2024 Plan Information for New York
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Location Specific Rates
| Contract | Enrollment Code | Enrollment Type | Option/Enrollment Type | Payment Period | Employee Payment |
|---|---|---|---|---|---|
| Aetna Direct | 224 | Non-Postal | HDHP Self | Monthly | 272.61 |
| Aetna Direct | 225 | Non-Postal | HDHP Self & Family | Monthly | 498.46 |
| Aetna Direct | 226 | Non-Postal | HDHP Self Plus One | Monthly | 590.61 |
| Aetna Direct | N61 | Non-Postal | CDHP Self | Monthly | 160.8 |
| Aetna Direct | N62 | Non-Postal | CDHP Self & Family | Monthly | 405.51 |
| Aetna Direct | N63 | Non-Postal | CDHP Self Plus One | Monthly | 352.64 |
| Aetna Direct | Z24 | Non-Postal | Advantage Self | Monthly | 125 |
| Aetna Direct | Z25 | Non-Postal | Advantage Self & Family | Monthly | 331.25 |
| Aetna Direct | Z26 | Non-Postal | Advantage Self Plus One | Monthly | 275 |
| Aetna HealthFund CDHP and Aetna Value Plan | EP1 | Non-Postal | CDHP Self | Monthly | 627.08 |
| Aetna HealthFund CDHP and Aetna Value Plan | EP2 | Non-Postal | CDHP Self & Family | Monthly | 1371.17 |
| Aetna HealthFund CDHP and Aetna Value Plan | EP3 | Non-Postal | CDHP Self Plus One | Monthly | 1473.05 |
| Aetna HealthFund CDHP and Aetna Value Plan | EP4 | Non-Postal | Value Self | Monthly | 518.35 |
| Aetna HealthFund CDHP and Aetna Value Plan | EP5 | Non-Postal | Value Self & Family | Monthly | 1133.6 |
| Aetna HealthFund CDHP and Aetna Value Plan | EP6 | Non-Postal | Value Self Plus One | Monthly | 1213.18 |
| Aetna Open Access | JC1 | Non-Postal | High Self | Monthly | 1175.24 |
| Aetna Open Access | JC2 | Non-Postal | High Self & Family | Monthly | 2957.17 |
| Aetna Open Access | JC3 | Non-Postal | High Self Plus One | Monthly | 3043.34 |
| Aetna Open Access | JC4 | Non-Postal | Basic Self | Monthly | 958.03 |
| Aetna Open Access | JC5 | Non-Postal | Basic Self & Family | Monthly | 2371.26 |
| Aetna Open Access | JC6 | Non-Postal | Basic Self Plus One | Monthly | 2463.26 |
| CDPHP Universal Benefits, Inc. | SG4 | Non-Postal | Standard Self | Monthly | 349.37 |
| CDPHP Universal Benefits, Inc. | SG5 | Non-Postal | Standard Self & Family | Monthly | 849.92 |
| CDPHP Universal Benefits, Inc. | SG6 | Non-Postal | Standard Self Plus One | Monthly | 810.44 |
| HIP of Greater New York | 511 | Non-Postal | High Self | Monthly | 572.93 |
| HIP of Greater New York | 512 | Non-Postal | High Self & Family | Monthly | 1975.11 |
| HIP of Greater New York | 513 | Non-Postal | High Self Plus One | Monthly | 849.33 |
| HIP of Greater New York | YL4 | Non-Postal | Standard Self | Monthly | 506.89 |
| HIP of Greater New York | YL5 | Non-Postal | Standard Self & Family | Monthly | 1783.03 |
| HIP of Greater New York | YL6 | Non-Postal | Standard Self Plus One | Monthly | 728.69 |
| Independent Health Assoc | C54 | Non-Postal | Standard Self | Monthly | 205.38 |
| Independent Health Assoc | C55 | Non-Postal | Standard Self & Family | Monthly | 742.25 |
| Independent Health Assoc | C56 | Non-Postal | Standard Self Plus One | Monthly | 752.57 |
| Independent Health Assoc | QA1 | Non-Postal | High Self | Monthly | 286.87 |
| Independent Health Assoc | QA2 | Non-Postal | High Self & Family | Monthly | 962.34 |
| Independent Health Assoc | QA3 | Non-Postal | High Self Plus One | Monthly | 960.42 |
| Independent Health Assoc | QA4 | Non-Postal | HDHP Self | Monthly | 169.19 |
| Independent Health Assoc | QA5 | Non-Postal | HDHP Self & Family | Monthly | 440.88 |
| Independent Health Assoc | QA6 | Non-Postal | HDHP Self Plus One | Monthly | 418.88 |