HMO-CNY - Syracuse/Binghamton/Elmira areas

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General Information

Plan Name:	HMO-CNY
Service Area:	Syracuse/Binghamton/Elmira areas
Brochure:	PDF Version
Brochure:	Text Version
NCQA Accreditation:	Yes
JCAHO Accreditation:	No
URAC Accreditation:	No
Plan Type:	HMO
Enrollment Code-Self:	EB1
Enrollment Code-Self & Family:	EB2
Link to Plan Home Page:	http://www.bcbscny.org
Telephone:	800/828-2887
Summary results of the 2001 consumers assessment of health plans survey

Benefits

Doctor Care/ Primary Office Visits:	$10
Hospital Inpatient Room and Board Charges:	None
RX/ Generic/ Retail:	$5
RX/ Brand/ Retail:	$20
RX/ Brand/ NonFormulary:	$35

Rates

Non-Postal
___Biweekly	Self: $33.84	Self: & Family: $125.86
___Monthly	Self: $73.32	Self: & Family: $272.69
___Twice Biweekly	Self: $67.68	Self: & Family: $251.72
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Annuitants
___Monthly	Self: $73.32	Self: & Family: $272.69
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U.S. Postal Service Employees (Type A)
___Biweekly	Self: $16.18	Self: & Family: $85.52
___Monthly	Self: $35.06	Self: & Family: $185.29
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U.S. Postal Service Employees (Type B)
___Biweekly	Self: $22.47	Self: & Family: $114.13
___Monthly	Self: $48.68	Self: & Family: $247.28
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Worker's Compensation Recipients
___Twice Biweekly	Self: $67.68	Self: & Family: $251.72
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Certain Temporary Employees
___Biweekly	Self: $131.70	Self: & Family: $349.27
___Monthly	Self: $285.35	Self: & Family: $756.75
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Former Spouse Enrollees
___Monthly	Self: $285.35	Self: & Family: $756.75
___Biweekly	Self: $131.70	Self: & Family: $349.27
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Temporary Continuation of Coverage
___Monthly	Self: $291.06	Self: & Family: $771.89
___Biweekly	Self: $134.33	Self: & Family: $356.26
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FDIC
___Biweekly	Self: $16.18	Self: & Family: $85.52
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