NYC Health Benefits Program

Summary of Benefits and Coverage (SBC)

 

Listed below are pdfs of summaries for each non-Medicare Health Plan offered by the New York City Health Benefits Program to its employees and non-Medicare retirees.

 

Aetna EPO Basic Plan 

Aetna EPO Basic Plan with Prescription Drugs 

Cigna HMO Basic Plan 

Cigna HMO Basic Plan with Prescription Drugs 

DC 37 Med-Team

Empire BlueCross BlueShield EPO Plan with Prescription Drugs

Empire BlueCross BlueShield EPO Plan without Prescription Drugs

Empire BlueCross BlueShield HMO with Prescription Drugs

Empire BlueCross BlueShield HMO without Prescription Drugs

Empire BlueCross BlueShield Hospital Plan Only (Companion to GHI-CBP Medical Coverage)

GHI-CBP Basic Plan 

GHI-CBP Basic Plan with Enhanced Schedule 

GHI-CBP Basic Plan with Enhanced Schedule and Prescription Drugs (Optional Rider)

GHI HMO Basic Plan   

GHI HMO Basic Plan with Prescription Drugs

HIP HMO Basic Plan 

HIP HMO Basic Plan with DME and PDN 

HIP HMO Basic Plan with Prescription Drugs 

HIP POS Basic Plan 

HIP POS Basic Plan with Prescription Drugs 

MetroPlus Gold

MetroPlus Gold with Prescription Drugs 

Vytra Basic Plan 

Vytra Basic Plan with Prescription Drugs