2016 Plan Information for New York
Choose a Location, Employee Type, & Payment Period
Click to view Plan Information for this state
Location Specific Rates
| Contract | Enrollment Code | Enrollment Type | Option/Enrollment Type | Payment Period | Employee Payment | 
|---|---|---|---|---|---|
| Aetna Direct | 224 | Non-Postal | HDHP Self | Monthly | 130.08 | 
| Aetna Direct | 225 | Non-Postal | HDHP Self & Family | Monthly | 286.94 | 
| Aetna Direct | 226 | Non-Postal | HDHP Self Plus One | Monthly | 281.31 | 
| Aetna Direct | N61 | Non-Postal | CDHP Self | Monthly | 118.33 | 
| Aetna Direct | N62 | Non-Postal | CDHP Self & Family | Monthly | 298.42 | 
| Aetna Direct | N63 | Non-Postal | CDHP Self Plus One | Monthly | 259.5 | 
| Aetna HealthFund CDHP and Aetna Value Plan | EP1 | Non-Postal | CDHP Self | Monthly | 302.84 | 
| Aetna HealthFund CDHP and Aetna Value Plan | EP2 | Non-Postal | CDHP Self & Family | Monthly | 686.55 | 
| Aetna HealthFund CDHP and Aetna Value Plan | EP3 | Non-Postal | CDHP Self Plus One | Monthly | 728.8 | 
| Aetna HealthFund CDHP and Aetna Value Plan | EP4 | Non-Postal | Value Self | Monthly | 131.62 | 
| Aetna HealthFund CDHP and Aetna Value Plan | EP5 | Non-Postal | Value Self & Family | Monthly | 301.42 | 
| Aetna HealthFund CDHP and Aetna Value Plan | EP6 | Non-Postal | Value Self Plus One | Monthly | 295.51 | 
| Aetna Open Access | JC1 | Non-Postal | High Self | Monthly | 578.18 | 
| Aetna Open Access | JC2 | Non-Postal | High Self & Family | Monthly | 1512.66 | 
| Aetna Open Access | JC3 | Non-Postal | High Self Plus One | Monthly | 1546.74 | 
| Aetna Open Access | JC4 | Non-Postal | Basic Self | Monthly | 288.02 | 
| Aetna Open Access | JC5 | Non-Postal | Basic Self & Family | Monthly | 771.74 | 
| Aetna Open Access | JC6 | Non-Postal | Basic Self Plus One | Monthly | 813.17 | 
| CDPHP Universal Benefits, Inc. | SG1 | Non-Postal | High Self | Monthly | 287.19 | 
| CDPHP Universal Benefits, Inc. | SG2 | Non-Postal | High Self & Family | Monthly | 1190.04 | 
| CDPHP Universal Benefits, Inc. | SG3 | Non-Postal | High Self Plus One | Monthly | 500.13 | 
| CDPHP Universal Benefits, Inc. | SG4 | Non-Postal | Standard Self | Monthly | 132.46 | 
| CDPHP Universal Benefits, Inc. | SG5 | Non-Postal | Standard Self & Family | Monthly | 530.98 | 
| CDPHP Universal Benefits, Inc. | SG6 | Non-Postal | Standard Self Plus One | Monthly | 264.91 | 
| EmblemHealth Plan | 801 | Non-Postal | High Self | Monthly | 390.96 | 
| EmblemHealth Plan | 802 | Non-Postal | High Self & Family | Monthly | 1462.32 | 
| EmblemHealth Plan | 803 | Non-Postal | High Self Plus One | Monthly | 635.98 | 
| EmblemHealth Plan | 804 | Non-Postal | Standard Self | Monthly | 196.04 | 
| EmblemHealth Plan | 805 | Non-Postal | Standard Self & Family | Monthly | 724.34 | 
| EmblemHealth Plan | 806 | Non-Postal | Standard Self Plus One | Monthly | 270.77 | 
| HIP of Greater New York | 511 | Non-Postal | High Self | Monthly | 194.37 | 
| HIP of Greater New York | 512 | Non-Postal | High Self & Family | Monthly | 825.02 | 
| HIP of Greater New York | 513 | Non-Postal | High Self Plus One | Monthly | 291.39 | 
