Beginning July 1, thousands of members will feel the sting of sharply rising health coverage costs.

Steep increases in premium copayments will hit members and non-Medicare eligible retirees in nine out of the 12 health care plans offered by the city. The hikes do not affect subscribers in the GHI, HIP and DC 37 Med Team/Choice plans, which do not charge premium copays for their basic plans.

The DC 37 Health and Security Plan will assist members and retirees who experience financial hardships to switch their coverage, said the plan's new administrator, Rosaria R. Esperon.

Ordinarily, the city lets subscribers change plans only during a period in the fall. But this year, the Municipal Labor Committee, an umbrella group of unions representing 300,000 public workers, convinced the city to make an exception because of the magnitude of the rate hikes.

"We are very concerned that our members don't remain stuck in a plan with a rate increase that wreaks havoc on their family budget," Ms. Esperon said. "We expressed that concern to the city, and it agreed to be flexible about letting people change plans."

Health care cost inflation, again topping 10 percent a year, caused the premium increases. Health insurers are asking an increase of over 20 percent next year.

"After several years of fairly reasonable increases, we are seeing the beginning of a cycle of double-digit increases," said Associate Administrator Abe Steinberg. "Unfortunately, we don't see this situation getting better anytime soon."

Rates are going up by as much as 300 percent.

Cigna Healthcare is increasing its premium copays from an average monthly payment of $4.23 for individuals and $52 for families in fiscal year 2002 to $17.65 and $91 in fiscal year 2003, which begins July 1. Aetna HMO is boosting its monthly copayments from an average of $28.26 for individuals and $77.54 for families in 2002 to $46.60 and $123.86.

Under an agreement between the city and the municipal unions, city funding for all plans is set by the state-approved HIP/HMO rate, which is the amount that the Health Insurance Plan of Greater New York charges for each enrolled individual. Participants in health-care plans whose basic premium is greater than the HIP/HMO rate have to make up the difference through payroll and pension deductions of their premium copayments.

Members and retirees in the plans that will raise rates will feel the impact of medical inflation even more intensely this year because they were paying artificially low premiums in April, May and June to compensate for excessive copayments they had made over the previous nine months.

— Gregory N. Heires