2018 COVERED LIVES/ASSESSMENTS/SURCHARGES

REGION	COUNTIES	2018 INDIVIDUAL COVERED LIVES ANNUAL ASSESSMENT	2018 FAMILY COVERED LIVES ANNUAL ASSESSMENT	2018 ALTERNATIVE PER UNIT OF PYMT SURCHARGE ∗
New York City	Bronx Kings New York Queens Richmond	$168.33	$555.48	27.28%
Long Island	Nassau Suffolk	$59.81	$197.37	13.89%
Northern Metro	Columbia Delaware Dutchess Orange Putnam Rockland Sullivan Ulster Westchester	$34.50	$113.86	9.31%
Northeastern	Albany Clinton Essex Fulton Greene Montgomery Rensselaer Saratoga Schenectady Schoharie Warren Washington	$39.51	$130.38	8.42%
Utica/Watertown	Chenango Franklin Hamilton Herkimer Jefferson Lewis Madison Oneida Oswego Otsego St. Lawrence	$8.32	$27.47	2.25%
Central	Broome Cayuga Chemung Cortland Onondaga Schuyler Steuben Tioga Tompkins	$54.99	$181.46	9.57%
Rochester	Livingston Monroe Ontario Seneca Wayne Yates	$102.92	$339.63	18.62%
Western	Allegany Cattaraugus Chautauqua Erie Genesee Niagara Orleans Wyoming	$36.80	$121.43	6.78%

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