Young Adult Option Coverage for Employees and Retirees of Participating Employers

Monthly Young Adult Option Rates

For young adult children of Active and Retired Employees of Participating Employers

PE YAO
Monthly Premium

Code

Plan

Individual

001

The Empire Plan

1,090.54

066

Blue Choice

818.86

063

Capital District Physicians’ Health Plan (CDPHP) (Capital)

936.76

300

Capital District Physicians’ Health Plan (CDPHP) (Central)

1,038.44

310

Capital District Physicians’ Health Plan (CDPHP) (Hudson Valley)

1,198.71

050

EmblemHealth – HIP (Downstate)

1,292.73

220

EmblemHealth – HIP (Capital)

1,358.42

350

EmblemHealth – HIP (Hudson Valley)

1,297.64

067

Highmark Blue Cross Blue Shield of Western New York

886.84

069

Highmark Blue Shield of Northeastern New York

933.17

072

HMOBlue (Central New York Region)

959.50

160

HMOBlue (Utica Region)

1,004.18

059

Independent Health

902.74

058

MVP Health Care (Rochester)

870.86

060

MVP Health Care (East)

916.35

330

MVP Health Care (Central)

1,028.05

340

MVP Health Care (Mid-Hudson)

1,037.62

360

MVP Health Care (North)

1,001.16