Silver 2017 Small Group Plans, Q3

Our Silver plans offer a variety of coverage options at lower than average premiums. View plan details 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 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 Silver plan, please contact your broker or account executive.

 
Region 1 Silver Standard Silver EPO 8000 Silver PPO 8000 Silver POS 8000
Monthly Premium        
   Single $492.22 $533.93 $549.62 $473.91
   Employee and child $836.77 $907.68 $934.36 $805.65
   Employee and spouse/domestic partner $984.44 $1,067.86 $1,099.24 $947.82
   Family $1,402.83 $1,521.70 $1,566.42 $1,350.64
Primary Care Doctor/Specialist $30/$50 after deductible 0% after deductible 0% after deductible

0% after deductible
Deductible (Single/Family) $2,000/$4,000 $3,000/$6,000 $3,000/$6,000  $3,000/$6,000
Inpatient Hospital (per admission) $1,500 after deductible 0% after deductible 0% after deductible   0% after deductible
Prescription Drugs:        
   Tier 1/2/3 $10/$35/$70  $10/$35/$70 after
deductible
$10/$35/$70 after
deductible
 $10/$35/$70 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 1 Silver EX 8000 Silver EPO 6300 Silver EPO 6000
Monthly Premium        
   Single $502.77 $532.79 $576.15
   Employee and child $854.71 $905.74 $979.46
   Employee and spouse/domestic partner $1,00.54 $1,065.58 $1,152.30
   Family $1,432.90 $1,518.45 $1,642.02
Primary Care Doctor/Specialist 0% after deductible $40/$60 after deductible $30/$50
Deductible (Single/Family) $3,000/$6,000 $2,000/$4,000 $2,500/$5,000 
Inpatient Hospital Stay 0% after deductible $500 after deductible 20% after deductible 

Prescription Drugs:      
   Tier 1/2/3 $10/$35/$70 after deductible $4/$35/$70 after deductible $10/$50/$80
   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 Silver Standard Silver EPO 8000 Silver PPO 8000 Silver POS 8000
Monthly Premium        
   Single $585.87 $637.03 $656.29 $563.38
   Employee and child $995.98 $1,082.95 $1,115.69 $957.75
   Employee and spouse/domestic partner $1,171.74 $1,274.06 $1,312.58 $1,126.76
   Family $1,669.73 $1,815.53 $1,870.43 $1,605.64
Primary Care Doctor/Specialist $30/$50 after deductible 0% after deductible 0% after deductible

0% after deductible
Deductible (Single/Family) $2,000/$4,000 $3,000/$6,000 $3,000/$6,000  $3,000/$6,000
Inpatient Hospital (per admission) $1,500 after deductible 0% after deductible 0% after deductible   0% after deductible
Prescription Drugs:        
   Tier 1/2/3 $10/$35/$70  $10/$35/$70 after deductible $10/$35/$70 after deductible  $10/$35/$70 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 Silver EX 8000 Silver EPO 6300 Silver EPO 6000
Monthly Premium        
   Single $595.24 $635.63 $688.86
   Single & Child $1,011.91 $1,080.57 $1,171.06
   Person $1,190.48 $1,271.26 $1,377.72
   Family $1,696.43 $1811.55 $1,963.25
Primary Care Doctor/Specialist 0% after deductible $40/$60 after deductible $30/$50
Deductible (Single/Family) $3,000/$6,000 $2,000/$4,000 $2,500/$5,000 
Inpatient Hospital Stay 0% after deductible $500 after deductible 20% after deductible 

Prescription Drugs:      
   Tier 1/2/3 $10/$35/$70 after deductible $4/$35/$70 after deductible $10/$50/$80
   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

 

Silver Standard
Region 1  
Monthly Premium  
   Single $492.22
   Employee and child $836.77
   Employee and spouse/
domestic partner
$984.44
   Family $1,402.83
Primary Care
Doctor/Specialist
$30 / $50 after deductible
Deductible (Single/Family) $2,000 / $4,000
Inpatient Hospital
(per admission)
$1,500 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

Silver Standard
Region 7  
Monthly Premium  
   Single $585.87
   Employee and child $995.98
   Employee and spouse/
domestic partner
$1,171.74
   Family $1,669.73
Primary Care
Doctor/Specialist
$30/$50 after deductible
Deductible (Single/Family) $2,000 /$4,000
Inpatient Hospital
(per admission)
$1,500 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 & Summary

