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Health Insurance Offerings 2010
updated 12/10/09

The Cooperstown Chamber of Commerce is pleased to offer the insurance plans listed below.  Each plan has distinct advantages as noted in the descriptions. Our Business Officer, Angela Chadwell, is available to assist you in selecting the plan that best fits your needs and budget. You will see monthly rates listed below for your personal budgeting but we only bill quarterly. Please feel free to call us at (607)547-5079, or e-mail us.

You will find that our rates are competitive and our service prompt and pleasant!

Insurance Offerings Comparison Grid 2010 available here

 

Excellus - SimplyBlue Click here for Benefit Schedule.

This is our most affordable plan offered. Health club reimbursement of $300. A $3,000 deductible for singles and $9,000 deductible for families.  It offers well visits, immunizations, mammography, pap smear , prostate cancer screening and colonscopy covered in full without meeting a deductible. Small co-pays for office visits, labs and x-rays without meeting deductible. Primary care provider and referrals are not needed.  Full time student coverage to age 23.  Prescription benefit of $7 for generics only for adults and $0 generics for children to age 19 without meeting deductible. 75% group participation needed. Discount rates for families of two.

Monthly
Quarterly
Small Group
Sole
Proprietor
Small Group
Sole
Proprietor
Individual
244.45
268.19
733.35
804.57
Ind & Spouse
481.90
529.39
1,445.70
1,588.17
Ind & Child
480.65
528.01
1,441.95
1,584.03
Family
660.40
725.75

1,981.20

2,177.25

 

CDPHP – High Deductible PPO Click here for Benefit Schedule.

This policy is HSA (Health Savings Account) Qualified.  It has a $2,700 deductible for singles and $5,400 deductible for families and 10% co-insurance with a maximum out of pocket expense of $4,000 for singles and $8,000 for families for in-network coverage.  No prescription drug coverage.  Primary care provider and referrals are not needed.  Full time student coverage to age 25.

Monthly Rate
Quarterly Rate
Small Group
Sole
Proprietor
Small Group
Sole
Proprietor
Individual
257.29
292.33
771.87
876.99
Family
657.75
748.86
1,973.25
2,246.58

Local Health Savings Accounts available at:

Bank of Cooperstown, 73 Chestnut Street Cooperstown (607)547-2210 (ask for Jessica)

NBT Bank, 62 Pioneer Street Cooperstown (607)547-9971 (ask for Donna or Peggy)

Key Bank, 103 Main Street Cooperstown (607)547-2551

 

Excellus - HealthyBlue High Deductible Click here for Benefit Schedule.

This policy is HSA (Health Savings Account) Qualified. This plan offers Healthy Lifestyle Rewards with opportunities to earn cash back. A $1,300 deductible for singles and $2,600 deductible for families and 20% co-insurance with a maximum out of pocket expense of $3,000 for singles and $6,000 for families.  It offers well visits, immunizations, mammography, pap smear and prostate screening in full without meeting a deductible. Primary care provider and referrals are not needed.  Full time student coverage to age 23.  Prescription benefit of $5/$35/$70 with $0 generics for children to age 19 but all subject to deductible. 75% group participation needed. Discount rates for families of two.

Monthly
Quarterly
Small Group
Sole
Proprietor
Small Group
Sole
Proprietor
Individual
290.01
318.31
870.03
954.93
Ind & Spouse
573.02
629.62
1,719.06
1,888.86
Ind & Child
582.95
640.56
1,748.85
1,921.68
Family
801.52
880.98

2,404.56

2,642.94

CDPHP – AO FOX First EPO Click here for Benefit Schedule.

This policy has a $25 co-pay and a $240 inpatient deductible. Vision hardware rider of $75 frames & lenses/contact lenses.  Prescription benefit of $10 generic/50% co-insurance w/ $100 per member per Brand Name Rx max. Primary care provider is not needed. Referrals out of Fox network are needed.  Full time student coverage to age 19.

