2021 COVERED LIVES/ASSESSMENTS/SURCHARGES

REGION COUNTIES 2021
INDIVIDUAL
COVERED LIVES
ANNUAL ASSESSMENT
2021
FAMILY
COVERED LIVES
ANNUAL ASSESSMENT
2021
ALTERNATIVE
PER UNIT OF
PYMT SURCHARGE ∗
New York City Bronx
Kings
New York
Queens
Richmond
$171.67 $566.52 27.28%
Long Island Nassau
Suffolk
$61.56 $203.14 13.89%
Northern Metro Columbia
Delaware
Dutchess
Orange
Putnam
Rockland
Sullivan
Ulster
Westchester
$35.44 $116.96 9.31%
Northeastern Albany
Clinton
Essex
Fulton
Greene
Montgomery
Rensselaer
Saratoga
Schenectady
Schoharie
Warren
Washington
$41.88 $138.21 8.42%
Utica/Watertown Chenango
Franklin
Hamilton
Herkimer
Jefferson
Lewis
Madison
Oneida
Oswego
Otsego
St. Lawrence
$9.20 $30.35 2.25%
Central Broome
Cayuga
Chemung
Cortland
Onondaga
Schuyler
Steuben
Tioga
Tompkins
$59.31 $195.72 9.57%
Rochester Livingston
Monroe
Ontario
Seneca
Wayne
Yates
$111.02 $366.36 18.62%
Western Allegany
Cattaraugus
Chautauqua
Erie
Genesee
Niagara
Orleans
Wyoming
$39.67 $130.91 6.78%

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