2009 COVERED LIVES/ASSESSMENTS/SURCHARGES

REGION COUNTIES 2009 INDIVIDUAL COVERED LIVES ANNUAL ASSESSMENT 2009 FAMILY COVERED LIVES ANNUAL ASSESSMENT 2009 ALTERNATIVE PER UNIT OF PYMT SURCHARGE ∗
New York City Bronx
Kings
New York
Queens
Richmond
$185.93 $613.56 27.28%
Long Island Nassau
Suffolk
$ 56.14 $185.26 13.89%
Northern Metro Columbia
Delaware
Dutchess
Orange
Putnam
Rockland
Sullivan
Ulster
Westchester
$ 32.74 $ 108.03 9.31%
Northeastern Albany
Clinton
Essex
Fulton
Greene
Montgomery
Rensselaer
Saratoga
Schenectady
Schoharie
Warren
Washington
$ 36.42 $120.19 8.42%
Utica/Watertown Chenango
Franklin
Hamilton
Herkimer
Jefferson
Lewis Madison
Oneida
Oswego
Otsego
St. Lawrence
$ 7.61 $ 25.11 2.25%
Central Broome
Cayuga
Chemung
Cortland
Onondaga
Schuyler
Steuben
Tioga
Tompkins
$ 48.03 $158.51 9.57%
Rochester Livingston
Monroe
Ontario
Seneca
Wayne
Yates
$ 92.24 $304.40 18.62%
Western Allegany
Cattaraugus
Chautauqua
Erie
Genesee
Niagara
Orleans
Wyoming
$ 34.77 $114.75 6.78%

∗ This would be in addition to the surcharges reflected in Attachment 4.