NYSHIP 2026 Premium Increase at 9.6% with Offset Benefits for State Employees

The New York State Health Insurance Program (NYSHIP) will see a 9.6% premium increase in 2026, reflecting broader trends in rising healthcare costs nationally. The premium rates are set by the Department of Civil Service, with unions negotiating the proportion of premiums paid by members. For 2026, individual coverage premiums will have members paying 16%, and family coverage requires 31% member contribution. This adjustment follows increases in related insurance sectors such as Medicare and the Affordable Care Act plans, which are also seeing significant premium hikes. The Public Employees Federation (PEF) leadership emphasized that these increases are widespread across New York State government and some municipal employees, not isolated to any single group. In response, PEF has promoted the Productivity Enhancement Program (PEP) which allows eligible employees to convert accrued leave time into credits to offset their health insurance premium contributions. This program's enrollment deadline is December 8, 2025, with credits varying based on salary grades to help mitigate the premium cost increases. Additionally, PEF members can leverage pre-tax Flexible Spending Accounts (FSAs) for healthcare and dependent care expenses, as well as an adoption account, with state contributions potentially adding $600 to $800. Enrollment for these accounts also closes December 8, 2025. For dental care, members in areas with limited Anthem dental providers can apply for the Limited Access Program, allowing out-of-network treatment reimbursed at in-network rates. The premium increase and these benefit adjustments highlight ongoing cost pressures within state employee health insurance plans, reflecting broader industry challenges. Negotiated measures like PEP and FSAs represent efforts to provide cost containment and financial relief options for members. The upward trend in premiums corresponds with national healthcare cost inflation trends, underscoring the regulatory and market challenges facing public sector health insurance in 2026.