RENSSELAER COUNTY HEALTH INSURANCE COSTS: January 1, 2017

NON-MEDICARE ELIGIBLE RETIREES

Rensselaer County 2017 Plan Options and Monthly Premiums

Coverage NYSHIP Empire Plan CDPHP HMO MVP HMO CO Plan 20 Empire Blue Cross Direct HMO
Single $944.39 $694.00 $720.91 $1,017.22
Two Person $2,160.64 $1,388.00 $1,658.09 $1,983.60
Family $2,160.64 $1,804.40 $1,766.23 $2,949.68

Plan Benefit Highlights

Coverage NYSHIP Empire Plan CDPHP HMO MVP HMO CO Plan 20 Empire Blue Cross Direct HMO
In Network  
Doctor Co-Pay $20 $25 $25 $25
Specialist Co-Pay $20 $25 $40 $25
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% 0 $500 0

Retiree Monthly Share of Premium

Coverage NYSHIP Empire Plan CDPHP HMO MVP HMO CO Plan 20 Empire Blue Cross Direct HMO
Single $472.20 $347.00 $360.46 $508.61
Two Person $1,262.76 $798.10 $969.62 $1,136.76
Family $1,262.76 $1,068.76 $1,039.91 $1,764.71

1. The County pays a partial amount for health insurance coverage for eligible retirees. The County pays 50% of the premium for the retiree and 35% of the additional premium to cover a spouse or other dependents.

2. Surviving spouses who continue coverage must pay the full monthly premium for the coverage they have.

3. The retiree shares listed above are either paid directly to the County by the retiree or deducted from his/her sick leave bank.