2022 COVERED LIVES/ASSESSMENTS/SURCHARGES

REGION COUNTIES 2022
INDIVIDUAL
COVERED LIVES
ANNUAL ASSESSMENT
2022
FAMILY
COVERED LIVES
ANNUAL ASSESSMENT
2022
ALTERNATIVE
PER UNIT OF
PYMT SURCHARGE ∗
New York City Bronx $173.67 $573.12 27.28%
Kings
New York
Queens
Richmond
Long Island Nassau $61.92 $204.33 13.89%
Suffolk
Northern Metro Columbia $36.70 $121.10 9.31%
Delaware
Dutchess
Orange
Putnam
Rockland
Sullivan
Ulster
Westchester
Northeastern Albany $42.52 $140.30 8.42%
Clinton
Essex
Fulton
Greene
Montgomery
Rensselaer
Saratoga
Schenectady
Schoharie
Warren
Washington
Utica/Watertown Chenango $9.60 $31.69 2.25%
Franklin
Hamilton
Herkimer
Jefferson
Lewis
Madison
Oneida
Oswego
Otsego
St. Lawrence
Central Broome $62.16 $205.12 9.57%
Cayuga
Chemung
Cortland
Onondaga
Schuyler
Steuben
Tioga
Tompkins
Rochester Livingston $114.04 $376.33 18.62%
Monroe
Ontario
Seneca
Wayne
Yates
Western Allegany $41.57 $137.17 6.78%
Cattaraugus
Chautauqua
Erie
Genesee
Niagara
Orleans
Wyoming

∗ This would be in addition to the surcharges reflected in Patient Services Surcharges (Attachment 4).