RENSSELAER COUNTY

Health Insurance Costs - January 1, 2018

For Employees Hired Prior to 9/28/2006

Full Monthly Premium Rates

Coverage NYSHIP EMPIRE PLAN CDPHP HMO MVP HMO Empire Blue Cross Direct HMO
Single $1,018.12 $733.60 $791.27 $1,014.89
Two Person $2,356.11 $1,468.88 $1,820.66 $1,980.89
Family $2,356.11 $1,907.16 $1,938.88 $3,190.57

*** Employee Bi-Weekly Share of Premium Cost at 20% ***

Coverage NYSHIP EMPIRE PLAN CDPHP HMO MVP HMO Empire Blue Cross Direct HMO
Single $93.98 $67.72 $73.04 $93.68
Two Person $217.49 $135.59 $168.06 $182.85
Family $217.49 $176.05 $178.97 $294.51

If you have Family Dental Coverage the bi-weekly cost will be $24.86 for 2018. There is no payroll deduction for individual dental coverage.

Employee Annual Share of Premium Cost at 20%

Coverage NYSHIP EMPIRE PLAN CDPHP HMO MVP HMO Empire Blue Cross Direct HMO
Single $2,443.49 $1,760.64 $1,899.05 $2,435.74
Two Person $5,654.66 $3,525.31 $4,369.58 $4,754.14
Family $5,654.66 $4,577.18 $4,653.31 $7,657.37

Plan Benefit Highlights

Coverage NYSHIP EMPIRE PLAN CDPHP HMO MVP HMO Empire Blue Cross Direct HMO
In Network  
Doctor Co-Pay $20.00 $25.00 $25.00 $25.00
Specialist Co-Pay $20.00 $25.00 $40.00 $25.00
Drug Co-Pay $5G/$25B/$45NF $10G/$25B/$40NF $10G/$30B/$50NF $10G/$25B/$50NF
Inpatient Co-Pay 0 0 $500 0
Out of Network  
Deductible $1,000 NA NA NA
Coinsurance 20% NA NA NA
Inpatient Co-Pay 10% NA $500 NA

*The payroll deduction for family dental coverage will remain at $24.86 for 2018. There is no payroll deduction for individual dental coverage.*

NOTE-THE EMPLOYEE SHARE LISTED ABOVE IS FOR FULL-TIME EMPLOYEES. IF YOU ARE NOT A FULL-TIME EMPLOYEE, THE HEALTH INSURANCE COVERAGE WILL COST YOU MORE, DEPENDING UPON THE NUMBER OF HOURS WORKED PER WEEK.

ONLY EMPLOYEES HIRED PRIOR TO 9/28/06 ARE ELIGIBLE TO ENROLL IN THE NYSHIP PLAN.

*** ANY PAYROLL DEDUCTIONS THAT ARE REQUIRED FOR ANY COVERAGE YOU ELECT WILL COME OUT OF YOUR PAYCHECK THE PAY-PERIOD BEFORE THE COVERAGE IS EFFECTIVE.