2016 Plans Available in Fulton County for Individuals & Families

Fulton County is served by 7 insurance carriers on the NYSOH Marketplace:
CDPHP; EmblemHealth; Empire Blue Cross; Excellus Blue Cross Blue Shield; Fidelis; HealthNow (BS of Northeastern NY); and MVP Health Plan.

This information is provided for research purposes only. The premium rates given are before any advance tax credits are applied. Please verify premium rates and plan details on the NYSOH Marketplace or directly with the insurance carrier.

CDPHP
(Capital District Physicians Health Plan)

Customer Service: 1-855-236-7113
PLATINUM PLANS Individual Couple Individual + Child(ren) Family
HMO Copayment 10 Platinum Standard
HiosID: 94788NY0280053
  $652.35 $1,304.70 $1,109.00 $1,856.20
HMO Hybrid 13 Platinum
HiosID: 94788NY0280129
Summary of Benefits $639.55 $1,279.10 $1,087.24 $1,822.72
GOLD PLANS Individual Couple Individual + Child(ren) Family
HMO Copayment 20 Gold Standard
HiosID: 94788NY0280054
Summary of Benefits $555.36 $1,110.72 $944.11 $1,582.78
HMO Hybrid 23 Gold
HiosID: 94788NY0280131
Summary of Benefits $536.06 $1,072.12 $911.30 $1,527.77
SILVER PLANS Individual Couple Individual + Child(ren) Family
HMO Copayment 30 Silver Standard
HiosID: 94788NY0280055
Summary of Benefits $467.13 $934.20 $794.12 $1,331.32
Smart Deductible HMO Coinsurance 34 Silver
HiosID: 94788NY0280017
Summary of Benefits $448.09 $896.18 $761.75 $1,277.06
HDHMO Qualified 33 Silver
HiosID: 94788NY0280021
Summary of Benefits $443.14 $886.28 $753.34 $1,262.95
SILVER PLANS: CSR 200-250% FPL Individual Couple Individual + Child(ren) Family
HMO Copayment 30 Silver Standard
HiosID: 94788NY0280055
Summary of Benefits $467.13 $934.20 $794.12 $1,331.32
Smart Deductible HMO Coinsurance 34 Silver
HiosID: 94788NY0280017
Summary of Benefits $448.09 $896.18 $761.75 $1,277.06
HDHMO Qualified 33 Silver
HiosID: 94788NY0280021
Summary of Benefits $443.14 $886.28 $753.34 $1,262.95
BRONZE PLANS Individual Couple Individual + Child(ren) Family
HDHMO Non-Qualified 40 Bronze Standard
HiosID: 94788NY0280059
Summary of Benefits $393.22 $786.44 $668.47 $1,120.68
HDHMO Qualified 44 Bronze
HiosID: 94788NY0280029
Summary of Benefits $390.56 $781.12 $663.94 $1,113.10
CATASTROPHIC PLANS Individual Couple Individual + Child(ren) Family
HDHMO Non-Qualified 50 Catastrophic Standard
HiosID: 94788NY0280047
Summary of Benefits $234.15 $468.30 $398.06 $667.33
HSA QUALIFIED PLANS:You can set up a pre-tax Health Savings Account (HSA) to pay for out-of-pocket health care expenses when you enroll one of the following plans: HDHMO Qualified 44 Bronze or HDHMO Qualified 33 Silver.


