Bronze  2018 Small Group Plans, Q1

Our Bronze plans are our most affordable plans, with the lowest monthly premiums. View our 2018 group plans below. Please note, all premiums listed represent coverage for dependents up to age 26.

 

Region 1: Albany, Columbia, Fulton, Greene, Montgomery, Rensselaer, Saratoga, Schenectady, Schoharie, Warren, and Washington.

Region 7: Clinton & Essex

 

If you are part of an existing group with BlueShield of Northeastern New York, visit BlueConnect to enroll. If you are a new group and would like to enroll in a Bronze plan, please contact your broker or account executive.

Region 1 Bronze Standard Bronze EPO 6300  
Monthly Premium      
   Single $462.41 $522.61  
   Employee and child $786.09 $888.44  
   Employee and spouse/domestic partner $924.82
$1,045.22
 
   Family $1,317.87 $1,489.44  
Primary Care Doctor/Specialist 50% after deductible $40/$60 after deductible  
Deductible (Single/Family) $4,000/$8,000 embedded $4,500/$9,000 embedded  
Inpatient Hospital Stay (per admission) 50% after deductible $1,500 after deductible  
Prescription Drugs:      
   Tier 1/2/3 $10/$30/$70 after deductible $10/$50/$100 after deductible  
   Generic Oral Contraceptives Covered in full Covered in full  
   Mail Order Drugs 2.5 Copays/90-day supply 2.5 Copays/90-day supply  
 

Benefits & Coverage

Benefits & Coverage

 

 
Region 1 Bronze PPO Bronze Value
Monthly Premium    
   Single $541.29 $481.59
   Employee and child $920.19 $818.70
   Employee and spouse/domestic partner $1,082.58
$963.18
   Family $1,542.68 $1,372.53
Primary Care Doctor/Specialist 0% after deductible 0% after deductible
Deductible (Single/Family) $6,650/$13,300 $6,650/$13,300
Inpatient Hospital Stay (per admission) 0% after deductible 0% after deductible
Prescription Drugs:    
   Tier 1/2/3 0% after deductible 0% after deductible
   Generic Oral Contraceptives Covered in full Covered in full
   Mail Order Drugs 2.5 Copays/90-day supply 2.5 Copays/90-day supply
 

Benefits & Coverage

Benefits & Coverage

 
Region 7 Bronze Standard Bronze EPO 6300  
Monthly Premium      
   Single $555.82 $629.46  
   Employee and child $944.90 $1,070.09  
   Employee and spouse/domestic partner $1,111.64
$1,258.92
 
   Family $1,584.08 $1,793.96  
Primary Care Doctor/Specialist 50% after deductible $40/$60 after deductible  
Deductible (Single/Family) $4,000/$8,000 embedded $4,500/$9,000 embedded  
Inpatient Hospital Stay (per admission) 50% after deductible $1,500 after deductible  
Prescription Drugs:      
   Tier 1/2/3 $10/$30/$70 after deductible $10/$50/$100 after deductible  
   Generic Oral Contraceptives Covered in full Covered in full  
   Mail Order Drugs 2.5 Copays/90-day supply 2.5 Copays/90-day supply  
 

Benefits & Coverage

Benefits & Coverage

 

 
Region 7  Bronze PPO Bronze Value
Monthly Premium    
   Single $652.34 $579.28
   Employee and child $1,108.98 $984.78
   Employee and spouse/domestic partner $1,304.68
$1,158.56
   Family $1,859.17 $1,650.95
Primary Care Doctor/Specialist 0% after deductible 0% after deductible
Deductible (Single/Family) $6,650/$13,300 $6,650/$13,300
Inpatient Hospital Stay (per admission) 0% after deductible 0% after deductible
Prescription Drugs:    
   Tier 1/2/3 0% after deductible 0% after deductible
   Generic Oral Contraceptives Covered in full Covered in full
   Mail Order Drugs 2.5 Copays/90-day supply 2.5 Copays/90-day supply
 

Benefits & Coverage

Benefits & Coverage

 
Bronze Standard
Region 1   
Monthly Premium  
   Single $462.41
   Employee and child $786.09
   Employee and spouse/domestic partner $924.82
   Family $1,317.87
Primary Care Doctor/Specialist 50% after deductible
Deductible (Single/Family) $4,000/$8,000
Inpatient Hospital Stay 50% after deductible
Prescription Drugs:  
   Tier 1/2/3 $10/$30/$70 after deductible
   Generic Oral Contraceptives Covered in full
   Mail Order Drugs 2.5 Copays/90-day supply
 

