RENSSELAER COUNTY

Health Insurance Costs - January 1, 2018

For Employees Hired On or After 11/13/2014

Full Monthly Premium Rates

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

** Employee Bi-Weekly Share of Premium Cost at 25% **

Coverage CDPHP HMO MVP HMO Empire Blue Cross Direct HMO
Single $84.65 $91.30 $117.10
Two Person $169.49 $210.08 $228.56
Family $220.06 $223.72 $368.14

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 25% **

Coverage CDPHP HMO MVP HMO Empire Blue Cross Direct HMO
Single $2,200.80 $2,373.81 $3,044.67
Two Person $4,406.64 $5,461.98 $5,942.67
Family $5,721.48 $5,816.64 $9,571.71

Plan Benefit Highlights

Benefit CDPHP HMO MVP HMO Empire Blue Cross Direct HMO
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 0
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 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.

*** 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.