Bronze  2017 Small Group Plans, Q2

Our Bronze plans are our most affordable plans, with the lowest monthly premiums. View our 2017 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, Schohaire, 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 Bronze PPO
Monthly Premium      
   Single $411.44 $458.64 $475.13
   Employee and child $699.45 $779.69 $807.73
   Employee and spouse/domestic partner $822.88 $917.28 $950.26
   Family $1,172.60 $1,307.13 $1,354.12
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 Stay (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 $437.40 $412.68
   Employee and child $743.58 $701.56
   Employee and spouse/domestic partner $874.80 $825.36
   Family $1,246.59 $1,176.14
Primary Care Doctor/Specialist 0% after deductible 0% after deductible
Deductible (Single/Family) $6,450 / $12,900 $6,450 / $12,900
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 Bronze PPO
Monthly Premium      
   Single $487.78 $545.80 $566.04
   Employee and child $829.23 $927.86 $962.27
   Employee and spouse/domestic partner $975.56 $1,091.60 $1,132.08
   Family $1,390.17 $1,555.53 $1,613.22
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 Stay (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 $516.63 $489.34
   Employee and child $878.27 $831.88
   Employee and spouse/domestic partner $1,033.26 $978.68
   Family $1,472.39 $1,394.62
Primary Care Doctor/Specialist 0% after deductible 0% after deductible
Deductible (Single/Family) $6,450/$12,900 $6,450/$12,900
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 $411.44
   Employee and child $699.45
   Employee and spouse/domestic partner $822.88
   Family $1,172.60
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/$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 $487.78
   Employee and child $829.23
   Employee and spouse/domestic partner $975.56
   Family $1,390.17
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/$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 $458.64
   Employee and child  $779.69
   Employee and spouse/domestic partner $917.28
   Family $1,307.13
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 $545.80
   Employee and child  $927.86
   Employee and spouse/domestic partner $1,091.60
   Family $1,555.53
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 $475.13
   Employee and child  $807.73
   Employee and spouse/domestic partner $950.26
   Family $1,354.12
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 $566.04
   Employee and child  $962.27
   Employee and spouse/domestic partner $1,132.08
   Family $1,613.22
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 $437.40
   Employee and child $743.58
   Employee and spouse/domestic partner $874.80
   Family $1,246.59
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 $516.63
   Employee and child $878.27
   Employee and spouse/domestic partner $1,033.26
   Family $1,472.39
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 $412.68
   Employee and child $701.56
   Employee and spouse/domestic partner $825.36
   Family $1,176.14
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 $489.34
   Employee and child $831.88
   Employee and spouse/domestic partner $978.68
   Family $1,394.62
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

>> 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 6300 Bronze EPO 8000 Bronze Value
Monthly Premium        
   Single $371.31 $430.51 $449.97 $374.62
   Employee and child $631.23 $731.87 $764.95 $636.86
   Employee and spouse/domestic partner $742.62 $861.02 $899.94 $749.24
   Family $1,058.23 $1,226.95 $1,282.42 $1,067.66
Primary Care Doctor/Specialist 50% after deductible $40/$60 after deductible 20% after deductible

0% after deductible
Deductible (Single/Family) $3,500/$7,000
embedded deductible
$5,000/$10,000
embedded deductible
$6,000/$12,000 
embedded deductible
$6,450/$12,000
embedded deductible
Inpatient Hospital (per admission) 50% after deductible  $500 after deductible 20% after deductible   0% after deductible
Prescription Drugs:        
   Tier 1/2/3 $10/$35/$70 after deductible  $4/$50/$80 after deductible $4/$100/$100 after deductible  0% after deductible
   Generic Oral Contraceptives Covered in full 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 2.5 Copays/90-day supply
 

Benefits & Coverage

Benefits & Coverage

Benefits & Coverage

Benefits & Coverage

 
Region 7 Bronze Standard Bronze Value
Monthly Premium    
   Single $437.17 $441.23
   Employee and child $743.19 $750.95
   Employee and spouse/domestic partner $874.34 $882.46
   Family $1,245.94 $1,257.51
Primary Care Doctor/Specialist 50% after deductible 0% after deductible
Deductible (Single/Family) $3,500/$7,000
embedded deductible
$6,450/$12,900
embedded deductible
Inpatient Hospital (per admission) 50% after deductible 0% after deductible
Prescription Drugs:    
   Tier 1/2/3 $10/$35/$70 
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 $371.31
   Employee and child  $631.23
   Employee and spouse/domestic partner $742.62
   Family $1,058.23
Primary Care Doctor/Specialist 50% after deductible
Deductible (Single/Family) $3,500 / $7,000 embedded deductible
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 $437.17
   Employee and child  $743.19
   Employee and spouse/domestic partner $874.34
   Family $1,245.94
Primary Care Doctor/Specialist 50% after deductible
Deductible (Single/Family) $3,500 / $7,000 embedded deductible
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 6300
Region 1  
Monthly Premium  
   Single $430.51
   Employee and child  $731.87
   Employee and spouse/domestic partner $861.02
   Family $1,226.95
Primary Care Doctor/Specialist $40/$60 after deductible
Deductible (Single/Family) $5,000/$10,000 embedded deductible
Inpatient Hospital Stay (per admission) $500 after deductible
Prescription Drugs:  
   Tier 1/2/3 $4/$50/$80  after deductible
   Generic Oral Contraceptives Covered in full
   Mail Order Drugs 2.5 Copays/90-day supply
 

Benefits & Coverage

Bronze  EPO 8000
Region 1  
Monthly Premium  
   Single $449.97
   Employee and child  $764.95
   Employee and spouse/domestic partner $899.94
   Family $1,282.42
Primary Care Doctor/Specialist 20% after deductible
Deductible (Single/Family) $6,000/$12,000 embedded deductible
Inpatient Hospital Stay (per admission) 20% after deductible
Prescription Drugs:  
   Tier 1/2/3 $4/$100/$100 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 $374.62
   Employee and child  $636.86
   Employee and spouse/domestic partner $749.24
   Family $1,067.66
Primary Care Doctor/Specialist 0% after deductible
Deductible (Single/Family) $6,450/$12,900 embedded deductible
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 $441.23
   Employee and child  $750.09
   Employee and spouse/domestic partner $882.46
   Family $1,257.51
Primary Care Doctor/Specialist 0% after deductible
Deductible (Single/Family) $6,450/$12,900 embedded deductible
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

Benefits of Blue

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Wellness Card

 

Offered with every small group plan

Preventive Services

$0 preventive services

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