Rate Locator

Participants and/or their employers wishing to change coverage (among Medical Plan A, B, and C options) for the upcoming Plan Year must do so in writing by November 15, 2019.  Notification should be emailed to This email address is being protected from spambots. You need JavaScript enabled to view it. or sent via fax to Member Services at 212-729-2701.

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HEALTH BENEFIT PLANS RATE LOCATOR - NON-MEDICARE


[Choose correct Plan Year]
[Choose employer's Conference]
[Enter employer's ZIP code]
[Choose correct age band for employee as of January 1]

MONTHLY RATES


Non-Medicare Rates: Plan A Plan B Plan C Plan HSA
Single
Two Adults
Single w/Child(ren)
Two Adults w/Child(ren)
Dental 2000:
Single $42.50
Two Adults $82.00
Single w/Child(ren) $83.25
Two Adults w/Child(ren) $93.50
Annual Vision Rates:
Single $100.00
Two Adults $183.00
Single w/Child(ren) $164.00
Two Adults w/Child(ren) $249.00
Stand Alone Dental 2000
For members not enrolled in the UCC Medical Benefits Plan, the Standalone Dental 2000 monthly rates will apply:
Single Tier 1 $46.75
Two Adults Tier 2 $90.25
Single w/Child(ren) Tier 3 $91.50
Two Adults w/Child(ren) Tier 4 $102.75


ALL RATES ARE MONTHLY, EXCEPT VISION


* The correct age rate is based on the employee's age as of January 1 of the current Plan Year.
* If an employee will age into a different age band during the current Plan Year, their rate will not change until January 1 of the following Plan Year.