Dear Chief Executive Officer: GME Regional Covered Lives Assessment Rates

October 28, 2022

Dear Chief Executive Officer:

The enclosed schedule provides updated 2022 Regional Covered Lives Assessment (CLA) rates to reflect the $40 million increase in CLA to support Early Intervention (EI) programs and costs.

Pursuant to the changes implemented in Chapter 820 of the Laws of 2022, CLA rates are increased retroactive to April 1, 2022.  This will be implemented in two parts.

  • Prospective rates will be increased effective with the October 2022 CLA reporting period. This change will be effectuated through the Office of Pool Administration (OPA) portal and standard monthly reporting process.
  • Retroactive adjustments for the April 2022 - September 2022 reporting months will be rolled out via the OPA portal no later than November 23, 2022. From this rollout date, remitters will have 90 days to submit the total retroactive amount due (i.e., no later than February 21, 2023).
  • Retroactive adjustments will be tied to previously submitted reports. Remitters will not need to refile reports if they were previously submitted and paid. Additional details will be forthcoming in November regarding this process through another New York State Department of Health notification.

Please note that this $40 million increase is being implemented as an incremental increase over the previously approved rates.

This notice has been sent to you because your organization is an electing payor under the New York State’s Health Care Reform Act (HCRA) Pools, paying and reporting directly to the HCRA Public Goods Pool. If you use a third-party administrator (TPA), the Department suggests that you contact your TPA directly concerning any questions you may have regarding this notice.

Others having questions regarding these rates should contact a HCRA representative at


Michael Spitz Bureau Director

Division of Finance and Rate Setting Office of Health Insurance Programs