Benefits & Coverage

Bronze Standard
Region 7   
Monthly Premium  
   Single $555.82
   Employee and child $944.90
   Employee and spouse/domestic partner $1,111.64
   Family $1,584.08
Primary Care Doctor/Specialist $50 after deductible
Deductible (Single/Family) $4,000/$8,000
Inpatient Hospital Stay $50 after deductible
Prescription Drugs:  
   Tier 1/2/3 $10/$30/$70 after deductible
   Generic Oral Contraceptives Covered in full
   Mail Order Drugs 2.5 Copays/90-day supply
 

Benefits & Coverage

Bronze  EPO 6300
Region 1  
Monthly Premium  
   Single $522.61
   Employee and child  $888.44
   Employee and spouse/domestic partner $1,045.22
   Family $1,489.44
Primary Care Doctor/Specialist $40/$60 after deductible
Deductible (Single/Family) $4,500/$9,000 embedded
Inpatient Hospital Stay (per admission) $1,500 after deductible
Prescription Drugs:  
   Tier 1/2/3$10/$ $10/$50/$100 after deductible
   Generic Oral Contraceptives Covered in full
   Mail Order Drugs 2.5 Copays/90-day supply
 

Benefits & Coverage

Bronze  EPO 6300
Region 7  
Monthly Premium  
   Single $629.46
   Employee and child  $1,070.09
   Employee and spouse/domestic partner $1,258.92
   Family $1,793.96
Primary Care Doctor/Specialist $40/$60 after deductible
Deductible (Single/Family) $4,500/$9,000 embedded
Inpatient Hospital Stay (per admission) $1,500 after deductible
Prescription Drugs:  
   Tier 1/2/3 $10/$50/$100 after deductible
   Generic Oral Contraceptives Covered in full
   Mail Order Drugs 2.5 Copays/90-day supply
 

Benefits & Coverage

Bronze  PPO
Region 1   
Monthly Premium  
   Single $541.29
   Employee and child  $920.19
   Employee and spouse/domestic partner $1,082.58
   Family $1,542.68
Primary Care Doctor/Specialist 0% after deductible
Deductible (Single/Family) $6,650/$13,300
Inpatient Hospital Stay (per admission) 0% after deductible
Prescription Drugs:  
   Tier 1/2/3 0% after deductible
   Generic Oral Contraceptives Covered in full
   Mail Order Drugs 2.5 Copays/90-day supply
 

Benefits & Coverage

Bronze  PPO
Region 7  
Monthly Premium  
   Single $652.34
   Employee and child  $1,108.98
   Employee and spouse/domestic partner $1,304.68
   Family $1,859.17
Primary Care Doctor/Specialist 0% after deductible
Deductible (Single/Family) $6,650/$13,300
Inpatient Hospital Stay (per admission) 0% after deductible
Prescription Drugs:  
   Tier 1/2/3 0% after deductible
   Generic Oral Contraceptives Covered in full
   Mail Order Drugs 2.5 Copays/90-day supply
 

Benefits & Coverage

Bronze  Value
Region 1  
Monthly Premium  
   Single $481.59
   Employee and child $818.70
   Employee and spouse/domestic partner $963.18
   Family $1,372.53
Primary Care Doctor/Specialist 0% after deductible
Deductible (Single/Family) $6,650/$13,300
Inpatient Hospital Stay (per admission) 0% after deductible
Prescription Drugs:  
   Tier 1/2/3  0% after deductible
   Generic Oral Contraceptives Covered in full
   Mail Order Drugs 2.5 Copays/90-day supply
 

Benefits & Coverage

Bronze  Value
Region 7  
Monthly Premium  
   Single $579.28
   Employee and child $984.78
   Employee and spouse/domestic partner $1,158.56
   Family $1,650.95
Primary Care Doctor/Specialist 0% after deductible
Deductible (Single/Family) $6,650/$13,300
Inpatient Hospital Stay (per admission) 0% after deductible
Prescription Drugs:  
   Tier 1/2/3  0% after deductible
   Generic Oral Contraceptives Covered in full
   Mail Order Drugs 2.5 Copays/90-day supply
 

Benefits & Coverage

>> View Bronze Plan Contracts

>> Some preventive drugs are a $0 cost-share; not subject to deductible on select plans. 

Visit BlueConnect to enroll. If you are a new group and would like to enroll in a Bronze plan, please contact your broker or account executive.

