RENSSELAER COUNTY

Health Insurance Costs - January 1, 2019

For Employees Hired On or After 11/13/2014

Full Monthly Premium Rates

Coverage CDPHP HMO MVP HMO Empire Blue Cross Direct HMO
Single $765.25 $807.39 $979.51
Two Person $1,532.18 $1,857.74 $1,911.90
Family $1,989.44 $1,978.37 $2,839.18

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

Coverage CDPHP HMO MVP HMO Empire Blue Cross Direct HMO
Single $88.30 $93.16 $113.02
Two Person $176.79 $214.35 $220.60
Family $229.55 $228.27 $327.60

If you have Family Dental Coverage the bi-weekly cost will be $24.86 for 2019. 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 $2,295.75 $2,422.17 $2,938.53
Two Person $4,596.54 $5,573.22 $5,735.70
Family $5,968.32 $5,935.11 $8,517.54

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 2019. 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.