Silver  EPO 8000
Region 1  
Monthly Premium  
   Single $533.93
   Employee and child $907.68
   Employee and spouse/
domestic partner
$1,067.86
   Family $1,521.70
Primary Care
Doctor/Specialist
0% after deductible
Deductible (Single/Family) $3,000 / $6,000
Inpatient Hospital
(per admission)
0% 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 & Summary

Silver  EPO 8000
Region 7  
Monthly Premium  
   Single $637.03
   Employee and child $1,082.95
   Employee and spouse/
domestic partner
$1,274.06
   Family $1,815.53
Primary Care
Doctor/Specialist
0% after deductible
Deductible (Single/Family) $3,000/$6,000
Inpatient Hospital
(per admission)
0% 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 & Summary

Silver  PPO 8000
Region 1  
Monthly Premium  
   Single $549.62
   Employee and child $934.36
   Employee and spouse/
domestic partner
$1,099.24
   Family $1,566.42
Primary Care
Doctor/Specialist
0% after deductible
Deductible (Single/Family) $3,000/$6,000
Inpatient Hospital
(per admission)
0% 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 & Summary

Silver  PPO 8000
Region 7  
Monthly Premium  
   Single $656.29
   Employee and child $1,115.69
   Employee and spouse/
domestic partner
$1,312.58
   Family $1,870.43
Primary Care
Doctor/Specialist
0% after deductible
Deductible (Single/Family) $3,000/$6,000
Inpatient Hospital
(per admission)
0% 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 & Summary

Silver POS 8000
Region 1  
Monthly Premium  
   Single $473.91
   Employee and child  $805.65
   Employee and spouse/
domestic partner
$947.82
   Family $1,350.64
Primary Care
Doctor/Specialist
0% after deductible
Deductible (Single/Family) $3,000/$6,000
Inpatient Hospital
(per admission)
0% 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 & Summary

Silver POS 8000
Region 7  
Monthly Premium  
   Single $563.38
   Employee and child  $957.75
   Employee and spouse/
domestic partner
$1,126.76
   Family $1,605.64
Primary Care
Doctor/Specialist
0% after deductible
Deductible (Single/Family) $3,000/$6,000
Inpatient Hospital
(per admission)
0% 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

Silver  EX 8000
Region 1  
Monthly Premium  
   Single $502.77
   Employee and child $854.71
   Employee and spouse/
domestic partner
$1,005.54
   Family $1,432.90
Primary Care
Doctor/Specialist
0% after deductible
Deductible (Single/Family) $3,000/$6,000
Inpatient Hospital
(per admission)
0% 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

Silver  EX 8000
Region 7  
Monthly Premium  
   Single $595.24
   Employee and child $1,011.91
   Employee and spouse/
domestic partner
$1,190.48
   Family $1,696.43
Primary Care
Doctor/Specialist
0% after deductible
Deductible (Single/Family) $3,000/$6,000
Inpatient Hospital
(per admission)
0% 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

Silver EPO 6300
Region 1  
Monthly Premium  
   Single $532.79
   Employee and child $905.74
   Employee and spouse/
domestic partner
$1,065.58
   Family $1,518.45
Primary Care
Doctor/Specialist
$40/$60 after deductible
Deductible (Single/Family) $2,000/$4,000
Inpatient Hospital
(per admission)
$500 after deductible
Prescription Drugs:  
   Tier 1/2/3 $4/$35/$70 after deductible
   Generic Oral
Contraceptives
Covered in full
   Mail Order Drugs 2.5 Copays/90-day supply
 

Benefits & Coverage

Silver EPO 6300
Region 7  
Monthly Premium  
   Single $635.63
   Employee and child $1,080.57
   Employee and spouse/
domestic partner
$1,271.26
   Family $1,811.55
Primary Care
Doctor/Specialist
$40/$60 after deductible
Deductible (Single/Family) $2,000/$4,000
Inpatient Hospital
(per admission)
$500 after deductible
Prescription Drugs:  
   Tier 1/2/3 $4/$35/$70 after deductible
   Generic Oral
Contraceptives
Covered in full
   Mail Order Drugs 2.5 Copays/90-day supply
 

