County of Orange � Division of Risk Management Michael T. Morris Risk Management Officer 18 Seward Avenue Middletown, New York 10940 Tel: (845) 615-3600 OCTOBER 7, 2008 PLEASE POST and CIRCULATE Important Benefits Alert For GHI HMO Enrollees There will be an additional Payroll Deduction for Family Coverage Based on current 2009 Empire Plan rate projections, GHI Family Coverage will cost an additional $16.62 per pay period. This excess premium amount will be in addition to any bi-weekly payroll health contributions you are currently required to make. Even if you do not pay anything for your HMO coverage now, you will have to pay the excess premium amount, as noted in the Estimated Additional Payroll Deduction box. GHI HMO Empire Plan Estimated Premium GHI HMO Premium Estimated Monthly Difference in Rate Estimated Additional Payroll Deduction Individual $632.23 537.81 00.00 $00.00 Family $1.345.88 1,381.89 36.01 $16.62 The Final Empire Plan premiums must be approved by the New York State Budget Division and will not be available until early November. If the rates are adjusted downward, the GHI Family excess premium will increase. IF YOU DO NOT WANT TO PAY THE INCREASED COST FOR YOUR HMO COVERAGE, YOU MUST SWITCH TO THE EMPIRE PLAN WHICH REQUIRES ONLY THE PAYROLL AMOUNT YOU CURRENTLY HAVE TO PAY BY CONTRACT, IF ANY. OPEN ENROLLMENT ENDS 10/31/08.