Platinum  Small Group Plans

Our Platinum plans contain our highest premiums and are designed to include the lowest cost-sharing (deductible and copays) compared to other plans. View the plan details below. Please note, all premiums listed represent coverage for dependents up to age 26.

If you are part of an existing group with BlueCross BlueShield of Western New York, visit BlueConnect to enroll. If you are a new group and would like to enroll in a Platinum plan, please contact your broker or account executive.


  Platinum Standard Platinum align*
Platinum focus*
Platinum HMO 110 Plus Platinum PPO 843
Monthly Premium        
   Single $562.13 $511.29 $543.67 $640.83
   Employee & Child(ren) $955.62 $869.19 $924.24 $1,089.41
   Employee and spouse/domestic partner  $1,124.26 $1,022.58 $1,087.34 $1,281.66
   Family $1,602.07 $1,457.18 $1,549.46 $1,826.36
Primary Care Doctor/Specialist $15/$35 $20/$30, Optimum/Preferred
40% after deductible,
Flexible/Participating 
$20/$30   20% after deductible
Deductible (Single/Family) $0 $0, Optimum/Preferred 
$1,500/$3,000 embedded,
Flexible/Participating 

$0 $500/$1,000 embedded 
Inpatient Hospital Stay (per admission) $500 $500, Optimum/Preferred
40% after deductible,
Flexible/Participating 
$500 20% after deductible
Prescription Drugs:        
   Tier 1/2/3 $10/$30/$60   $5/$30/50%  $5/$30/50%  $10/$30/50% after deductible 
   Generic Oral Contraceptives Covered in full Covered in full Covered in full Covered in full
   Mail Order Drugs 2.5 Copays/90-day supply 2.5 Copays/90-day supply 2.5 Copays/90-day supply 2.5 Copays/90-day supply
 

Benefits & Coverage

Benefits & Coverage, align

 

Benefits & Coverage, focus

 

Benefits & Coverage

Benefits & Coverage

*Available in Erie and Niagara counties only

Platinum Standard*
   
Monthly Premium  
   Single $562.13
   Employee & Child(ren) $955.62
   Employee and spouse/domestic partner  $1,124.26
   Family $1,602.07
Primary Care Doctor/Specialist $15/$35 
Deductible (Single/Family) $0
Inpatient Hospital Stay (per admission)  $500 
Prescription Drugs:  
   Tier 1/2/3 $10/$30/$60 after deductible
   Generic Oral Contraceptives Covered in full
   Mail Order Drugs 2.5 Copays/90-day supply
 

Benefits & Coverage

*Available on SHOP

Platinum align* & Platinum focus*
   
Monthly Premium  
   Single $511.29
   Employee & Child(ren) $869.19
   Employee and spouse/domestic partner  $1,022.58
   Family $1,457.18
Primary Care Doctor/Specialist $20/$30, Optimum/Preferred
40% after deductible, Flexible/Participating
Deductible (Single/Family) $0, Optimum/Preferred
$1,500/$3,000 embedded, Flexible/Participating 
Inpatient Hospital Stay (per admission)  $500, Optimum/Preferred
40% after deductible, Flexible/Participating
Prescription Drugs:  
   Tier 1/2/3 $5/$30/50%
   Generic Oral Contraceptives Covered in full
   Mail Order Drugs 2.5 Copays/90-day supply
 

Benefits & Coverage, align

 

Benefits & Coverage, focus

 

   *Available in Erie and Niagara counties only

Platinum HMO 110 Plus
   
Monthly Premium  
   Single $543.67
   Employee & Child(ren) $924.24
   Employee and spouse/domestic partner  $1,087.34
   Family $1,549.46
Primary Care Doctor/Specialist $20/$30
Deductible (Single/Family) $0
Inpatient Hospital Stay (per admission)  $500 
Prescription Drugs:  
   Tier 1/2/3 $5/$30/50%
   Generic Oral Contraceptives Covered in full
   Mail Order Drugs 2.5 Copays/90-day supply
 

Benefits & Coverage

Platinum PPO 843
   
Monthly Premium  
   Single $640.83
   Employee & Child(ren) $1,089.41
   Employee and spouse/domestic partner  $1,281.66
   Family $1,826.36
Primary Care Doctor/Specialist 20% after deductible 
Deductible (Single/Family) $500/$1,000 embedded 
Inpatient Hospital Stay (per admission)  20% after deductible 
Prescription Drugs:  
   Tier 1/2/3 $10/$30/50% after deductible 
   Generic Oral Contraceptives Covered in full
   Mail Order Drugs 2.5 Copays/90-day supply
 

Benefits & Coverage

Visit BlueConnect to enroll. If you are a new group and would like to enroll in a Platinum plan, please contact your broker or account executive.


