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Short term disability insurance is mandatory in New York, but not all insurance providers are created equal. Here is our list of the best NY short term disability insurance companies.  As independent insurance agents, we are not beholden to any insurance company. Our recommendations are based on more than 25 years of working with these companies and the following criteria:

  • Financial Strength – Ability to pay claims
  • Most Competitive Price
  • Highest Quality
  • Ease of Doing Business
  • Customer Service

This list can change at any time depending on which companies are offering the best coverage at the best price. But first, let’s briefly discuss what the New York State Mandatory Disability program is and how it works.

  1. Standard Security
  2. ShelterPoint
  3. Arch
  4. Hartford
  5. Guardian
What Is New York Short Term Disability Insurance?

If you are an employer in the state of New York, you are required to provide short term disability benefits to all your employees. New York is one of a handful of states that require this coverage. You can purchase this coverage directly from the Worker’s Compensation Board which oversees this program, or you can purchase coverage from a state approved insurance company.

How Do Short Term Disability Benefits Work?

An employee is eligible to receive benefits if he or she suffers an off-the-job illness, injury or disability, including pregnancy. Benefits are paid weekly to the employee and are equal to 50% of the employee’s average weekly salary up to a maximum of $170.00 per week.

Benefits become payable on the 8th consecutive day of disability and continue for up to 26 weeks. Employers can pay 100% of the premium or require employees to pay their share. However, an employee cannot pay more than 60 cents per week or $31.20 per year. You can read more about the program here: NY Mandatory Disability

The Best NY Short Term Disability Insurance Companies 1. Standard Security Life Insurance Co of New York

This company takes our top spot because of the ease of doing business with them. They usually can approve a new short-term disability policy in less than 48 hours.

And if you received one of those nasty fines from the worker’s compensation board for forgetting to provide coverage to your employees, Standard Security can often back-date your policy up to 6 months to reduce the fine.

Standard Security is located in mid-town Manhattan and is rated A-(Excellent) by A.M. Best. They have been providing disability insurance for more than 60 years and cover more than 50,000 employers. If you have not compared your current rates to those of Standard Security, you’re probably paying too much.

2. ShelterPoint

Formally known as First Rehabilitation Company of America, ShelterPoint has been providing short term disability coverage for more than 40 years. This company is also one of the largest providers of DBL coverage with more than 150,000 business customers.

We like this company for their excellent customer service, competitive pricing (not the lowest) and their ability to handle difficult cases where coverage has lapsed for several years. Shelter Point is located in Long Island, NY and is rated A-(Excellent) by A.M. Best

3. ARCH Insurance

Also known as Arch Capital Group Ltd. (Arch Capital or ACGL), is a Bermuda public limited liability. The company writes short term disability insurance in both New York and New Jersey where this coverage is mandatory. Arch also specializes in Accident insurance, mortgage insurance, worker’s comp and provides insurance solutions for alternative markets such as aviation and construction.

We like working with Arch because of their outstanding customer service, ability to pay claims quickly and their knowledge of specialty markets. Arch is rated A+ (Superior) from A.M. Best and A+ from Standard & Poors. Their New York division is located in downtown Manhattan.

4. The Hartford

Hartford Financial is one of the oldest insurance companies in the United States. It was founded in 1810 and is one the largest insurance and financial institutions in the world. This company covers all lines of personal and business insurance but also excels in the NY DBL program. Their rates are very competitive, and their customer service department is helpful. However, they are slow to approve new policies, taking about 7 business days or more.

So, if you are looking for a fast turnaround for your policy, Hartford is probably not the best choice. But if you are looking to bundle your business insurance and group insurance policies with your DBL program, then Hartford would be our top choice. Hartford is headquartered in Hartford CT and receives an A rating (Excellent) from A.M. Best

5. Guardian

Guardian Life Insurance Company has been around for more than 150 years. They are one of the largest and highest financially rated insurance companies in the world. Although the company provides many lines of personal and business insurance, they also provide NY short term disability insurance. Their rates are competitive but definitely not the lowest.

This company has weathered the great depression and numerous financial calamities so if you are looking for financial stability, Guardian is our top choice. Guardian is located in downtown Manhattan and is rated A++(Superior) by A.M. Best.

NY Short Term Disability Quotes For Your Business

We represent some of the highest rated disability insurance companies in the industry. If you would like a NY short-term disability insurance quote for your business, please give us a call today at 914-633-1717 to speak to a licensed, independent disability insurance agent.

The post Best NY Short Term Disability Insurance Companies appeared first on Healthplansny.

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The IRS has released the inflation adjusted HSA Contribution Limits For 2018. All limits have increased over the amounts announced in 2017. HSA’s are tax advantaged savings accounts and have become a very popular way for people to pay for out-of-pocket medical expenses. In fact, according to the latest research by Devenir Investments, it is predicted that HSA assets could reach more than $53 billion in 2018. But to fully unlock the benefits of HSA’s, you should understand how they can be a powerful financial planning tool.