 
Region 1 Bronze Standard Bronze EPO Bronze PPO  
Monthly Premium        
   Single $425.12 $473.90 $490.93  
   Employee and child $722.71 $805.63 $834.58  
   Employee and spouse/domestic partner $850.24 $947.80 $981.86  
   Family $1,211.59 $1,350.62 $1,399.16  
Primary Care Doctor/Specialist 50% after deductible 0% after deductible 0% after deductible
 
Deductible (Single/Family) $4,000/$8,000
$6,450/$12,900
$6,450/$12,900 
 
Inpatient Hospital (per admission) 50% after deductible  0% after deductible 0% after deductible    
Prescription Drugs:        
   Tier 1/2/3 $10/$35/$70 after deductible  0% after deductible 0% after deductible  
   Generic Oral Contraceptives Covered in full Covered in full Covered in full  
   Mail Order Drugs 2.5 Copays/90-day supply 2.5 Copays/90-day supply 2.5 Copays/90-day supply  
 

Benefits & Coverage

Benefits & Coverage

Benefits & Coverage

 

 
Region 1 Bronze EX Bronze Value    
Monthly Premium        
   Single $451.95 $426.41    
   Employee and child $768.32 $724.90    
   Employee and spouse/domestic partner $903.90 $852.82    
   Family $1,288.06 $1,215.27    
Primary Care Doctor/Specialist 0% after deductible 0% after deductible    
Deductible (Single/Family) $6,450/$12,900
$6,450/$12,900
   
Inpatient Hospital (per admission) 0% after deductible  0% after deductible    
Prescription Drugs:        
   Tier 1/2/3 0% after deductible  0% after deductible    
   Generic Oral Contraceptives Covered in full Covered in full    
   Mail Order Drugs 2.5 Copays/90-day supply 2.5 Copays/90-day supply    
 

Benefits & Coverage

Benefits & Coverage

 

 

 
Region 7 Bronze Standard Bronze EPO Bronze PPO  
Monthly Premium        
   Single $504.00 $563.96 $584.88  
   Employee and child $856.80 $958.73 $994.30  
   Employee and spouse/domestic partner $1,008.00 $1,127.92 $1,169.76  
   Family $1,436.40 $1,607.29 $1,666.91  
Primary Care Doctor/Specialist 50% after deductible 0% after deductible 0% after deductible
 
Deductible (Single/Family) $4,000/$8,000
$6,450/$12,900
$6,450/$12,900 
 
Inpatient Hospital (per admission) 50% after deductible  0% after deductible 0% after deductible    
Prescription Drugs:        
   Tier 1/2/3 $10/$35/$70 after deductible  0% after deductible 0% after deductible  
   Generic Oral Contraceptives Covered in full Covered in full Covered in full  
   Mail Order Drugs 2.5 Copays/90-day supply 2.5 Copays/90-day supply 2.5 Copays/90-day supply  
 

Benefits & Coverage

Benefits & Coverage

Benefits & Coverage

 

 
Region 7 Bronze EX Bronze Value    
Monthly Premium        
   Single $533.81 $505.62    
   Employee and child $907.48 $859.55    
   Employee and spouse/domestic partner $1,067.62 $1,011.24    
   Family $1,521.35 $1,441.02    
Primary Care Doctor/Specialist 0% after deductible 0% after deductible    
Deductible (Single/Family) $6,450/$12,900
$6,450/$12,900
   
Inpatient Hospital (per admission) 0% after deductible  0% after deductible    
Prescription Drugs:        
   Tier 1/2/3 0% after deductible  0% after deductible    
   Generic Oral Contraceptives Covered in full Covered in full    
   Mail Order Drugs 2.5 Copays/90-day supply 2.5 Copays/90-day supply    
 

Benefits & Coverage

Benefits & Coverage

 

 

Bronze  Standard 
Region 1  
Monthly Premium  
   Single $425.12
   Employee and child  $722.71
   Employee and spouse/domestic partner $850.24
   Family $1,211.59
Primary Care Doctor/Specialist 50% after deductible
Deductible (Single/Family) $4,000/$8,000
Inpatient Hospital Stay (per admission) 50% after deductible
Prescription Drugs:  
   Tier 1/2/3 $10/$35/$70 after deductible
   Generic Oral Contraceptives Covered in full
   Mail Order Drugs 2.5 Copays/90-day supply
 

Benefits & Coverage

Bronze  Standard 
Region 7  
Monthly Premium  
   Single $504.00
   Employee and child  $856.80
   Employee and spouse/domestic partner $1,008.00
   Family $1,436.40
Primary Care Doctor/Specialist 50% after deductible
Deductible (Single/Family) $4,000/$8,000
Inpatient Hospital Stay (per admission) 50% after deductible
Prescription Drugs:  
   Tier 1/2/3 $10/$35/$70 after deductible
   Generic Oral Contraceptives Covered in full
   Mail Order Drugs 2.5 Copays/90-day supply
 

