| Code | Plan | Monthly NY Young Adult Rates |
|---|---|---|
| 001 | The Empire Plan |
A: 609.56 B: 618.45 C: 609.56 D: 639.67 |
| 210 | Aetna | 808.02 |
| 066 | Blue Choice | 459.61 |
| 067 | BlueCross BlueShield of Western New York | 594.73 |
| 063 | Capital District Physicians’ Health Plan (CDPHP) | 556.95 |
| 300 | Capital District Physicians’ Health Plan (CDPHP) | 642.99 |
| 310 | Capital District Physicians’ Health Plan (CDPHP) | 625.03 |
| 280 | Empire BlueCross BlueShield HMO (Upstate) | 587.90 |
| 290 | Empire BlueCross BlueShield HMO (Downstate) | 752.54 |
| 320 | Empire BlueCross BlueShield HMO (Mid-Hudson) | 756.71 |
| 220 | GHI HMO | 620.69 |
| 350 | GHI HMO | 640.60 |
| 050 | HIP Health Plan of New York | 682.30 |
| 072 | HMOBlue Excellus BlueCross BlueShield (Central New York Region) | 775.99 |
| 160 | HMOBlue Excellus BlueCross BlueShield (Utica Region) | 783.75 |
| 059 | Independent Health | 599.90 |
| 060 | MVP Health Care (East) | 548.08 |
| 330 | MVP Health Care (Central) | 613.06 |
| 340 | MVP Health Care (Mid-Hudson) | 608.06 |
| 360 | MVP Health Care (North) | 722.34 |
| 058 | MVP Health Care (Rochester) | 503.32 |
Rates Effective January 1, 2013
A: For young adult children of employees of the State of New York Executive Branch who are Management/Confidential, employees of the Legislature, employees of the Unified Court System (UCS), represented by CSEA, represented by Public Employees Federation (PEF), represented by Council 82, represented by NYSCOPBA and APSU Employees represented by PBANYS.
B: For young adult children of employees of the State of New York Executive Branch who are represented by District Council 37 (DC-37), Police Benevolent Association (PBA) (Supervisors or Troopers), Police Investigators Association (PIA) or United University Professors (UUP).
C: For young adult children of Retirees, Vestees and Dependent Survivors of the State of New York.
D: For young adult children of employees of the State of New York Executive Branch in lifeguard titles represented by United University Professors (UUP).