Monthly
Quarterly
Small Group
Sole
Proprietor
Small Group
Sole
Proprietor
Individual
322.48
361.21
967.44
1,083.63
Family
827.26
927.95

2,481.78

2,783.85

 

MVP - EPO High Deductible Click here for Benefit Schedule

This policy is HSA (Health Savings Account) Qualified. This policy has an annual deductible of $2,000 per individual and $5,000 per family.  A $40 primary care  and specialist co-pay without paying the deductible. Inpatient coverage at 80% co-insurance after deductible.  Prescription benefit of $10 generic and 50% brand name. Primary care provider and referrals are not needed.  Unmarried dependent coverage to age 23.

Monthly
Quarterly
Small Group
Sole
Proprietor
Small Group
Sole
Proprietor
Individual
341.09
391.20
1,023.27
1,173.60
Family
865.89
994.72

2,597.67

2,984.16

 

CDPHP – EPO $25 Transitional Click here for Benefit Schedule.

Preventive dental rider option for children and adults.Click here for Benefit Schedule Dental Rider.

This policy has a $25 co-pay, a $500 inpatient deductible and 20% co-insurance. Prescription benefit of $4 generic/50% co-insurance. Primary care provider and referrals are not needed.  Full time student coverage to age 19.

Monthly
Quarterly
Small Group
Sole
Proprietor
Small Group
Sole
Proprietor
Individual
392.78
446.80
1,178.34
1,340.40
Individual w/dental
418.51
418.51
1,255.53
1,428.42
Family
1,010.04
1,150.47

3,030.12

3,451.41
Family w/dental
1,076.95
1,226.74
3,230.85
3,680.22

 

MVP - EPO $40 Click here for Benefit Schedule.

This policy has an annual deductible of $1,000 per individual and $2,500 per family.  A $40  co-pay without paying the deductible. Inpatient coverage at 80% co-insurance after deductible.  Prescription benefit of $10/$30/$50. Eyeglasses and contact lenses $100 allowance once every two years. Primary care provider and referrals are not needed.  Unmarried dependent coverage to age 23.

Monthly
Quarterly
Small Group
Sole
Proprietor
Small Group
Sole
Proprietor
Individual
412.62
473.47
1,237.86
1,420.41
Family
1,048.51
1,204.73

3,145.53

3,614.19

 

 

MVP - HMO Basix Click here for Benefit Schedule.

A $25 pcp co-pay and a specialist co-pay of $40 with a $500 inpatient deductible.  Prescription drug coverage for generic only at $10 co-pay.  Primary care provider and referrals are needed.  Unmarried dependent coverage to age 23.

Monthly
Quarterly
Small Group
Sole
Proprietor
Small Group
Sole
Proprietor
Individual
423.40
485.86
1,270.20
1,457.58
Family
1,083.22
1,244.65

3,249.66

3,733.95

 

CDPHP - HMO Click here for Benefit Schedule.

A pcp co-pay of $25 and specialist co-pay of $40 with a $500 inpatient deductible.  Prescription benefit is $4 generic and 50% brand name.  Primary care provider and referrals are needed.  Full time student coverage to age 25.

Monthly
Quarterly
Small Group
Sole
Proprietor
Small Group
Sole
Proprietor
Individual
458.61
521.83
1,375.83
1,565.49
Family
1,184.67
1,349.53

3,554.01

4,048.59

 

Excellus - Blue Healthy Choices Click here for Benefit Schedule.

This plan offers Lifestyle Benefits of an annual allowance per family toward gym membership, Lasik, teeth whitening, toddler gym and swim programs and drivers education.  The Fit & Healthy option offers a $300 Lifestyle Benefit allowance, a $20 pcp co-pay and separate co-pays for maternity.  The Healthy Family option offers $100 Lifestyle Benefit allowance, a $25 pcp co-pay, and maternity services are paid in full.  Both options offer a prescription benefit of $10/$30/$50 w/$0 generics for kids to age 19.  Primary care provider and referrals are not needed.  Full time student coverage to age 23.  75% Group participation needed.

