Sample NYWIFT Health Insurance Plans TEIGIT (Prices valid from January 1 through December 31, 2008) OXFORD Liberty Metro In-Network Primary Co-pay: $25 In-Network Specialist Co-pay: $40 Out of Network Deductible: single: $2,000/Family: $6,000 Out of Network Reimbursement: 70% Out of Network Maximum Out-of-Pocket: Single:$5,000 / family: $15,000 **There is no prescription drug coverage** Monthly Premium: $399.14 (Member), $878.12 (Member/Spouse), $738.42 (Member/Child), $1237.34 (Full Family). OXFORD Freedom Metro In-Network Primary Co-pay: $15 In-Network Specialist Co-pay: $25 Out of Network Deductible: $1000 Out of Network Reimbursement: 70% Out of Network Maximum Out-of-Pocket: single: $4000 / family: $12,000 RX: $10/$25/$50. * There is $50 annual deductible on brand name drugs. Monthly Premium: $586.87 (Member), $1,291.11 (Member/Spouse), $1085.72 (Member/Child), $1819.30 (Full Family). OXFORD Freedom Plan In-Network Primary Co-pay: $10 In-Network Specialist Co-pay: $10 Out of Network Deductible: single: $300 / family: $750 Out of Network Reimbursement: 70% Out of Network Maximum Out-of-Pocket: Single: $3,300 / family: $8,250 RX: $10/$25/$50. * There is no deductible on brand name drugs. Monthly Premium: $792.42 (Member), $1,584.84 (Member/Spouse), $1,505.60 (Member/Child), $2,456.49 (Full Family).
ATLANTIS HEALTH PLAN (2008 - Prices Subject To Change)
Health Maintenance Organization (HMO) Open Access – No Referrals Needed Single: $278.99; Couple: $557.980; Parent/Child: $561.05; Family: $715.61 $25 Doctor co-pay $40 Specialist co-pay $40 Diagnostic/Lab co-pay $50 ER/Out-patient co-pay $500 Hospital/In-patient co-pay or $75 Out-patient co-pay Unlimited lifetime benefits Mandatory Generic Prescription Drug Coverage: 1. $10 Co-pay per generic prescription (no annual limit) 2. $25 Co-pay per authorized brand prescription ($250 deductible/$2000 limit per year) Point of Service Plan (POS) Open Access – No Referrals needed Single: $345.589; Couple: $691.16; Parent/Child: $694.96; Family: $886.41 Option of In or Out-of-network coverage and treatment* In-Network office & specialist co-pay is $20, Emergency room $50, Hospital in-patient $500 $2000 (Individual)/ $4000 (couple/parent-child/family) deductibles if out-of-network 70/30 coinsurance split after deductible if out-of-network $5000 / $10,000 maximum out-of-pocket $1 million lifetime benefit out-of-network. Unlimited $ benefit in-network 7/30/50 Prescription Rider (no annual deductible or annual limit): 1. $7 co-pay per generic prespcription 2. $30 co-pay per brand prescription 3. $50 co-pay per formulary prescription *Physical therapy must be obtained at Atlantis Medical Group Centers, but can also be in-network if following post-hospital treatment. NOTE: Any treatment performed at any Atlantis Medical Group office is ZERO co-pay and ZERO deductible for all Atlantis Health Plans regardless of plan (e.g. general preventive care, basic sick visits, blood work, x-rays, sonograms, minor surgical procedures, OB/GYN, physical therapy). ATLANTIS DENTAL PLAN CapDent & CapDent Plus Dental Plans Fully-Insured Dental Plans by monthly premium. Comprehensive dental benefits Offering Managed Care and Point-of Service options for Individuals and Groups that can be added to all Atlantis Health Plan options. CapDent DMO Managed Care Single: $13.25 Couple: $22.00 Family: $28.00 CapDent Plus POS Single: $22.00 Couple: $38.00 Family: $49.50
______ WORKING TODAY/FREELANCER’S UNION
Working Today's Freelancers Union now offers 5 group-rate health insurance plans through Empire Blue Cross / Blue Shield, and The PerfectHealth Insurance Company for members who live in New York, or who live in New Jersey & Connecticut, and work in New York. Members must pay a $50 Annual Access fee, and a $40 Application Fee. (Note: These fees only apply to their Insurance plans. Membership in the Freelancers Union itself is free.) 1. The Empire Direct POS plan includes: * In-network and out-of-network coverage * $25 Co-payment for in-network office visits, with no deductible * Coinsurance out-of-network, after a $3000 annual deductible for individuals * Generic and Name Brand Prescription drug coverage, with a $50 deductible * Preventive Dental and Optical Empire Direct POS Monthly Rates: Individual $382.63 Individual & Child(ren) $683.65 Individual & Spouse/Partner: $750.20 Family $1067.49 2. Empire EPO #2 plan includes: * In-network coverage only * $30/$50 Co-payment for office visits * Coinsurance for in-patient care, after a $2000 deductible for indivduals * Prescription drug coverage with a $100 deductible Empire Direct EPO #2 Monthly Rates: Individual $277.79 Individual & Child(ren) $477.29 Individual & Spouse/Partner: $535.59 Family $777.42 3. Empire EPO #1 plan includes: * In-network coverage only * $30/$50 Co-payment for office visits, * Coinsurance for in-patient care, after a $3000 annual deductible for individuals * Generic Prescription drug coverage only with a $100 deductible Empire EPO#1 Monthly Rates: Individual $239.64 Individual & Child(ren) $425.50
Individual & Spouse/Partner: $470.32 Family $670.51 4. • • • • • • Empire PH (Perfect Health) Platinum (HSA) plan includes: Linked with a Health Savings Acount (HSA) In-network coverage only $5000 annual deductible for individuals Well-child care expenses covered 100% Before deductible, in-network expenses are discounted; covered 100% after deductible Prescription discounts before deductible; covered 70% after deductible Empire PH Platinum (HSA) Monthly Rates: Individual: $202.66 Individual & Child(ren): $390.84 Individual & Spouse/ Partner: $460.33 Family: $651.07 Empire PH Diamond plan includes: In-network coverage only $10,000 annual deductible for individuals Well-child care expenses covered 100% Before deductible, in-network expenses are discounted; covered 100% after deductible Prescription discounts before deductible, covered 70% after deductible Empire PH Diamond Monthly Rates: Individual: $130.37 Individual & Child(ren): $247.99 Individual & Spouse/Partner: $290.72 Family: $411.85
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