Benefits & Coverage

Silver EPO 6000
Region 1  
Monthly Premium  
   Single $576.15
   Employee and child $979.46
   Employee and spouse/
domestic partner
$1,152.30
   Family $1,642.02
Primary Care
Doctor/Specialist
$30/$50
Deductible (Single/Family) $2,500/$5,000
Inpatient Hospital
(per admission)
20% after deductible
Prescription Drugs:  
   Tier 1/2/3 $10/$50/$80
   Generic Oral
Contraceptives
Covered in full
   Mail Order Drugs 2.5 Copays/90-day supply
 

Benefits & Coverage

Silver EPO 6000
Region 7  
Monthly Premium  
   Single $688.86
   Employee and child $1,171.06
   Employee and spouse/
domestic partner
$1,377.72
   Family $1,963.25
Primary Care
Doctor/Specialist
$30 / $50
Deductible (Single/Family) $2,500 / $5,000
Inpatient Hospital
(per admission)
20% after deductible
Prescription Drugs:  
   Tier 1/2/3 $10/$50/$80
   Generic Oral
Contraceptives
Covered in full
   Mail Order Drugs 2.5 Copays/90-day supply
 

Benefits & Coverage

>> View Silver 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 Silver plan, please contact your broker or account executive.

Region 1 Silver Standard Silver EPO 8000 a Silver EPO 8000 b
Monthly Premium      
   Single $441.55 $473.22 $497.11
   Employee and child $750.64 $804.47 $845.09
   Employee and spouse/domestic partner $883.10 $946.44 $994.22
   Family $1,258.42 $1,348.68 $1,416.76
Primary Care Doctor/Specialist $30/$50 after deductible 20% after deductible 0% after deductible
Deductible (Single/Family) $2,000/$4,000 
embedded deductible
$2,000/$4,000
embedded deductible
$3,000/$6,000
embedded deductible
Inpatient Hospital Stay (per admission) $1,500 after deductible 20% after deductible 0% after deductible
Prescription Drugs:      
   Tier 1/2/3 $10/$35/$70  $4/$35/$70 after deductible  $4/$35/$70 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 Silver EPO 6300  Silver EPO 6000 Silver Aqua
Monthly Premium      
   Single $496.91 $527.32 $448.58
   Employee and child $844.74 $896.45 $762.59
   Employee and spouse/domestic partner $993.82 $1,054.64 $897.16
   Family $1,416.20 $1,502.86 $1,278.45
Primary Care Doctor/Specialist $40/$60 after deductible $30/$50 20% after deductible
Deductible (Single/Family) $1,500/$3,000
embedded deductible
$2,500/$5,000 
embedded deductible
$3,000/$6,000
embedded deductible
Inpatient Hospital Stay (per admission) $500 after deductible 20% after deductible 20% (not subject to deductible)
Prescription Drugs:      
   Tier 1/2/3 $4/$35/$70 after deductible $10/$50/$80   $15/$60/$100 
   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 Silver Standard Silver EPO 8000 a
Monthly Premium    
   Single $522.60 $561.24
   Employee and child $888.43 $954.11
   Employee and spouse/domestic partner $1,045.20 $1,122.48
   Family $1,489.41 $1,599.53
Primary Care Doctor/Specialist $30/$50 after deductible 20% after deductible
Deductible (Single/Family) $2,000/$4,000 
embedded deductible
$2,000/$4,000
embedded deductible
Inpatient Hospital Stay (per admission) $1,500 after deductible 20% after deductible
Prescription Drugs:    
   Tier 1/2/3 $10/$35/$70  $4/$35/$70 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

 
Silver Standard
Region 1  
Monthly Premium  
   Single $441.55
   Employee and child $750.64
   Employee and spouse/
domestic partner
$883.10
   Family $1,258.42
Primary Care
Doctor/Specialist
$30/$50 after deductible
Deductible (Single/Family) $2,000/$4,000 embedded deductible
Inpatient Hospital
(per admission)
$1,500 after deductible
Prescription Drugs:  
   Tier 1/2/3 $10/$35/$70 
   Generic Oral
Contraceptives
Covered in full
   Mail Order Drugs 2.5 Copays/90-day supply
 

