP official
annual option transfer
period will be held after
rates are approved; dates have not
yet been announced.
Selecting a health insurance
plan for you and your family is an
important and personal decision;
only you know your family’s
lifestyle, health, budget and benefit
preferences. An important step
toward making the best choice for
you and your family is to understand
the NYSHIP options and how they
may differ.
The 2026 Health Insurance
Choices guide has been sent to state
agencies. The Choices guide includes
a summary of The Empire Plan
and each of the NYSHIP health
maintenance organizations
(HMO). Current NYSHIP
HMO enrollees
are encouraged
to familiarize
themselves with
the side-by-side
comparison of
2025-26 benefits
sent by the HMO.
If you are thinking
of changing options,
also familiarize yourself
with other health plans
available in your area. Please
note that several of the NYSHIP
HMOs have made changes to the
required employee out-of-pocket
costs (copayments) for 2026.
New York state also offers a plan
comparison tool (updated annually
to reflect new rates) to assist by
creating a side-by-side comparison of
the benefits provided by each of the
NYSHIP plans in your area. To make
a comparison, go to nyship.ny.gov
and enter your group and plan if
prompted. From the NYSHIP online
home page, select Health Benefits
& Option Transfer. Click on Rates
and Health Plan Choices, and then
NYSHIP Plan Comparison. You can
select the counties in which you live
or work. A listing of available health
plans will appear, and you can check
the box next to the plans you want
included in the comparison.
As this edition went to press, the
2026 NYSHIP premium rates had not
yet approved. Once approved, the
2026 NYSHIP health plan rates will be
mailed and posted on NYSHIP Online.
Included in the rate flyer will also
be important dates and deadlines,
as well as information on when any
changes to health insurance payroll
deductions will occur.
PTCP election period
The Pre-Tax Contribution Program
(PTCP) election period for Executive
Branch state employees runs
concurrent with the annual option
transfer period. PTCP is a voluntary
program that allows employees to
have their share of health insurance
OCTOBER 2025
HEALTH INSURANCE
CHOICES
FOR 2026
For employees of NYS and Participating
Employers, covered dependents,
COBRA enrollees with NYSHIP benefits
and Young Adult Option enrollees
New York State Department of Civil Service, Employee Benefits Division, Albany, New York 12239 • cs.ny.gov/employee-benefits
Negotiation update: Empire Plan Hospital
Program and Mount Sinai facilities
Contract renewal negotiations
between Anthem, the
Empire Plan’s Hospital Program
administrator, and Mount Sinai in
downstate New York are underway.
Negotiations between health plans
and health systems are a routine
part of the health care industry.
The current contract with Mount
Sinai is due to expire effective Dec.
31, 2025. If Anthem does not reach
an agreement, the following Mount
Sinai hospitals will become out-
of-network with the Empire Plan
Hospital Program on March 1, 2026:
•
Mount Sinai Brooklyn
(Brooklyn)
•
•
•
•
•
•
The Mount Sinai Hospital
(Manhattan)
Mount Sinai Morningside
(Manhattan)
Mount Sinai Queens (Queens)
Mount Sinai South Nassau
(Oceanside)
Mount Sinai West
(Manhattan)
New York Eye and Ear
Infirmary of Mount Sinai
(Manhattan)
Anthem has advised they are
optimistic a new agreement with
Mount Sinai will be reached before
the current contract expires.
This situation does not impact
medically necessary emergency
services and does not impact any
services covered under The Empire
Plan’s Medical/Surgical Program,
administered by Unted Healthcare.
As noted, it is hopeful that an
agreement between Anthem and
Mount Sinai facilities will be reached
prior to any potential impact on
patients.
Any questions or request
for updates can be addressed
by calling 1-877-769-7447
(1-877-7-NYSHIP) and press or say 2
for the Hospital Program or visiting
anthembluecross.com/nys for
regular updates.
18 The Work Force premium deducted from their wages
before taxes are withheld, which
may lower tax liability. Per Internal
Revenue Service (IRS) rules, the
PTCP election period is the only
opportunity for employees to
change their PTCP status without a
qualifying event. If you wish to verify
your PTCP status, please review your
health insurance premium notice on
your paycheck.
•
If you are enrolled in PTCP,
your paycheck stub shows
“Regular Before-Tax Health.”
Your health insurance
premium is deducted from
your wages before taxes are
withheld.
•
If you are not enrolled in PTCP,
or part of your deduction is
taken after tax (for example,
if you have a non-federally
qualified dependent), your
paycheck stub shows “Regular
After-Tax Health.” Your health
insurance premium (or a
portion of) is deducted after
taxes are withheld.
No action is required if you wish to
keep your current health insurance
option or current PTCP election.
Once the official option transfer
period is announced, if you wish
to make changes to your NYSHIP
health insurance, complete and sign
all the necessary paperwork, keep
a copy for your records, and return
all required forms on time to your
agency health Benefits administrator.
December 2025