2009 Health Insurance Payroll Deductions

Bi-weekly Premium

Deductions will be made on a pre-tax basis unless you elect to decline this benefit.

Insurance Plan
Options
M/C
B.U. 06, 13
CSEA
B.U. 02, 03, 04
PEF
B.U. 05
NYSCOPBA/Council 82
B.U. 21, 31
UUP
B.U. 08
Empire Plan
Individual $22.16 $22.46 $22.16 $22.61 $22.16
Family $97.06 $98.16 $97.06 $98.77 $97.06
HIP HMO
Individual $34.92 $34.92 $34.92 $34.25 $34.92
Family $129.53 $129.53 $129.53 $128.08 $129.53
Empire Blue Cross / Blue Shield HMO
Individual $82.62 $82.62 $82.62 $81.95 $82.62
Family $286.97 $286.97 $286.97 $285.52 $286.97
AETNA - HMO
Individual $97.26 $97.26 $97.26 $96.59 $97.26
Family $363.03 $363.03 $363.03 $361.58 $363.03

Empire Plan Deductibles and Out-of-Pocket Maximum

Deductible $363.00 $225.00 $363.00 $363.00 $363.00
Out-of-Pocket Maximum $1,000.00 $500.00 $1,000.00 $1,345.00 $1,000.00

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