EmblemHealth

Customer Service: 1-800-223-1831
PLATINUM PLANS Region 1 Region 3 Region 4 Region 6
Select Care Platinum
HiosID: 88582NY0140001
Summary of Benefits $777.99 $1,555.98 $1,322.58 $2,217.27
GOLD PLANS Individual Couple Individual + Child(ren) Family
Select Care Gold
HiosID: 88582NY0150001
Summary of Benefits $658.33 $1,316.66 $1,119.16 $1,876.24
SILVER PLANS Individual Couple Individual + Child(ren) Family
Select Care Silver
HiosID: 88582NY0160001
Summary of Benefits $542.55 $1,085.10 $922.34 $1,546.27
SILVER PLANS: CSR 200-250% FPL Individual Couple Individual + Child(ren) Family
Select Care Silver
HiosID: 88582NY0160001
  $542.55 $1,085.10 $922.34 $1,546.27
BRONZE PLANS Individual Couple Individual + Child(ren) Family
Select Care Bronze
HiosID: 88582NY0170001
Summary of Benefits $464.78 $929.56 $790.13 $1,324.62
CATASTROPHIC PLANS Individual Couple Individual + Child(ren) Family
Select Care Basic
HiosID: 88582NY0180001
Summary of Benefits $273.47 $546.94 $464.90 $799.39
NOTES: EmblemHealth has not provided Summary of Benefit and Coverage sheets for the Cost Sharing Reduced Silver Plans.


Empire Blue Cross

Customer Service: 1-855-748-1806
PLATINUM PLANS Individual Couple Individual + Child(ren) Family
Empire HMO 0 X Platinum
HiosID: 80519NY0160014
Summary of Benefits $699.02 $1,398.04 $1,188.33 $1,992.21
Empire HMO 250 X Platinum
HiosID: 80519NY0160115
Summary of Benefits $675.13 $1,350.26 $1,147.72 $1,924.12
GOLD PLANS Individual Couple Individual + Child(ren) Family
Empire HMO 600 X Gold
HiosID: 80519NY0160012
Summary of Benefits $601.17 $1,202.34 $1,021.99 $1,713.33
Empire HMO 1000 X Gold
HiosID: 80519NY0160107
Summary of Benefits $571.81 $1,143.62 $972.08 $1,629.66
Empire BC HMO 1000 X Gold, a Multi-State Plan
HiosID: 80519NY0330006
Summary of Benefits $572.18 $1,144.36 $972.71 $1,630.71
SILVER PLANS Individual Couple Individual + Child(ren) Family
Empire HMO 2000 X Silver
HiosID: 80519NY0160008
Summary of Benefits $515.27 $1,030.54 $875.96 $1,468.52
Empire HMO 2250 X Silver
HiosID: 80519NY0160010
Summary of Benefits $472.37 $944.74 $803.03 $1,346.25
Empire HMO 2750 X for HSA Silver
HiosID: 80519NY0160099
Summary of Benefits $480.55 $961.10 $816.94 $1,369.57
Empire BC HMO 2750 for HSA X Silver, a Multi-State Plan
HiosID: 80519NY0330004
Summary of Benefits $480.76 $961.52 $817.29 $1,370.17
SILVER PLANS: CSR 200-250% FPL Individual Couple Individual + Child(ren) Family
Empire HMO 2000 X Silver
HiosID: 80519NY0160008
Summary of Benefits $515.27 $1,030.54 $875.96 $1,468.52
Empire HMO 2250 X Silver
HiosID: 80519NY0160010
Summary of Benefits $472.37 $944.74 $803.03 $1,346.25
Empire HMO 2750 X for HSA Silver
HiosID: 80519NY0160099
Summary of Benefits $480.55 $961.10 $816.94 $1,369.57
Empire BC HMO 2750 X Silver, a Multi-State Plan
HiosID: 80519NY0330004
Summary of Benefits $480.76 $961.52 $817.29 $1,370.17
BRONZE PLANS Individual Couple Individual + Child(ren) Family
Empire HMO 4000 X for HSA Bronze
HiosID: 80519NY0160002
Summary of Benefits $412.90 $825.80 $701.93 $1,176.77
Empire HMO 5850 X Bronze
HiosID: 80519NY0160006
Summary of Benefits $405.05 $810.10 $688.59 $1,154.39
Empire HMO 6000 X Bronze
HiosID: 80519NY0160004
Summary of Benefits $407.17 $814.34 $692.19 $1,160.43
Empire HMO 5850 X Bronze, 0 PCP
HiosID: 80519NY0160118
Summary of Benefits $413.06 $810.10 $688.59 $1,154.39
CATASTROPHIC PLANS Individual Couple Individual + Child(ren) Family
Empire HMO 6850 X Catastrophic
HiosID: 80519NY0160016
Summary of Benefits $206.74 $413.48 $351.46 $589.21
HSA QUALIFIED PLANS: You can set up a pre-tax Health Savings Account (HSA) to pay for out-of-pocket health care expenses when you enroll in one of the following 2016 plans: Empire HMO 4000 X Bronze for HSA, Empire HMO 2750 X Silver for HSA or Empire BC HMO 2470 X Silver, a Multi-State Plan.
NOTES: I've linked to pdfs of the Summary Benefits and Coverage that I saved on my sever from here.