Fourth Quarter Platinum Standard* Platinum align**
Platinum HMO 110 Plus Platinum PPO 843
Monthly Premium        
   Single $525.56 $479.63 $513.40 $590.66
   Employee & Child $893.46 $815.38 $872.78 $1,004.12
   Employee and spouse/domestic partner  $1,051.12 $959.26 $1,026.80 $1,181.32
   Family $1,497.85 $1,366.95 $1,463.19 $1,683.38
Primary Care Doctor/Specialist $15/35 $20/$30, Optimum
$20/40% after deductible, Flexible 
$20/$30   20% after deductible
Deductible (Single/Family) $0 $0, Optimum 
$1,500/$3,000, Flexible embedded 

$0 $500 / $1,000 embedded 
Inpatient Hospital Stay (per admission) $500 $500, Optimum
40% after deductible, Flexible 
$500 20% after deductible
Prescription Drugs:        
   Tier 1/2/3 $10/$30/$60   $5/ $30 / 50%  $5/ $30 / 50%  $10/$30/50% after deductible 
   Generic Oral Contraceptives Covered in full Covered in full Covered in full Covered in full
   Mail Order Drugs 2.5 Copays/90-day supply 2.5 Copays/90-day supply 2.5 Copays/90-day supply 2.5 Copays/90-day supply
 

Benefits & Coverage

Benefits & Coverage

Benefits & Coverage

Benefits & Coverage

 
 $5/ $30 / 50% 
 $5/ $30 / 50% 

*Available on SHOP
**Available in Erie and Niagara counties only

Platinum Standard*
Fourth Quarter   
Monthly Premium  
   Single $525.56
   Employee & Child $893.46
   Employee and spouse/domestic partner  $1,051.12
   Family $1,497.85
Primary Care Doctor/Specialist $15/$35 
Deductible (Single/Family) $0
Inpatient Hospital Stay (per admission)  $500 
Prescription Drugs:  
   Tier 1/2/3 $10/$30/$60
   Generic Oral Contraceptives Covered in full
   Mail Order Drugs 2.5 Copays/90-day supply
 

Benefits & Coverage

*Available on SHOP

Platinum align**
Fourth Quarter   
Monthly Premium  
   Single $479.63
   Employee & Child $815.38
   Employee and spouse/domestic partner  $959.26
   Family $1,366.95
Primary Care Doctor/Specialist $20/$30, Optimum
$20/40% after deductible, Flexible 
Deductible (Single/Family) $0, Optimum
$1,500/$3,000 embedded, Flexible 
Inpatient Hospital Stay (per admission)  $500, Optimum
40% after deductible, Flexible 
Prescription Drugs:  
   Tier 1/2/3 $5/$30/50%
   Generic Oral Contraceptives Covered in full
   Mail Order Drugs 2.5 Copays/90-day supply
 

Benefits & Coverage

**Available in Erie and Niagara counties only

Platinum HMO 110 Plus
Fourth Quarter   
Monthly Premium  
   Single $513.40
   Employee & Child $872.78
   Employee and spouse/domestic partner  $1,026.80
   Family $1,463.19
Primary Care Doctor/Specialist $20/$30
Deductible (Single/Family) $0
Inpatient Hospital Stay (per admission)  $500 
Prescription Drugs:  
   Tier 1/2/3 $5/$30/50%
   Generic Oral Contraceptives Covered in full
   Mail Order Drugs 2.5 Copays/90-day supply
 

Benefits & Coverage

Platinum PPO 843
Fourth Quarter   
Monthly Premium  
   Single $590.66
   Employee & Child $1,004.12
   Employee and spouse/domestic partner  $1,181.32
   Family $1,683.38
Primary Care Doctor/Specialist 20% after deductible 
Deductible (Single/Family) $500/$1,000 embedded 
Inpatient Hospital Stay (per admission)  20% after deductible 
Prescription Drugs:  
   Tier 1/2/3 $10/$30/50% after deductible 
   Generic Oral Contraceptives Covered in full
   Mail Order Drugs 2.5 Copays/90-day supply
 

Benefits & Coverage

Benefits of Blue

BlueConnect

A comprehensive online benefits solution.

Wellness Card

Offered with every small group plan.

Preventive Services

$0 preventive drugs for small group plans.

Tiered Plan Benefits

Keep costs in line while having choices.