| Independent Health Assoc | C54 | Non-Postal | Standard Self | Monthly | 148.5 | 
| Independent Health Assoc | C55 | Non-Postal | Standard Self & Family | Monthly | 545.39 | 
| Independent Health Assoc | C56 | Non-Postal | Standard Self Plus One | Monthly | 515.84 | 
| Independent Health Assoc | QA1 | Non-Postal | High Self | Monthly | 157.78 | 
| Independent Health Assoc | QA2 | Non-Postal | High Self & Family | Monthly | 615.76 | 
| Independent Health Assoc | QA3 | Non-Postal | High Self Plus One | Monthly | 582.29 | 
| Independent Health Assoc | QA4 | Non-Postal | HDHP Self | Monthly | 112.24 | 
| Independent Health Assoc | QA5 | Non-Postal | HDHP Self & Family | Monthly | 297.48 | 
| Independent Health Assoc | QA6 | Non-Postal | HDHP Self Plus One | Monthly | 274.92 | 
| MVP Health Care | GA1 | Non-Postal | High Self | Monthly | 216.63 | 
| MVP Health Care | GA2 | Non-Postal | High Self & Family | Monthly | 607.42 | 
| MVP Health Care | GA3 | Non-Postal | High Self Plus One | Monthly | 564.02 | 
| MVP Health Care | GA4 | Non-Postal | Standard Self | Monthly | 157.35 | 
| MVP Health Care | GA5 | Non-Postal | Standard Self & Family | Monthly | 456.93 | 
| MVP Health Care | GA6 | Non-Postal | Standard Self Plus One | Monthly | 434.39 | 
| MVP Health Care | GV1 | Non-Postal | High Self | Monthly | 173.38 | 
| MVP Health Care | GV2 | Non-Postal | High Self & Family | Monthly | 500.58 | 
| MVP Health Care | GV3 | Non-Postal | High Self Plus One | Monthly | 463.27 | 
| MVP Health Care | GV4 | Non-Postal | Standard Self | Monthly | 140.6 | 
| MVP Health Care | GV5 | Non-Postal | Standard Self & Family | Monthly | 344.81 | 
| MVP Health Care | GV6 | Non-Postal | Standard Self Plus One | Monthly | 323.39 | 
| MVP Health Care | M91 | Non-Postal | High Self | Monthly | 212.62 | 
| MVP Health Care | M92 | Non-Postal | High Self & Family | Monthly | 597.82 | 
| MVP Health Care | M93 | Non-Postal | High Self Plus One | Monthly | 558.63 | 
| MVP Health Care | M94 | Non-Postal | Standard Self | Monthly | 179.32 | 
| MVP Health Care | M95 | Non-Postal | Standard Self & Family | Monthly | 517.31 | 
| MVP Health Care | M96 | Non-Postal | Standard Self Plus One | Monthly | 480.39 | 
| MVP Health Care | MF1 | Non-Postal | High Self | Monthly | 310.16 | 
| MVP Health Care | MF2 | Non-Postal | High Self & Family | Monthly | 835.98 | 
| MVP Health Care | MF3 | Non-Postal | High Self Plus One | Monthly | 777.81 | 
| MVP Health Care | MF4 | Non-Postal | Standard Self | Monthly | 283.08 | 
| MVP Health Care | MF5 | Non-Postal | Standard Self & Family | Monthly | 769.53 | 
| MVP Health Care | MF6 | Non-Postal | Standard Self Plus One | Monthly | 715.45 | 
| MVP Health Care | MX1 | Non-Postal | High Self | Monthly | 258.57 | 
| MVP Health Care | MX2 | Non-Postal | High Self & Family | Monthly | 708.89 | 
| MVP Health Care | MX3 | Non-Postal | High Self Plus One | Monthly | 657.8 | 
| MVP Health Care | MX4 | Non-Postal | Standard Self | Monthly | 222.56 | 
| MVP Health Care | MX5 | Non-Postal | Standard Self & Family | Monthly | 621.05 | 
| MVP Health Care | MX6 | Non-Postal | Standard Self Plus One | Monthly | 583.48 | 