Excellus Blue Cross Blue Shield

Customer Service: 1-800-817-8400
PLATINUM PLANS Individual Couple Individual + Child(ren) Family
Platinum Standard
HiosID: 78124NY0880004
Summary of Benefits $793.86 $1,587.72 $1,349.58 $2,262.50
Platinum Select
HiosID: 78124NY0880010
Summary of Benefits $766.17 $1,532.34 $1,302.49 $2,183.58
GOLD PLANS Individual Couple Individual + Child(ren) Family
Gold Standard
HiosID: 78124NY0890004
Summary of Benefits $683.38 $1,366.76 $1,161.75 $1,947.63
Gold Select
HiosID: 78124NY0890016
Summary of Benefits $656.01 $1,312.02 $1,115.22 $1,869.63
SILVER PLANS Individual Couple Individual + Child(ren) Family
Silver Standard
HiosID: 78124NY0890010
Summary of Benefits $575.53 $1,151.06 $978.40 $1,640.26
Silver Select
HiosID: 78124NY0900010
Summary of Benefits $503.09 $1,006.18 $855.25 $1,433.81
SILVER PLANS: CSR 200-250% FPL Individual Couple Individual + Child(ren) Family
Silver Standard
HiosID: 78124NY0890010
Summary of Benefits $575.53 $1,151.06 $978.40 $1,640.26
Silver Select
HiosID: 78124NY0900010
Summary of Benefits $503.09 $1,006.18 $855.25 $1,433.81
BRONZE PLANS Individual Couple Individual + Child(ren) Family
Bronze Standard HSA
HiosID: 78124NY0900004
Summary of Benefits $420.07 $840.14 $714.12 $1,197.20
Bronze Select
HiosID: 78124NY0900014
Summary of Benefits $394.97 $789.94 $671.45 $1,125.66
Bronze Standard
HiosID: 78124NY0900018
Summary of Benefits $427.07 $854.14 $726.02 $1,217.15
CATASTROPHIC PLANS Individual Couple Individual + Child(ren) Family
Base
HiosID: 78124NY0910002
Summary of Benefits $224.13 $448.26 $381.02 $638.77
HSA QUALIFIED PLANS: You can set up a pre-tax Health Savings Account (HSA) to pay for out-of-pocket health care expenses when you enroll in one of the following plans: Bronze Standard HSA, Bronze Select or Silver Select.


Fidelis Care

Customer Service: 1-888-343-3547
PLATINUM PLANS Individual Couple Individual + Child(ren) Family
Fidelis Care Platinum
HiosID: 25303NY0040001
Summary of Benefits $558.07 $1,116.14 $948.72 $1,590.50
GOLD PLANS Individual Couple Individual + Child(ren) Family
Fidelis Care Gold
HiosID: 25303NY0030001
Summary of Benefits $459.23 $918.46 $780.69 $1,308.81
SILVER PLANS Individual Couple Individual + Child(ren) Family
Fidelis Care Silver
HiosID: 25303NY0020001
Summary of Benefits $374.89 $749.48 $637.31 $1,068.44
SILVER PLANS: CSR 200-250% FPL Individual Couple Individual + Child(ren) Family
Fidelis Care Silver
HiosID: 25303NY0020001
Summary of Benefits $374.89 $749.48 $637.31 $1,068.44
BRONZE PLANS Individual Couple Individual + Child(ren) Family
Fidelis Care Bronze
HiosID: 25303NY0010001
Summary of Benefits $298.09 $596.18 $506.75 $849.56
CATASTROPHIC PLANS Individual Couple Individual + Child(ren) Family
Fidelis Care Catastrophic
HiosID: 25303NY0090001
Summary of Benefits $162.52 $325.04 $276.28 $463.18


