2005 COVERED LIVES/ASSESSMENTS/SURCHARGES

REGION COUNTIES 2005 INDIVIDUAL COVERED LIVES ANNUAL ASSESSMENT 2005 FAMILY COVERED LIVES ANNUAL ASSESSMENT 2005 ALTERNATIVE PER UNIT OF PYMT SURCHARGE ∗
New York City Bronx
Kings
New York
Queens
Richmond
$126.04 $415.94 26.98%
Long Island Nassau
Suffolk
$ 37.37 $123.32 13.73%
Northern Metro Columbia
Delaware
Dutchess
Orange
Putnam
Rockland
Sullivan
Ulster
Westchester
$ 21.70 $ 71.60 9.21%
Northeastern Albany
Clinton
Essex
Fulton
Greene
Montgomery
Rensselaer
Saratoga
Schenectady
Schoharie
Warren
Washington
$ 24.02 $ 79.28 8.33%
Utica/Watertown Chenango
Franklin
Hamilton
Herkimer
Jefferson
Lewis Madison
Oneida
Oswego
Otsego
St. Lawrence
$4.89 $ 16.13 2.22%
Central Broome
Cayuga
Chemung
Cortland
Onondaga
Schuyler
Steuben
Tioga
Tompkins
$ 32.38 $106.86 9.46%
Rochester Livingston
Monroe
Ontario
Seneca
Wayne
Yates
$ 61.51 $202.99 18.41%
Western Allegany
Cattaraugus
Chautauqua
Erie
Genesee
Niagara
Orleans
Wyoming
$ 21.25 $ 70.13 6.70%

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