Background on Health Savings Accounts

A Health Savings Account, or HSA, is a financial savings account established by an individual or family to pay for qualified medical expenses. HSA’s combine the benefits of qualified plans such as 401(k)s and IRAs whereas contributions are tax-deductible and grow tax-deferred.

Taxpayers receive a 100% income tax deduction on annual contributions. Unlike a 401k or IRA, withdrawals from an HSA are tax-free as long as funds are used for qualified medical expenses. There is no “use it or lose it” rule and unused funds can be rolled over each year to pay for future medical expenses.

Common Questions About Health Savings Accounts What Type of health Plan is Required?

A High Deductible Health Plan (HDHP) which is defined as a health plan with an annual deductible that is not less than $1,350 for single coverage or $2,700 for family coverage

What Are the HSA Contribution Limits For 2018?

For calendar year 2018, the limitation on deductions for an individual with self-only coverage under a high deductible health plan is $3,450. The limits on deductions for an individual with family coverage under a high deductible health plan is $6,900. See Chart below:

Who Is Eligible For an HSA?

Any employee who is enrolled in a Qualified High Deductible Health Plan (QHDHP) and not covered by any other insurance program for health expenses. Medicare recipients are not eligible.

Who Owns The Account?

The employee or individual

How is The Account Funded?

Money is deposited directly into the employee’s account. Contributions can be made by the employee through lump sum contributions or pre-tax payroll deductions. An employer may also contribute to the employee’s account.

What Investment Options Are Available With An HSA?

Many HSA custodians such as banks, offer a wide range of investment options; mutual funds, money market funds or savings accounts. Invest wisely and you may see your HSA balance grow each year.

Is A Health Savings Account Portable?

Yes, the employee owns the HSA, and they can take it with them into retirement and even pass it on to their heirs.

What is The Tax Treatment of An HSA Account?

Contributions to these accounts are made on a pre-tax basis, and funds may be used tax free for qualified health care expenses.

What are Qualified Medical Expenses?

Medical expenses are the costs of diagnosis, cure, treatment or prevention of sickness or disease. These expenses include payments for legal medical services rendered by physicians, surgeons, dentists, and other medical practitioners. They include the costs of equipment, supplies, and diagnostic devices needed for treatment.

Can The Account Be Used For Non-Medical Expenses?

Yes. However, funds used for non-medical expenses are taxed as income and incur a 20% penalty. After 65, there is no penalty but withdrawals for non-medical expenses are still taxed as regular income.

Little Known Benefits Of Health Savings Accounts.

HSAs provide four substantial tax benefits that other retirement savings options cannot provide.

1. Your HSA contributions are not taxed
2. Contributions are tax-deductible
3. No taxes are paid on the interest earnings in an HSA.
4. You may make tax-free withdrawals for qualified medical expenses.

At age 65, you may take penalty-free distributions from your account for any reason, but you will still have to pay income tax. If you use your account for qualified medical expenses, distributions will  be tax-free and penalty-free.  This is a huge advantage over other retirement vehicles such as 401(k) plans and IRA’s.

Studies show that Americans face higher out-of-pocket medical expenses after age 65. With an HSA, you can pay these medical expenses with tax-free dollars. Furthermore, you can use your HSA funds to pay for Medicare parts A, B, D, and Medicare HMO premiums.

Is An HSA Right For Your Company?

HSA’s are becoming one of the most popular insurance planning vehicles for employers to reduce health care premiums and provide additional compensation to employees. If you would like to know how your company can implement an HSA plan, call our office at: 914-633-1717

The post HSA Contribution Limits For 2018 appeared first on Healthplansny.

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Text messaging provides an easy way to make sure your employees understand their new health plans. Here’s how SMS can make your open enrollment process easier. Direct communication speeds up the enrollment process and makes it easier to share information on the various medical plans available. Texts are received within minutes, while most emails are ignored.

This is a guest post by Ken Rhie, the CEO of Trumpia. “Text messaging is a quick and cost-effective way to improve awareness of your company’s open enrollment period.”

When you want your HR department to have a direct way to reach employees to choose health plans, text messaging is the answer.

Here’s why text messaging will make your open enrollment period run more smoothly:

It’s Easy to Share Open Enrollment Dates and Timelines

Digital communication is less expensive than traditional methods used to promote the open enrollment period when choosing health plans. Instead of creating all kinds of printed materials, digital materials can be created instead. While you may have a few employees that rely on posters and postcards, most will appreciate having a link sent regarding dates and timelines. Text messages are easy to refer back to at any time.

