RENSSELAER COUNTY

Health Insurance Costs - January 1, 2021

For Employees Hired Prior to 1/1/2018 and After 9/28/2006

Full Monthly Premium Rates

Coverage CDPHP HMO MVP HMO Empire Blue Cross EPO
Single $836.65 $868.52 $1,168.77
Two Person $1,678.98 $1,998.33 $2,280.94
Family $2,180.29 $2,128.15 $3,388.50

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

Coverage CDPHP HMO MVP HMO Empire Blue Cross EPO
Single $77.41 $80.17 $107.89
Two Person $154.98 $184.46 $210.55
Family $201.26 $196.44 $312.78

If you have Family Dental Coverage the bi-weekly cost will be $24.86 for 2021. There is no payroll deduction for individual dental coverage.

Employee Annual Share of Premium Cost at 20%

Coverage CDPHP HMO MVP HMO Empire Blue Cross EPO
Single $2,012.76 $2,084.45 $2,805.05
Two Person $4,029.55 $4,795.99 $5,474.26
Family $5,232.70 $5,107.56 $8,132.40

Plan Benefit Highlights

Coverage CDPHP HMO MVP HMO Empire Blue Cross EPO
In Network  
Doctor Co-Pay $25.00 $25.00 $25.00
Specialist Co-Pay Same as above $40.00 $25.00
Drug Co-Pay $10G/$25B/$40NF $10G/$30B/$50NF $10G/$25B/$50NF
Inpatient Co-Pay 0 $500 $100
Out of Network  
Deductible NA NA NA
Coinsurance NA NA NA
Inpatient Co-Pay 0 $500 0

*The payroll deduction for family dental coverage will be $24.86 for 2021. 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.

Plan information, including summaries of benefits and coverage (SBC) and links to health plan websites, can be found here.

*** 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.