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    Healthcare Plan Information

    2017 Plan Information for New York

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    State Specific Rates
    Contract Enrollment Code Employee Type Option/Enrollment Type Payment Period Employee Payment
    Aetna Direct N61 Non-Postal CDHP Self Monthly $120.05
    Aetna Direct N62 Non-Postal CDHP Self & Family Monthly $302.77
    Aetna Direct N63 Non-Postal CDHP Self Plus One Monthly $263.29
    Aetna HealthFund CDHP and Value Plan EP1 Non-Postal CDHP Self Monthly $330.93
    Aetna HealthFund CDHP and Value Plan EP2 Non-Postal CDHP Self & Family Monthly $755.39
    Aetna HealthFund CDHP and Value Plan EP3 Non-Postal CDHP Self Plus One Monthly $800.84
    Aetna HealthFund CDHP and Value Plan EP4 Non-Postal Value Self Monthly $135.57
    Aetna HealthFund CDHP and Value Plan EP5 Non-Postal Value Self & Family Monthly $310.46
    Aetna HealthFund CDHP and Value Plan EP6 Non-Postal Value Self Plus One Monthly $304.37
    Aetna HealthFund HDHP 224 Non-Postal HDHP Self Monthly $138.70
    Aetna HealthFund HDHP 225 Non-Postal HDHP Self & Family Monthly $305.95
    Aetna HealthFund HDHP 226 Non-Postal HDHP Self Plus One Monthly $299.95
    Aetna Open Access JC1 Non-Postal High Self Monthly $566.90
    Aetna Open Access JC2 Non-Postal High Self & Family Monthly $1492.99
    Aetna Open Access JC3 Non-Postal High Self Plus One Monthly $1531.16
    Aetna Open Access JC4 Non-Postal Basic Self Monthly $324.19
    Aetna Open Access JC5 Non-Postal Basic Self & Family Monthly $867.62
    Aetna Open Access JC6 Non-Postal Basic Self Plus One Monthly $911.99
    CDPHP Universal Benefits, Inc. SG1 Non-Postal High Self Monthly $269.20
    CDPHP Universal Benefits, Inc. SG2 Non-Postal High Self & Family Monthly $1153.82
    CDPHP Universal Benefits, Inc. SG3 Non-Postal High Self Plus One Monthly $468.13
    CDPHP Universal Benefits, Inc. SG4 Non-Postal Standard Self Monthly $132.46
    CDPHP Universal Benefits, Inc. SG5 Non-Postal Standard Self & Family Monthly $494.76
    CDPHP Universal Benefits, Inc. SG6 Non-Postal Standard Self Plus One Monthly $264.91
    GHI Health Plan 801 Non-Postal High Self Monthly $475.34
    GHI Health Plan 802 Non-Postal High Self & Family Monthly $1497.82
    GHI Health Plan 803 Non-Postal High Self Plus One Monthly $1296.25
    GHI Health Plan 804 Non-Postal Standard Self Monthly $230.70
    GHI Health Plan 805 Non-Postal Standard Self & Family Monthly $601.21
    GHI Health Plan 806 Non-Postal Standard Self Plus One Monthly $594.32
    Highmark Choice Company NP1 Non-Postal High Self Monthly $154.80
    Highmark Choice Company NP2 Non-Postal High Self & Family Monthly $351.09
    Highmark Choice Company NP3 Non-Postal High Self Plus One Monthly $291.34
    HIP Health of Greater New York 511 Non-Postal High Self Monthly $241.51
    HIP Health of Greater New York 512 Non-Postal High Self & Family Monthly $1012.34
    HIP Health of Greater New York 513 Non-Postal High Self Plus One Monthly $392.43
    Independent Health Assoc QA1 Non-Postal High Self Monthly $208.93
    Independent Health Assoc QA2 Non-Postal High Self & Family Monthly $766.27
    Independent Health Assoc QA3 Non-Postal High Self Plus One Monthly $726.66
    Independent Health Assoc QA4 Non-Postal HDHP Self Monthly $112.43
    Independent Health Assoc QA5 Non-Postal HDHP Self & Family Monthly $297.99
    Independent Health Assoc QA6 Non-Postal HDHP Self Plus One Monthly $275.41
    Independent Health Association C54 Non-Postal Standard Self Monthly $174.65
    Independent Health Association C55 Non-Postal Standard Self & Family Monthly $673.69
    Independent Health Association C56 Non-Postal Standard Self Plus One Monthly $639.21
    MVP Health Care GA1 Non-Postal High Self Monthly $277.05
    MVP Health Care GA2 Non-Postal High Self & Family Monthly $760.87
    MVP Health Care GA3 Non-Postal High Self Plus One Monthly $711.01
    MVP Health Care GA4 Non-Postal Standard Self Monthly $215.45
    MVP Health Care GA5 Non-Postal Standard Self & Family Monthly $609.90
    MVP Health Care GA6 Non-Postal Standard Self Plus One Monthly $569.31
    MVP Health Care GV1 Non-Postal High Self Monthly $203.60
    MVP Health Care GV2 Non-Postal High Self & Family Monthly $580.84
    MVP Health Care GV3 Non-Postal High Self Plus One Monthly $542.03
    MVP Health Care GV4 Non-Postal Standard Self Monthly $152.60
    MVP Health Care GV5 Non-Postal Standard Self & Family Monthly $400.88
    MVP Health Care GV6 Non-Postal Standard Self Plus One Monthly $373.08
    MVP Health Care M91 Non-Postal High Self Monthly $221.47
    MVP Health Care M92 Non-Postal High Self & Family Monthly $624.61
    MVP Health Care M93 Non-Postal High Self Plus One Monthly $583.14
    MVP Health Care M94 Non-Postal Standard Self Monthly $205.98
    MVP Health Care M95 Non-Postal Standard Self & Family Monthly $586.76
    MVP Health Care M96 Non-Postal Standard Self Plus One Monthly $547.56
    MVP Health Care MF1 Non-Postal High Self Monthly $458.59
    MVP Health Care MF2 Non-Postal High Self & Family Monthly $1205.56
    MVP Health Care MF3 Non-Postal High Self Plus One Monthly $1128.49
    MVP Health Care MF4 Non-Postal Standard Self Monthly $395.48
    MVP Health Care MF5 Non-Postal Standard Self & Family Monthly $1050.97
    MVP Health Care MF6 Non-Postal Standard Self Plus One Monthly $983.36
    MVP Health Care MX1 Non-Postal High Self Monthly $346.32
    MVP Health Care MX2 Non-Postal High Self & Family Monthly $930.61
    MVP Health Care MX3 Non-Postal High Self Plus One Monthly $870.35
    MVP Health Care MX4 Non-Postal Standard Self Monthly $323.11
    MVP Health Care MX5 Non-Postal Standard Self & Family Monthly $873.69
    MVP Health Care MX6 Non-Postal Standard Self Plus One Monthly $816.94
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