Boost Open Enrollment Awareness Via Keywords

Usually, open enrollment dates and deadlines include sending emails, printing handouts, printing info graphics, and mostly by answering questions through calls or emails. However, all of these methods have proven to be out of date and less efficient than new communication tools, such as SMS. A quick and cost-effective way to improve awareness of your company’s open enrollment period is to use mobile keywords. With a read rate of 98%, it is crucial to opt-in your employees to receive text alerts.

By advertising a keyword, such as “MEDICAL”, you can check to see who have received the requested information and are aware of the upcoming healthcare enrollment period. By creating multiple keywords, you can sort your employees into specific distribution lists to send targeted enrollment information.

For more information on how SMS keywords can boost your open enrollment awareness, text OPEN to 76000! (message & data rates may apply)

You’ll Save Valuable Time

It’s easy to track employees and created targeted groups by using texting. Once you have delineated different groups, you can make communications relevant to specific employee groups. Once you begin to send relevant, targeted information regarding various health plans to your employees, you won’t be wasting time on unnecessary communication. Employees will be aware of what is going on at all times without being inundated with too much information.

Bulk Messages Reach Everyone Quickly

Open enrollment periods are more successful when your employees have plenty of notice that the open enrollment period is beginning. When you send out a group text message to alert employees that the enrollment period is about to start, this will get employees thinking about their current health plan benefits. With the ability to remind employees that it’s time to think about benefits, employees will be able to make more informed choices.

Links to Specific Information are Easier to Share

Your employees will have questions about the various health plans that are available to choose from. When you have links to content created that explains each plan in detail, it’s easy to share these links through text messaging. This allows your employees to read about plans on mobile devices and have a set of links that can be referred to at any time within easy reach.

Questions Can be Answered With Automated Messaging

You will have a specific set of questions that are the most frequently asked. Instead of having an HR employee answer each question individually, you can save time with automated messaging. For example, an employee could ask, “When does open enrollment end?” and a text can be sent back automatically with the date the open enrollment period is over.

Feedback is Simple to Gather through Text Messaging

Text messaging is a simple way to gather feedback from your employees who just went through the open enrollment period. The process can be lengthy and complex for everyone involved. Asking for feedback right when the period ends will help you be more prepared for the following year. Providing a digital way to provide feedback instead of traditional paper makes it easier for you to collect data and analyze it.

The open enrollment period is a time that requires solid communication between your HR department and the employees it serves. With text messaging, communication will be streamlined. It is easier for employees to ask quick questions about health plans through texting. HR will be able to reach employees, even if they are on the go. It’s fast communication and improves the overall experience of open enrollment.

Author Biography:

Ken Rhie

Ken Rhie is the CEO of Trumpia, which earned a reputation as the most complete SMS solution including user-friendly user interface and API for mobile engagement, Smart Targeting, advanced automation, enterprise, and cross-channel features for both mass texting and landline texting use cases. Mr. Rhie holds an MBA degree from Harvard Business School. He has over 30 years of experience in the software, internet, and mobile communications industries.

The post How SMS Can Make Your Open Enrollment Process Easier appeared first on Healthplansny.

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Our unbiased Healthfirst Insurance review sheds light on this new comer to the New York group health insurance marketplace. As independent insurance agents we give you the real scoop whether this insurance carrier is worth consideration for your business.

About Healthfirst Insurance Company

At first glance, most New Yorker’s might recognize the Healthfirst insurance company as a provider of Medicare, Medicaid and individual health plans to lower income consumers. However, their organization has been steadily expanding their insurance products from its start of Medicaid plans, Medicare and now to the small business market.
The company was founded in the early 1990’s by a group of hospitals under the backing of the Greater New York Hospital Association. Healthfirst serves more than 1.2 million members in downstate New York and Nassau county.

Quick Tip! Use our group health comparison tool to get a free quote for your small business.”

Healthfirst Health Insurance Network

This not-for-profit insurance carrier has established alliances with some of the most prestigious hospitals in the New York City area. Hospitals such as Phelps, Jacobi Medical Center, Montefiore and Northern Westchester Hospital just to name a few.

The Healthfirst provider network is relatively small compared to most other major health care providers. Their network of doctors and hospitals are limited to the New York City area, boroughs and Nassau county. As the company increases its membership base, they will undoubtedly expand their alliances to more doctors and medical groups in other regions.

Why Healthfirst for Small Business?

If you are a small business owner, you might want to consider this company as your new group health insurance provider. After all, there aren’t too many choices for small business health insurance in the state of New York. The main providers are Oxford, Oscar, Aetna, Emblem, Empire Blue Cross and MVP and now, Healthfirst.
Their pricing is competitive but not the lowest. If your business and workers are located in New York City, you might find this company a good fit for your business.

