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If you have any questions about any of the
plans,
please feel free to call us at (914) 948-2110.
Click here to find a Provider
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Emblem - (EPO) -
Option #: 3 -
Click here for the detailed
plan summary. |
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This plan is an EPO
(Exclusive Provider Organization) with no out of network
coverage & no referrals needed. It has a $40 primary &
specialist office visit co-pay. The inpatient hospital
is a $500 co-pay for an emergency room visit is a $100
co-pay. The prescription coverage is 0/30/50 with a $50
annual deductible and a $3000 maximum. |
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Monthly |
Monthly |
Quarterly |
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Small
Group |
Sole Proprietor |
Sole Proprietor |
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Employee |
$425.49 |
N/A |
N/A |
| Employee
+ One |
$935.95 |
N/A |
N/A |
| Employee + Child(ren) |
$811.56 |
N/A |
N/A |
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Family |
$1,259.36 |
N/A |
N/A |
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Plan Selection |
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Instructions |
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Application |
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Student Verification Form |
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