All eligible Rensselaer Faculty and Staff have the choice between two medical plans which are administered by Capital District Physicians Health Network (CDPHN): Rensselaer Health Plan (RHP) and Rensselaer HMO. Both plans include prescription drug coverage administered by Capital Rx, the cost of which is included in the employee’s medical plan premium. You have the option to receive specialty medications through ConnectRx or CVS Specialty Pharmacy Services.
Faculty and Staff should refer to the Benefits Guide and additional documents referenced below for specific health and prescription coverage information and costs. Understanding our health insurance is important to us.
CDPHP members have access to the national network of providers. Access CDPHP's Find A Doc tool to search for providers and 24/7 access to plan information via the My CDPHP app on a smartphone.
Important information regarding our health plan’s Machine-Readable Files (MRF)
This link leads to the machine-readable files that are made available in response to the federal Transparency in Coverage Rule and includes in-network negotiated service rates and out-of-network allowed amounts between health plans and healthcare providers. The machine-readable files are formatted to allow researchers, regulators, and application developers to more easily access and analyze data. https://www.cdphp.com/interoperability/machine-readable-pricing-data-files
Under the Rensselaer HMO plan, the plan pays for the employee’s care regardless of the nature or extent of treatment, except for any small co-payments the employee may need to make. There are no claim forms or deductibles for the HMO plan. Employees who choose to join the HMO plan must have all care coordinated by their Primary Care Physician (PCP). Employees may also assign and change their PCP at any time online or by contacting Member Services.
Employees who do not coordinate their care through their PCP will be responsible for paying the full cost of all care, although there are certain exceptions for emergencies.
- Rensselaer HMO Plan Summary Plan Description
- HMO Summary of Benefits and Coverage (In-Network only Coverage)
- HMO Benefit Summary
The Rensselaer Health Plan (RHP) offers in and out-of-network coverage. Rensselaer employees who decide to use a doctor or facility outside the network — or who see a network provider without a referral from their PCP — will still receive benefits from the plan, but they will pay a larger share of the costs, and you will have to file a claim for reimbursement.
Rensselaer employees who live outside of the area serviced by the network of doctors and medical service providers, you can still join the RHP, and be eligible for benefits of the Traditional Plan component, and you will have the freedom to select any doctor. Preventive care/annual exams are covered in full. For all other covered services, the employee’s cost share is a copayment or coinsurance after they have met their required deductible.
- Rensselaer Health Plan and Traditional Summary Plan Description
- Rensselaer Health Plan Summary of Benefits and Coverage (In and Out of Network Coverage)
- Rensselaer Health Plan Benefit Summary
- Traditional Summary of Benefits and Coverage (for employees out of area only)
- Traditional Plan Benefit Summary
Use CDPHP's Find-A-Doc tool to search for providers in your area.
- Visit Find-A-Doc
- Enter your location
- To find participating providers for the HMO Plan select: HMO National
- To find participating providers for the Rensselaer Health Plan select: POS National
- To find participating providers for the Traditional Plan select: Traditional Plan National
- For additional assistance locating providers, contact CDPHP by calling the phone number on the back of your ID card.
All offered CDPHP Medical Plans include Prescription coverage administered by Capital Rx. Covered members can always access prescription benefit information via their CDPHP member account online or via the CDPHP ConnectRx, On the Go app for smartphones.
The tiered format places drugs into tiers in the following manner:
- Tier 1: Preferred Generics
- Tier 2: Preferred brands, non-preferred generics
- Tier 3: Non-preferred brands, select non-preferred generics
- Tier 4: Preferred Specialty
- Tier 5: Non-preferred specialty
To find a specific medication visit CDPHP's Formulary 5 then view your plan Benefit Summary above or PRPI's Benefits Guide for the cost.
Prescription coverage also includes:
- CDPHP Preferred Rx Network pharmacy: Location search
- Beginning January 1, 2024: Optum Home Delivery will offer home delivery services for prescriptions for a 90 day supply for two copays. Call 1-888-292-6330 for help with transferring your prescriptions.
- Costco Home Delivery - call the phone number on the back of your CDPHP ID cards to switch to this additional option for a 90 day supply for two copays. A Costco membership is not required.
- Rx for Less is a program for all CDPHP members, offering deep discounts on a specific list of medications when purchased at Market 32/Price Chopper, Walmart, Hannaford, Walgreens , ShopRite and other participating pharmacies. Many generic prescription medications are available for as little as $1.
- Free Local Home Delivery with ConnectRx: ConnectRx pharmacies, offer free and personalized local home delivery services in the broader Capital Region. With locations in Watervliet, Clifton Park, and Latham, you can pick up your prescriptions in-person or have them delivered. Visit pharmacyconnectrx.com find locations or to transfer your prescription now.
- Manage Prescriptions from Your Phone: With the CDPHP ConnectRx, On the Go app, you can change pharmacies quickly and easily, plus view prescriptions and cost-saving alternatives. Search in your Android or Apple app store on your smartphone to download.
CDPHP supports the health and wellbeing of our Faculty & Staff and families in many other ways:
- Doctor on Demand: 24/7 access to doctors via live video. Online counseling services include online therapy and psychiatry for behavioral health.
- Additional Mental Health Resources
- CDPHP Health Hub: Powered by Personify Health, earn points for the healthy activities you do such as walking, eating well, participating in challenges, and competitions, and more! These points turn into CDPHP Life Points® Rewards. Up to $365 each year (redeem by the end of each year)
- Free Wellness Classes: A variety of classes online or in the Capital Area.
- Weight Management: Support tools and a eligible program reimbursement
- Fitness Reimbursement: Up to $400 for members and $200 for spouses and dependents (combined) for eligible gym, fitness, qualified devices, parent and baby, youth sports programs and more!
- Register for your CDPHP member account for access to other covered programs.