Healthfirst Group Health Plans

The company offers a robust suite of EPO (Exclusive Provider Organization) health plans. Compared to other health care providers, their plan offerings are relatively simple. They offer 2 EPO health plans designs: Pro EPO and Pro Plus EPO.

The only difference between the EPO Pro and EPO Pro Plus is that PRO includes the option to purchase adult dental and vision insurance. Both plan designs meet all the essential health care requirements as mandated by The Affordable Care Act (ACA). They include, Platinum, Gold, Silver and Bronze options.

Small Group Health Plan Requirements

For an employer to be eligible for a Healthfirst small group health plan, the employer must have at least 1 eligible employee on payroll and no more than 100 employees.
In addition, the employer must be located in New York state and have employees who work or live in: Manhattan, Queens, Bronx, Brooklyn, Nassau and Staten Island.

60% of employee participation is required. For employees that are not enrolling, valid waivers of coverage are required. These waivers include: Spousal coverage, Domestic Partner group coverage, Medicare, Medicaid, Veterans coverage, COBRA, Parental Coverage, Individual/Family Qualified Health Plan from NY State

Standard health care benefits include:

• No-cost annual checkups
• Urgent care visits
• Hospital stays
• Lab tests (blood tests & X-rays)
• Maternity and newborn care
• Prescription drugs
• Vision and dental benefits for all ages*
• $0 copay for access to 24/7 telemedicine
• Up to $600 in exercise rewards
• Coverage for acupuncture visits

*Available for EPO Pro Plus Only

The Healthfirst Bottomline

We like this company because of the simplicity their health plan offerings. Their plans are simple to understand and not confusing like other insurance carriers. Although their network coverage is rather limited to lower New York, we are confident they will expand as they gain more customers. With such a limited group health marketplace as we have now, it’s refreshing to have an additional company to offer our clients.

Compare Healthfirst Insurance Quotes

The best way to decide if Healthfirst is right for your business is to shop around. We provide real-time group health quotes from our comparison tool. You can compare quotes, rates, and services from all our top health insurance companies. This information will help you decide if Healthfirst Insurance is right for you and would meet your insurance needs.

As independent agents, we offer unbiased advice and will not try to push you to one particular insurance carrier. We work the best health insurance companies in New York, New Jersey and Connecticut. If you would like a free group health consultation, give our office a call at: 800-514-3513

The post HealthFirst Insurance Company Review appeared first on Healthplansny.

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Most employers understand that in order to attract and retain quality employees, they need to offer a comprehensive group benefits program. Nowadays, employees are looking for more than just health insurance benefits.

Disability insurance is probably one of the most overlooked types of insurance coverage and yet, it is one of the most important. The ability to earn an income is your most important financial asset.

Many people insure their homes, their cars and their valuables but without the ability to earn an income, those precious assets would not exist. According to the Council For Disability Awareness, 90% of people know they should be prepared for a disability but less than 5% of the workforce has disability insurance protection.

As an employer, you can help protect your employers from a financial disaster by offering a group disability program to your employees.

What Is Group Disability Insurance?

Group disability insurance is insurance coverage that helps employees protect their income should they become sick or injured and unable to work for an extended period of time. This coverage does not insure employees if they are injured at work. Workman’s Compensation covers work related injuries.

A disability contract covers many employees or a group or association. The group has a mutual interest with the company or employer. All eligible employees may be covered under the policy, and the cost of group coverage is often less expensive than the cost of individual coverage.

Who Pays The Cost Of Group Disability Insurance?

The employer can pay the full cost for the employee which is called non-contributory or the employee can pay for the cost of coverage through payroll deductions. Employee paid is called a contributory contract and this type of arrangement will require participation requirements, usually 75%.

There are 2 types of disability insurance an employer can offer to his or her employees: Short Term and Long Term Disability

Short Term Disability – Coverage for Temporary Disabilities

Short-term disability (STD) insurance is coverage for temporary disability due to sickness or injury. It pays a percentage of your salary for a short period of time. Short-term disability reimburses up to 66 2/3% of the insured’s weekly earnings. In addition, the plan could include rehabilitation benefits to help the employee return to work.

  • Pays a percentage of your salary temporarily – usually 26 weeks
  • Reimburses up to 66 2/3% of your weekly earnings
  • May include rehab services to help you get back to work
Long Term Disability – Coverage For Permanent or Total Disabilities

Long Term Disability Insurance (LTD) protects you if you become disabled for a prolonged period of time. Coverage begins when short term disability runs out or after the “Waiting Period” which is normally 180 days. It reimburses up to 60% of your salary to help pay monthly bills and expenses.

  • Starts after waiting period or when short term disability runs out
  • Reimburses up to 60% to 70% of your monthly earnings
  • Helps pays for monthly bills and expenses
Are Group Disability Benefits Taxable?