Benefits & Coverage

Silver Standard
Region 7  
Monthly Premium  
   Single $522.60
   Employee and child $888.43
   Employee and spouse/
domestic partner
$1,045.20
   Family $1,489.41
Primary Care
Doctor/Specialist
$30/$50 after deductible
Deductible (Single/Family) $2,000/$4,000 embedded deductible
Inpatient Hospital
(per admission)
$1,500 after deductible
Prescription Drugs:  
   Tier 1/2/3 $10/$35/$70 
   Generic Oral
Contraceptives
Covered in full
   Mail Order Drugs 2.5 Copays/90-day supply
 

Benefits & Coverage

Silver EPO 8000 a
Region 1  
Monthly Premium  
   Single $473.22
   Employee and child $804.47
   Employee and spouse/
domestic partner
$946.44
   Family $1,348.68
Primary Care
Doctor/Specialist
20% after deductible
Deductible (Single/Family) $2,000/$4,000 embedded deductible
Inpatient Hospital
(per admission)
20% after deductible
Prescription Drugs:  
   Tier 1/2/3 $4/$35/$70 after deductible
   Generic Oral
Contraceptives
Covered in full
   Mail Order Drugs 2.5 Copays/90-day supply
 

Benefits & Coverage

Silver EPO 8000 a
Region 7  
Monthly Premium  
   Single $561.24
   Employee and child $954.11
   Employee and spouse/
domestic partner
$1,122.48
   Family $1,599.53
Primary Care
Doctor/Specialist
20% after deductible
Deductible (Single/Family) $2,000/$4,000 embedded deductible
Inpatient Hospital
(per admission)
20% after deductible
Prescription Drugs:  
   Tier 1/2/3 $4/$35/$70 after deductible
   Generic Oral
Contraceptives
Covered in full
   Mail Order Drugs 2.5 Copays/90-day supply
 

Benefits & Coverage

Silver EPO 8000 b
Region 1  
Monthly Premium  
   Single $497.11
   Employee and child $845.09
   Employee and spouse/
domestic partner
$994.22
   Family $1,416.76
Primary Care
Doctor/Specialist
0% after deductible
Deductible (Single/Family) $3,000/$6,000 embedded deductible
Inpatient Hospital
(per admission)
0% after deductible
Prescription Drugs:  
   Tier 1/2/3 $4/$35/$70 after deductible
   Generic Oral
Contraceptives
Covered in full
   Mail Order Drugs 2.5 Copays/90-day supply
 

Benefits & Coverage

Silver EPO 6300
Region 1  
Monthly Premium  
   Single $496.91
   Employee and child $844.74
   Employee and spouse/
domestic partner
$993.82
   Family $1,416.20
Primary Care
Doctor/Specialist
$40/$60 after deductible
Deductible (Single/Family) $1,500/$3,000
Inpatient Hospital
(per admission)
$500 after deductible
Prescription Drugs:  
   Tier 1/2/3 $4/$35/$70 after deductible
   Generic Oral
Contraceptives
Covered in full
   Mail Order Drugs 2.5 Copays/90-day supply
 

Benefits & Coverage

Silver EPO 6000
Region 1  
Monthly Premium  
   Single $527.32
   Employee and child $896.45
   Employee and spouse/
domestic partner
$1,054.64
   Family $1,502.86
Primary Care
Doctor/Specialist
$30/$50 after deductible
Deductible (Single/Family) $2,500/$5,000 embedded deductible
Inpatient Hospital
(per admission)
20% after deductible
Prescription Drugs:  
   Tier 1/2/3 $10/$50/$80 
   Generic Oral
Contraceptives
Covered in full
   Mail Order Drugs 2.5 Copays/90-day supply
 

Benefits & Coverage

Silver Aqua
Region 1  
Monthly Premium  
   Single $448.58
   Employee and child $762.59
   Employee and spouse/
domestic partner
$897.16
   Family $1,278.45
Primary Care
Doctor/Specialist
20% after deductible
Deductible (Single/Family) $3,000/$6,000
Inpatient Hospital
(per admission)
20% (not subject to deductible)
Prescription Drugs:  
   Tier 1/2/3 $15/$60/$100 after deductible
   Generic Oral
Contraceptives
Covered in full
   Mail Order Drugs 2.5 Copays/90-day supply
 

Benefits & Coverage

Benefits of Blue

BlueConnect

A comprehensive online benefits solution

Wellness Card

 

Offered with every small group plan

Preventive Services

$0 preventive services

HealthyLife Rewards

Eat healthy and save money