BCBS PPO National Network
| Deductible: | $1,000 |
| Coinsurance: | 80/20 |
| Out-of-Pocket: | $3,800 |
| Primary Care Co-pay: | $25 |
| Specialist Co-Pay: | $50 |
| Medications: | Generic 10%; Brand 35% (see SBC for more details) |
| Wellness & Teledoc Visits: | No Charge |
(In-network only)
See Health Plan Outline for More Details
Principal PPO Dental Network
| Annual deductible network | Coinsurance network pays | |
| Preventative | $0 | 100% |
| Basic | $50 | 80% |
| Major | $50 | 50% |
Max benefit: $2,000 per calendar year
New Benefit: Implant coverage (see SBC for details).
Out-of-Network Coverage Available (Click Here to See Claim Example)
VSP Vision
| Exams: $10 copay, 1 exam every 12 mo |
| Glasses: $25 copay for single lenses |
| Frames: Up to $250 every 24 mo |
| Contacts: Up to $250 every 12 mo |
At PEO4YOU, we believe comprehensive healthcare should be accessible, transparent, and tailored to your needs. That’s why every member receives a complete benefits package — medical, dental, vision, and life benefits — designed to give you peace of mind and real value.
BCBS PPO National Network
| Deductible: | $1,000 |
| Coinsurance: | 80/20 |
| Out-of-Pocket: | $3,800 |
| Primary Care Co-pay: | $25 |
| Specialist Co-Pay: | $50 |
| Medications: | Generic 10%; Brand 35% (see SBC for more details) |
| Wellness & Teledoc Visits: | No Charge |
(In-network only)
See Health Plan Outline for More Details
Principal PPO Dental Network
| Annual deductible network | Coinsurance network pays | |
| Preventative | $0 | 100% |
| Basic | $50 | 80% |
| Major | $50 | 50% |
Max benefit: $2,000 per calendar year
New Benefit: Implant coverage (see SBC for details).
Out-of-Network Coverage Available (Click Here to See Claim Example)
VSP Vision
| Exams: $10 copay, 1 exam every 12 mo |
| Glasses: $25 copay for single lenses |
| Frames: Up to $250 every 24 mo |
| Contacts: Up to $250 every 12 mo |
5 year average renewal of less than 3% – Trust established in 1958 – BCBS network since 2004 – Enrollment available year round – No underwriting
Features | H&W 125 | DENTAL 125 | VISION 125 | LIFE 10K | ADMIN125 | Union | Total |
|---|---|---|---|---|---|---|---|
Employee Only | $731.00 | $65.00 | $10.00 | $5.00 | $100.00 | $27.00 | $938.00 |
Employee + Spouse | $1,500.00 | $130.00 | $22.00 | $5.00 | $200.00 | $27.00 | $1,884.00 |
Employee + (Children) | $1,146.00 | $130.00 | $22.00 | $5.00 | $200.00 | $27.00 | $1,530.00 |
Employee + Family | $1,636.00 | $190.00 | $35.00 | $5.00 | $200.00 | $27.00 | $2,093.00 |
Waived Employees | $5.00 | $27.00 | $32 |
6 consecutive renewals of 3% or less – Trust established in 1958 – BCBS network since 2004 – Enrollment available year round
Features | H&W 125 | DENTAL 125 | VISION 125 | ACCIDENT | LIFE 10K | ADMIN125 | Union | Total |
|---|---|---|---|---|---|---|---|---|
Employee Only | $746.00 | $75.00 | $15.00 | $12.00 | $10.00 | $100.00 | $27.00 | $985.00 |
Employee + Spouse | $1,530.00 | $150.00 | $30.00 | $12.00 | $10.00 | $200.00 | $27.00 | $1,959.00 |
Employee + (Children) | $1,169.00 | $150.00 | $30.00 | $12.00 | $10.00 | $200.00 | $27.00 | $1,598.00 |
Employee + Family | $1,669.00 | $220.00 | $45.00 | $12.00 | $10.00 | $200.00 | $27.00 | $2,183.00 |
Waived Employees | $10.00 | $27.00 | $37 |
Accident coverage is for Employee/Member only
Groups above 10 have custom ancillary rates
First Year Dental Max is $1,000, Second year increases to $2,000
Surcharge for 4 or more dependent children – Dental :$50 , Vision: $15 per child.
Why Choosing the Right Plan Matters in New York
Choosing a health plan is a significant decision that can impact your health, finances, and access to care. The Affordable Care Act and New York State law require all qualified health plans for sale in New York to provide essential health benefits. However, picking the right plan ensures you receive the right benefits for you and/or your family.
Cost, networks, drug coverage, and whether your current doctor or preferred specialist is “in-network” are all factors to consider when comparing plans. Small business employees and self-employed individuals may have the option of purchasing coverage through the New York marketplace or through their employer. Child Health Plus, Medicaid, and New York's Essential plan make sure that families, children, and the elderly have the care and coverage they need when they need it most.
New Yorkers can go to the New York State of Health website to compare plans, find out if they are eligible for benefits, and apply for financial assistance. The process is open and transparent, and New Yorkers can comparison shop for the right plan that meets their needs.
At PEO4YOU, we get it. Finding the right health insurance that you can actually afford is a very important and often daunting task for both individuals and families, not to mention employers. Our experts guide you, your family or your company through affordable New York health plan options and help you understand your plan’s benefits to create a path forward towards better health and financial freedom.
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