IRS Code, Section 105 indicates that disability benefits are to be included in the gross income of employees if the employer pays all or part of the premium (Non- Contributory). If the employee pays for the disability premium (Contributory), the benefits received are tax free. See chart below:

 Advantages of Group Disability Insurance

Probably the biggest advantage is that most plans do not require or ask for medical background information making it easier for the employee to qualify for coverage. Disability insurance covers employees when they get sick or injured and can’t come to work because of their illness or injury. The employee receives a percentage of their salary – usually 60% to help them pay their personal expenses and sometimes medical expenses for an extended period of time.

Another advantage is that the employer does not need to have a salary continuation program in place should the employee become sick or injured. The disability benefits will help provide income so the employee can pay monthly bills or extended medical expenses.

Disadvantages of Group Disability Insurance

No Coverage For Pre-existing Conditions: Group policies will most likely have a number of exclusions. There certain types of disabilities that won’t be covered. Pre-existing conditions such as back problems or cancer will most likely not be covered should the employee get re-injured or fall sick due to a previous health condition.

Any Occupation Not Own Occupation: Most group policies have language that does not cover the employee in their own occupation. These contracts are written so if an employee is disabled and cannot work at his or her job but can do any job, the employee must go back to work or benefits won’t be paid.

Taxation of Benefits: With group disability insurance, your premium payments are most likely tax-deductible so that makes your disability benefits taxable while you are collecting. The 60% monthly income from your policy is reportable on your tax return making it really 40 or 50%.

Most Policies are not Portable: If you leave your employer, your policy stays behind.

Long Term Disability “Must Haves”

Own Occupation Coverage:

This coverage protects the job responsibilities you perform on a daily basis. If you become injured or sick and cannot perform 2 or more of your duties, you are considered disabled. You will qualify for benefits after the waiting period. “Any Occupation” contracts on the other hand, will force an employee to go back to work if they can work at any job. Even if it means flipping burgers or sweeping floors.

Partial or Residual Benefits:

Most people become partially disabled before they become totally disabled. Meaning an employee can work a few days a week due to a sickness or injury but cannot work full time. Some policies will not pay anything unless the employee is totally disabled. Partial or residual benefits pay for the time the employee works – even if it is only one day a week.

Short Elimination or Waiting Periods:

The Elimination Period is the amount of time you must wait before benefits are paid. During this time, no benefits are paid and the employee must pay household expenses and bills from their savings. The best disability contracts have Elimination Periods of 60, 90 or 180 days. Beware of contracts that have 1 or 2 year Elimination Periods.

Earnings Testing

The monthly benefit should be based on total compensation including, salary, bonuses, commissions and so on. Some contracts base the monthly benefit on salary only reducing the amount of income that will be paid by the insurance carrier.

Benefits Duration to Age 65

If the employee becomes totally or permanently disabled, the payment period should last to the normal retirement age of 65. Watch out for contracts that only pay benefits for 2, 5 or 10 years.

Best Group Disability Insurance Companies

There are many insurance companies in the employee benefits arena that offer group disability insurance. But just because you have your group health plan or dental plan with a certain carrier, does not mean you should let them provide your group disability contract. Disability insurance contracts differ from company to company. By no means will a group policy compare with an individual policy but you want to make sure your employees have the best coverage available.

Here’s how we rate the best group disability insurance providers:

Quality of Contract: Most group disability carriers offer similar contracts with the same definition of disability and benefit options. However, the companies on our list make a habit of providing superior contracts that stand above the rest.

Financial Ratings: The financial strength of an insurance company is very important when considering any type of insurance program for your company. You want to be sure the insurance carrier will be able to pay claims and has stability to be in business for the long term.

The rating agencies we follow are:

A.M. Best: Provides objective opinion regarding an insurer’s, issuer’s, or financial obligation’s relative creditworthiness. Their top rating is A++ – Superior
Standard and Poors (S&P): Measures the credit quality of an insurer and the ability to meet their financial obligations. Top rating is AAA – Extremely Strong
Moodys: Provides opinion of future creditworthiness of an insurers ability to pay claims in relation to the investments and current book of business. Top rating is Aaa – Highest
Fitch: This agency provides an opinion on the relative ability of a company to meet their financial commitments, such as interest, repayment of principal, and insurance claims. Fitch’s’ highest rating is AAA – Exceptionally Strong

Competitive Pricing:

While financial stability is essential, competitive pricing is just as important. You don’t want to pay more to one company when another company is offering the same coverage at a lower price.

The 5 Best Group Disability Insurance Providers

Reliance Standard is a leading insurance company specializing employee benefits including short and long term disability income. Reliance Standard markets their contracts through independent brokers and agents to employers of all sizes. Their rates are very competitive and continuously make our list of top providers.