Benefits & Coverage

Bronze  EPO
Region 1  
Monthly Premium  
   Single $473.90
   Employee and child  $805.63
   Employee and spouse/domestic partner $947.80
   Family $1,350.62
Primary Care Doctor/Specialist 0% after deductible
Deductible (Single/Family) $6,450/$12,900
Inpatient Hospital Stay (per admission) 0% after deductible
Prescription Drugs:  
   Tier 1/2/3 0%  after deductible
   Generic Oral Contraceptives Covered in full
   Mail Order Drugs 2.5 Copays/90-day supply
 

Benefits & Coverage

Bronze  EPO
Region 7  
Monthly Premium  
   Single $563.96
   Employee and child  $958.73
   Employee and spouse/domestic partner $1,127.92
   Family $1,607.29
Primary Care Doctor/Specialist 0% after deductible
Deductible (Single/Family) $6,450/$12,900
Inpatient Hospital Stay (per admission) 0% after deductible
Prescription Drugs:  
   Tier 1/2/3 0%  after deductible
   Generic Oral Contraceptives Covered in full
   Mail Order Drugs 2.5 Copays/90-day supply
 

Benefits & Coverage

Bronze  PPO
Region 1  
Monthly Premium  
   Single $490.93
   Employee and child  $834.58
   Employee and spouse/domestic partner $981.86
   Family $1,399.16
Primary Care Doctor/Specialist 0% after deductible
Deductible (Single/Family) $6,450/$12,900
Inpatient Hospital Stay (per admission) 0% after deductible
Prescription Drugs:  
   Tier 1/2/3 0%  after deductible
   Generic Oral Contraceptives Covered in full
   Mail Order Drugs 2.5 Copays/90-day supply
 

Benefits & Coverage

Bronze  PPO
Region 7  
Monthly Premium  
   Single $584.88
   Employee and child  $994.30
   Employee and spouse/domestic partner $1,169.76
   Family $1,666.91
Primary Care Doctor/Specialist 0% after deductible
Deductible (Single/Family) $6,450/$12,900
Inpatient Hospital Stay (per admission) 0% after deductible
Prescription Drugs:  
   Tier 1/2/3 0%  after deductible
   Generic Oral Contraceptives Covered in full
   Mail Order Drugs 2.5 Copays/90-day supply
 

Benefits & Coverage

Bronze  EX
Region 1  
Monthly Premium  
   Single $451.95
   Employee and child  $768.32
   Employee and spouse/domestic partner $903.90
   Family $1,288.06
Primary Care Doctor/Specialist 0% after deductible
Deductible (Single/Family) $6,450/$12,900
Inpatient Hospital Stay (per admission) 0% after deductible
Prescription Drugs:  
   Tier 1/2/3 0%  after deductible
   Generic Oral Contraceptives Covered in full
   Mail Order Drugs 2.5 Copays/90-day supply
 

Benefits & Coverage

Bronze  EX
Region 7  
Monthly Premium  
   Single $533.81
   Employee and child  $907.48
   Employee and spouse/domestic partner $1,067.62
   Family $1,521.35
Primary Care Doctor/Specialist 0% after deductible
Deductible (Single/Family) $6,450/$12,900
Inpatient Hospital Stay (per admission) 0% after deductible
Prescription Drugs:  
   Tier 1/2/3 0%  after deductible
   Generic Oral Contraceptives Covered in full
   Mail Order Drugs 2.5 Copays/90-day supply
 

Benefits & Coverage

Bronze  Value
Region 1  
Monthly Premium  
   Single $426.41
   Employee and child  $724.90
   Employee and spouse/domestic partner $852.82
   Family $1,215.27
Primary Care Doctor/Specialist 0% after deductible
Deductible (Single/Family) $6,450/$12,900 
Inpatient Hospital Stay (per admission) 0% after deductible
Prescription Drugs:  
   Tier 1/2/3 0% after deductible
   Generic Oral Contraceptives Covered in full
   Mail Order Drugs 2.5 Copays/90-day supply
 

Benefits & Coverage

Bronze  Value
Region 7  
Monthly Premium  
   Single $505.62
   Employee and child  $859.55
   Employee and spouse/domestic partner $1,011.24
   Family $1,441.02
Primary Care Doctor/Specialist 0% after deductible
Deductible (Single/Family) $6,450/$12,900
Inpatient Hospital Stay (per admission) 0% deductible
Prescription Drugs:  
   Tier 1/2/3 0% after deductible
   Generic Oral Contraceptives Covered in full
   Mail Order Drugs 2.5 Copays/90-day supply
 

Benefits & Coverage

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Preventive Services

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