HealthNow
(Blue Shield of Northeastern NY)

Customer Service: 1-855-344-3425
PLATINUM PLANS Individual Couple Individual + Child(ren) Family
Platinum Standard
HiosID: 36346NY0480035
Summary of Benefits $687.51 $1,375.02 $1,168.77 $1,959.40
GOLD PLANS Individual Couple Individual + Child(ren) Family
Gold Standard
HiosID: 36346NY0480026
Summary of Benefits $568.62 $1,137.24 $966.65 $1,620.57
SILVER PLANS Individual Couple Individual + Child(ren) Family
Silver Standard
HiosID: 36346NY0480014
Summary of Benefits $475.11 $950.22 $807.69 $1,354.06
SILVER PLANS: CSR 200-250% FPL Individual Couple Individual + Child(ren) Family
Silver Standard A
HiosID: 36346NY0480014
  $475.11 $950.22 $807.69 $1,354.06
BRONZE PLANS Individual Couple Individual + Child(ren) Family
Bronze Standard
HiosID: 36346NY0480001
Summary of Benefits $362.80 $725.60 $616.76 $1,033.98
Bronze Value
HiosID: 36346NY0660007
Summary of Benefits $363.59 $727.18 $618.10 $1,036.23
CATASTROPHIC PLANS Individual Couple Individual + Child(ren) Family
Catastropic   n/a n/a n/a n/a
HSA QUALIFIED PLANS: You can set up a pre-tax Health Savings Account (HSA) to pay for out-of-pocket health care expenses when you enroll in one of the following plans: Bronze Standard and Bronze Value.
OUT-OF-NETWORK COVERAGE: All 2016 plans include Out-of-Network Coverage.
NOTES: I haven't been able to find the Summary of Benefits for the 2016 Silver Cost Sharing Reduced Plans, however, here's a chart showing deductibles, out-of-pocket maximums and copays/coinsurance - Silver CSR Plans


MVP Health Plan

Customer Service: 1-800-825-5687
PLATINUM PLANS Individual Couple Individual + Child(ren) Family
Premier Platinum
HiosID: 56184NY0140016
Summary of Benefits $642.65 $1,285.30 $1,092.51 $1,831.55
GOLD PLANS Individual Couple Individual + Child(ren) Family
Premier Gold
HiosID: 56184NY0140014
Summary of Benefits $552.29 $1,104.58 $938.89 $1,574.03
SILVER PLANS Individual Couple Individual + Child(ren) Family
Premier Silver
HiosID: 56184NY0140012
Summary of Benefits $469.78 $939.56 $798.63 $1,338.87
SILVER PLANS: CSR 200-250% FPL Individual Couple Individual + Child(ren) Family
Premier Silver
HiosID: 56184NY0140012
Summary of Benefits $469.78 $939.56 $798.63 $1,338.87
BRONZE PLANS Individual Couple Individual + Child(ren) Family
Premier HDHP Bronze 1
HiosID: 56184NY0140010
Summary of Benefits $375.59 $751.18 $638.50 $1,070.43
Premier Bronze 2
HiosID: 56184NY0140030
Summary of Benefits $368.07 $736.14 $622.03 $1,049.00
CATASTROPHIC PLANS Individual Couple Individual + Child(ren) Family
Secure Catastrophic
HiosID: 56184NY0220002
Summary of Benefits $222.84 $445.68 $378.83 $635.09
HSA QUALIFIED PLANS: You can set up a pre-tax Health Savings Account (HSA) to pay for out-of-pocket health care expenses when you enroll in one of the following plans: Premier HDHP Bronze 1