Reliance Standard Financial Ratings:

AM Best Rating: A+ (Superior)
Standard & Poor’s Rating: A (Excellent)

Reliance Group Disability Plan Features:

  • No earnings test
  • Extended disability benefit
  • Partial and Residual Disability Benefits
  • Maximum monthly benefits up to $24,000 – Best in Class!
  • Benefit percentage from 40% up to 66 ⅔%
  • Elimination (Waiting) periods from 30 days up to 5 years
  • “Own Occupation” definition of disability from 12-60 months, or long term
  • Partial and residual benefit available
  • Rate guarantees up to 3 years

Cigna is the number 1 provider of group disability benefits with almost 1 $Billion in annual premium. The company offers employer paid and employee paid group long term and short term disability insurance with very competitive rates.

Financial Ratings

Standard & Poor’s – AA-
Fitch – A+
A.M. Best – A
Moody’s – A1

Cigna Group Disability Plan Features:

  • All classes of employees working more than 30 hours per week
  • Regular Occupation
  • Partial and Residual Disability Benefits
  • 6 Month Waiting Period
  • 60% of monthly Salary
  • $4,000 per Month Maximum Benefit
  • 24 Months Deemed Totally Disabled

The Hartford Life Insurance Company is part of The Hartford Financial family. The company was founded in 1810 and is one of the world’s largest providers of group benefits.
They offer a full line of flexible benefits including short term and long term disability. Hartford is one of the one of our lowest priced competitors.

Financial Ratings:

A.M Best – A-
Moody’s – Baa2
S&P – BBB+

Hartford Group Disability Features:

  • Up to 67% Monthly Salary
  • Modified Own Occupation
  • Partial and Residual Disability Benefits
  • Waiver of premium
  • 100% return-to-work incentive
  • Workplace modification and family care credit
  • Competitive Pricing
  • 2 Year Rate Guarantee

MetLife is the largest group benefits provider in the world. They are one of the most recognized names in the benefits market. The company specializes in the large group marketplace for companies with more than 100 employees but still offers policies to smaller groups with as few as 10 employees. Their policy pricing is competitive but it is not the lowest.

Financial Ratings:

A.M Best rating – A+
Moody’s rating – Aa3
Fitch rating – AA-
S&P rating – AA-

Met Group Disability Features:

  • Regular and Own Occupation Coverage
  • Partial and Residual Disability Benefits
  • 90 to 180 Day Waiting Period
  • Maximum benefit periods are two years, five years, and to age 65
  • 24 Months Totally Disabled
  • 60% of Gross Monthly Salary
  • $5,000 Maximum Monthly Benefit
  • Return to Work Incentive

The Standard was founded in 1906 and is probably not as well-known as the other big name group benefit providers. However, the company is ranked # 9 of all group disability insurance providers. The Standard makes our Best Group Disability Company list due to its competitive pricing, customer service and quality of contract.

Financial Ratings

A.M. Best – A (Excellent)
S&P Rating – A2 (Strong)
Moody’s – A2 (Good)

The Standard Group Disability Features:

  • Any Occupation and Own Occupation Coverage
  • Own Occupation Coverage to Age 65 – Best in Class!
  • 30 to 180 Day Waiting Period
  • Maximum benefit periods to age 65
  • Partial and Residual Disability Benefits
  • 24 Months Totally Disabled
  • 30 to 70% of Gross Monthly Salary
  • Rehabilitation Benefits
  • Return to Work Incentive
Group Disability Insurance For Your Business

If your small business is looking for group disability quotes, we can help. We work with these top 5 companies and many more. The advantage of working with many insurance carriers is that we can obtain numerous quotes and we are not beholden to any company. Our advice is unbiased and we work for you – our client!

We can help you compare pricing, benefits and features side by side so you can make an educated decision about which carrier would be the best fit for your business as well as your employees. Just call our office at: 800-514-3513

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Northwell Health, the parent company of CareConnect Health Insurance has just announced that CareConnect plans to exit the New York Health Insurance marketplace in 2018. This news comes as a major blow to the already limited health insurance marketplace available to consumers and small businesses in the state of NY.

CareConnect will be winding down their operations over the next year and will no longer be offering individual or group health insurance plans for 2018. In addition, all existing CareConnect individual plans sold on the New York State Health Exchange will expire at the end of this year. Leaving more than 100,000 consumers scrambling to find another health insurance plan for 2018.

The company is New York state’s largest health care provider, insuring more than 14 percent of small businesses and 8 percent of consumers in the individual ObamaCare marketplace. CareConnect served customers in New York City, Long Island and Westchester with 22 hospitals and 550 outpatient facilities.