Monthly
Quarterly
Small Group
Sole
Proprietor
Small Group
Sole
Proprietor
Individual
485.68
533.56
1,457.04
1,600.68
Family
1,223.74
1,345.41

3,671.22

4,036.23

Excellus - HealthyBlue $15/$25 Click here for Benefit Schedule.

This plan offers Healthy Lifestyle Rewards with opportunities to earn cash back. It offers well visits, immunizations, mammography, pap smear, routine GYN, prostate cancer screening and colonoscpoy covered in full. Primary care provider and referrals are not needed.  Full time student coverage to age 23.  Prescription benefit of $5/$25/$50 with $0 generics for children to age 19. 75% group participation needed. Discount rates for families of two.

Monthly
Quarterly
Small Group
Sole
Proprietor
Small Group
Sole
Proprietor
Individual
496.28
545.21
1,488.84
1,635.63
Ind & Spouse
985.56
1,083.42
2,956.68
3,250.26
Ind & Child
980.31
1,077.63
2,940.93
3,232.89
Family
1,349.66
1,483.92

4,048.98

4,451.76

 

MVP - TRiVantage EPO Click here for Benefit Schedule

This plan offers Healthy Lifestyle Rewards of an annual allowance per family of $300 and an additional $300 per subscriber for a range of healthy activities.  There are three benefit schedules to choose from to fit your families needs.   All options offer a prescription benefit of $10/$30/$50 with an annual max of $4000. Primary care provider and referrals are not needed.  Unmarried dependent coverage to age 23.

Monthly
Quarterly
Small Group
Sole
Proprietor
Small Group
Sole
Proprietor
Individual
499.93
573.87
1,499.79
1,721.61
Family
1,276.28
1,466.67

3,828.84

4,400.01

MVP - HMO $15 Click here for Benefit Schedule

A $15 co-pay with a $240 inpatient deductible. Prescription benefit with a $100 yearly deductible.  A $5/$20/$40 drug card. Primary care provider and referrals are needed.  Unmarried dependent coverage to age 23.

Monthly
Quarterly
Small Group
Sole
Proprietor
Small Group
Sole
Proprietor
Individual
574.17
659.24
1,722.51
1,977.72
Family
1,466.67
1,685.62

4,400.01

5,056.86

Excellus - Traditional BlueCross BlueShield Click here for Benefit Schedule1. and Click here for Benefit Schedule2. 

This is the Cadillac of all plans.  There is a $100 deductible and 20% co insurance of the first $2000.  After that everything is covered everywhere BlueCross operates.  Full time student coverage to age 18.  Primary care provider and referrals are not needed.  75% Group participation is needed.

Monthly
Quarterly
Small Group
Sole
Proprietor
Small Group
Sole
Proprietor
Individual
757.04
832.47
2,271.12
2,497.41
Family
1,881.68
2,069.16

5,645.04

6,207.48

Excellus - Prime Blue Dental

This dental policy is separate from any of the above health insurance policies.  There are no dentists locally that accept the benefits schedule of this policy as payment in full.  The coverage seems to be about 60-70% reimbursement from Excellus with local dentists.  Sole proprietors are not eligible for dental coverage at this time.  75% Group participation is needed.

Monthly
Quarterly
Individual
38.57
115.71
Family
96.87

290.61

Excellus - Medicare 65+ Medallion

Click here for Benefit Schedule1.  and Click here for Benefit Schedule2.

This is a Medicare Supplement that provides comprehensive coverage including prescription drug coverage.  You must have been part of an employer group to be eligible but you need not still be working.  This is an expensive but comprehensive supplemental plan for those who have retired and are working beyond age 65.  $100 major medical deductible.  No Sole Proprietor surcharge.                

Monthly Quarterly
Individual 580.05 1,740.15