Benetech

RENSSELAER COUNTY HEALTH INSURANCE COSTS:  JANUARY 1, 2021

NON-MEDICARE ELIGIBLE RETIREES

Rensselaer  County 2021 Plan Options and Monthly Premiums

CoverageNYSHIP Empire PlanCDPHP HMOMVP HMO CO Plan 20Empire BCBS EPO
Single$1,074.87$835.51$865.38$1,165.63
Two Person$2,452.24$1,671.02$1,990.37$2,272.98
Family$2,452.24$2,172.33$2,120.19$3,380.54
Plan Benefit Highlights

CoverageNYSHIP Empire PlanCDPHP HMOMVP HMO CO Plan 20Empire BCBS EPO
In Network




Doctor Co-Pay
$25$25$25$25
Specialist Co-Pay
$25$25$40$25
 Drug Co-Pay
 $5G/$30B/$60NF $10G/$25B/$40NF $10G/$30B/$50NF $10G/$25B/$50NF
 Inpatient Co-Pay
$0 $0$500$100
Out of Network
 Deductible$1,250 NANANA
 Coinsurance20% NANANA
 Inpatient Co-Pay
10% $0$500$0
Retiree Monthly Share of Premium

CoverageNYSHIP Empire PlanCDPHP HMOMVP HMO CO Plan 20Empire BCBS EPO
Single$537.44$417.76$432.69$582.82
Two Person$1,432.73$960.84$1,163.93$1,302.59
Family$1,432.73$1,286.69$1,248.32$2,022.51