CareConnect Has Become Financially Unsustainable

Northwell Health, one of NY’s major insurance companies, has sustained severe losses and blames a flawed provision in the Affordable Care Act (ACA) as the culprits for winding down its CareConnect insurance company. The company said it had to pay $112 million or 44% of their revenue last year (2016) and more than 100 million next year into a health insurance risk pool. The risk pool was created by The Affordable Care Act (ACA) to spread the risk of insurers that had take on clients with serious pre-existing health conditions.

According to a statement made by Northwell’s CEO, Michael Dowling, “It has become increasingly clear that continuing the CareConnect health plan is financially unsustainable, given the failure of the federal government and Congress to correct regulatory flaws that have destabilized insurance markets and their refusal to honor promises of additional funding,”

Small Group Employers Offering CareConnect Health Insurance

Small group employers (2-100 employees) will need to take action to purchase a new group policy before the renewal date of their current CareConnect health plan. These employers will need to apply as a new group at least 45 days before their renewal with another insurance company. Other small group options include; Oxford, Aetna, EmblemHealth, Empire Blue Cross and new comer, Oscar health insurance – which only covers New York City and the surrounding boroughs.

CareConnect Individual Health Plan Members

CareConnect has announced that all individual health plans purchased on the New York state of health (NYSOH) marketplace will expire on 12/31/2017. A new health insurance plan must be purchased during “Open Enrollment.” The open enrollment period begins on 11/1/17 and runs through 12/15/17. If you want new health insurance coverage effective by 1/1/2018, you will need to purchase a plan within that time-frame.

CareConnect Private Health Insurance Members

Consumers that have purchased private health insurance through brokers or third party providers might still be able to keep their health plans until mid-2018 according to our source at CareConnect. The company is working with New York Department of Financial Services to withdraw their private health plans gradually from the marketplace.

What’s Next For Individual Health Insurance in New York?

Unfortunately, once CareConnect withdraws their private insurance plans, there are not many options to buy individual health insurance. Oxford, Aetna and Affinity Health have all discontinued their individual health plans. It is rumored that Empire Blue Cross will be pulling out of the individual insurance market in early 2018.

The options for individual health insurance are slim to none. Most consumers will be forced to purchase ObamaCare coverage on the health exchange which is inferior coverage and not accepted by many doctors. One of the few private health insurance options still available is through the Employers Network Association (ENA). ENA provides 4 different health plan options and 2 different networks for insurance coverage. For more information on the ENA health plan options, you can learn more here: Individual Health Insurance Plans.

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If you’re an employer, looking for a group health insurance, our Cigna health insurance company review will help you know if this company is right for you. There are many insurance companies that offer group health insurance but very few can compare to the prestigious list of Fortune 500 companies that use Cigna to provide health insurance for their employees.

While Cigna also provides individual health insurance and Medicare plans to consumers in more than 15 states across the country, their main focus is providing group benefits to small and large companies in the U.S and around the globe. This is why Cigna makes our list of the Best New York Health Insurance Companies.

Cigna is a global health service leader that provides medical, dental, disability, life and accident insurance to consumers and businesses. In 2016 Cigna was the sixth largest health insurance provider in the world calculated by earned revenue.

Their Global network includes more than 1 million relationships with health care professionals, clinics and facilities including:

  • 96,000 Behavioral health care professionals
  • 70,000 Pharmacies
  • 76,000 Vision care providers
  • 140,000+ Dental facilities

If you are a small business owner lucky enough to qualify for a Cigna health insurance plan, you know the importance of Cigna’s plan diversity and vast network of doctors and hospitals.

Cigna Health Insurance Company History

Not many insurance companies can date back to the days when Kings ruled most of the world but Cigna is one of them. The insurance company was founded in 1792 by a group of Philadelphia citizens. They formed the Insurance Company of North America (INA) which was the first marine insurance company in the United States.

In 1865, the Governor of Connecticut signed a special law creating Connecticut General Life Insurance Company (CG). In 1919, the company began its move into the health insurance market.

The name Cigna was formed in 1982 through a merger of INA Corporation and Connecticut General Corporation.

Cigna is headquartered in Bloomfield, CT and Philadelphia, PA. Their customer service number for employers and employees is: 1.800.244.6224

Health Plans for Small Businesses (51 to 250 employees)

Cigna Guided Solutions

Guided Solutions provides a suite of flexible group benefit solutions including medical and prescriptions, dental, vision, disability, life and accident insurance. If you’re an employer with more than 51 employees (New York, 100 eligible employees), Cigna is offering its own Private Retail Exchange solution where clients and eligible employees can access health insurance and ancillary products online. Their online portal allows your employees to sign up for benefits, change family membership and view claim processing.

Cigna Guided Solutions offers your employees access to two networks:

Cigna LocalPlus®: Gives your employees cost effective access to local quality doctors, specialists and hospitals where they live.

