Updates to Covered Lives Assessment Rates for 2026
January 8, 2026
This notice has been sent to you because your organization is an electing payor, paying and reporting, directly to the Health Care Reform Act (HCRA) Public Goods Pool. The enclosed provides updated regional Covered Lives Assessment (CLA), and alternative inpatient surcharge, rates for the 2026 calendar year. For reporting purposes, these amounts will be reflected in the 2026 service year portion of the Payor Report for Covered Lives Assessment and the Hospital Report of Patient Services Revenues for Inpatient Services.
Pursuant to sections 2807-s and 2807-t of Public Health Law, CLA rates have been adjusted from the 2025 rates based on:
- Finalized CY 2024 CLA collections;
- Finalized CY 2024 covered lives enrollment;
- Regional allocations; and,
- Prior period adjustments.
Additionally, since 2022, included in the rates, is a $40 million increase to the annual CLA collection target, for early intervention services.
If you have any questions regarding these rates please contact a HCRA representative at webpools@hcrapools.org.If you use a third-party administrator (TPA), we suggest that you contact your TPA directly concerning any questions you may have regarding this notice.
Sincerely,
Emily Hoops-Darling Bureau Director
Division of Finance and Rate Setting
Office of Health Insurance Programs
