Young Adult Option Coverage for Employees and Retirees of New York State Agencies

Monthly Young Adult Rates

For young adult children of Active and Retired Employees of the State of New York.

Code Plan Monthly Young Adult Rates
001 The Empire Plan For employees of the State of New York who are represented by CSEA, DC-37, PBA, UUP; or employees of the Unified Court System (excluding Court Officers Benevolent Association of Nassau County [COBANC]) 776.66
For employees of the State of New York who are Management/Confidential; Legislature or represented by Council 82; NYSCOPBA; PBA-NYS; PEF; PIA; or UCS employees represented by COBANC 791.45
For retirees of the State of New York 781.81
066 Blue Choice 665.69
067 BlueCross BlueShield of Western New York 692.27
063 Capital District Physicians' Health Plan (CDPHP) (Capital) 735.77
300 Capital District Physicians' Health Plan (CDPHP) (Central) 857.13
310 Capital District Physicians' Health Plan (CDPHP) (Hudson Valley) 936.83
280 Empire BlueCross BlueShield HMO (Upstate) 894.93
290 Empire BlueCross BlueShield HMO (Downstate) 1,212.68
320 Empire BlueCross BlueShield HMO (Mid-Hudson) 1,255.68
050 HIP Health Plan of New York (Downstate) 952.76
220 HIP Health Plan of New York (Capital) 1,050.81
350 HIP Health Plan of New York (Hudson Valley) 1,050.81
072 HMOBlue (Central New York Region) 738.02
160 HMOBlue (Utica Region) 900.59
059 Independent Health 676.33
058 MVP Health Care (Rochester) 712.83
060 MVP Health Care (East) 727.36
330 MVP Health Care (Central) 829.64
340 MVP Health Care (Mid-Hudson) 817.04
360 MVP Health Care (North) 1,001.76