Open Access Plus (OAP): Gives employees more choices and convenience for medical care with direct access to Cigna’s national network.

Health Plans For Medium To Large Businesses (250+ Employees)

Cigna Funding Solutions

Cigna Funding Solutions offers two options to employers that helps employers and employees save money with predictable premiums and medical expenses.

Level Funding Program:

The level funding health program combines traditional fully insured medical insurance with a level premium that does not change for one whole year. Premiums are calculated on the employees’ health and medical history. Medical bills are paid by Cigna and if there are less claims than anticipated, funds are refunded to the company/employees.

Self-funding with Stop Loss:

Very similar to a Health Reimbursement Arrangement, this plan requires a third party administer (TPA) and claims are paid via an employer’s dedicated bank account. The account can be funded by the employer or employee through premium payments.
Medical expenses or claims are paid from the bank account up to a certain amount, i.e. deductibles, coinsurance. Once met, the balance of claims are paid by the insurance carrier, Cigna.

Since this is not a fully insured medical plan such as the Level Funding Program, the employer has additional benefit flexibility, lower premiums, employee funding and so on. But the employer also takes on more risk is responsible for all covered claims. Cigna offers optional Individual and Aggregate Stop Loss protection to offset that risk.

Cigna Health Plan Options

Like many insurance companies, Cigna offers your company a diverse range of health care options. You can choose the plan or plans that fit your employee’s needs.

HMO Plan

The Cigna HMO Plan is an in network only plan. You are required to choose a Primary Care Physician (PCP) and if you need to see a specialist, a referral must be provided by your PCP. There are no out of network benefits or reimbursement with this plan.

HMO Point of Service (POS) plan

Similar to their HMO plan, this plan combines in network medical care and out of network services. A PCP is required to see a specialist in network but you also have the freedom go out of network with this plan as long as your PCP provides a referral.

Open Access Plus In Network

Cigna’s OAP plan is an in network only plan but gives employees access to Cigna’s vast national network of doctors and hospitals. For your health care to be covered by the plan, you must choose a health care professional who is in the Cigna Open Access Plus network. Referrals are not needed to see a specialist but any out of network care is not covered.

Open Access Plus plan (OAP)

You choose the doctor or facility that works best for you and you are not required to choose a PCP. You have the freedom to go in network or out of network and still be reimbursed for all your medical care services.

Preferred Provider Organization (PPO)

Cigna’s PPO plan lets your employees choose a network or doctor of their choice. In network and out of network medical care is covered.

Cigna Health Insurance For Your Small or Large Business

If you are looking for a group health plan which not only serves the small business market but also the large business market, Cigna is probably one of the top insurers in this field. Employers have numerous plan options and access to a vast network of quality doctors and health care facilities.

Your employees will love having Cigna as their health care provider. We can help “shop” a health plan for you and compare plan options side by side so you can make an educated decision.

At Healthplansny, we work with the best health insurance companies in New York, New Jersey and Connecticut. We are not beholden to any particular insurance company. We are independent agents and we work for you, our client! If you would like a free group health consultation, give our office a call at: 800-514-3513

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If you’re like most New York small business owners, you’ve probably heard of EmblemHealth. Now, it is worth mentioning that although Emblem is one of the numerous insurance companies we represent, we have not been paid to give them a review.

As independent insurance agents, our reviews are unbiased and are only meant to help you make the best decision regarding a group health insurance program for your business.

About EmblemHealth Insurance Company

Emblem is one of the Nation’s largest not-for-profit health plan providers and has more than 3.1 million customers as of 2016. The company is headquartered in downtown New York City and was formed through a merger of GHI (Group Health Incorporated) and HIP (Health Insurance Plan of New York) in 2006. GHI and HIP were serving the New York City as health insurance providers for more than 75 years.

Benefits Of EmblemHealth

Emblem primarily offers medical coverage to the New York Tri-State area. They offer a range of health care coverage to small and large businesses as well as government and union organizations. If your business is located in New York, you and your employees will have access to an extensive network of doctors and hospitals throughout the New York, New Jersey and Connecticut.

Emblem Small Business Health Plans

Emblem separates their health plan programs between small business groups (less than 100 employees) and large groups (over 100 employees). For small groups, employees would utilize the Select Care regional HMO network. This network has more than 34,000 primary care doctors and specialists, plus the tri-state area’s leading hospitals.

Select Care Health Plans for small business

Select Care offers your small business a choice of 4 HMO (Health Maintenance Organization) plans. HMO plans require referrals from a PCP (Primary Care Physician) and do not cover out of network medical services.

1. Bronze Value S (with adult dental & vision)

The Bronze Value is a low-cost HMO Plan and has the highest deductibles of any plan that Emblem offers. The deductibles or out of pocket costs to members are $7,150 for singles and $14,000 for Families. This plan is a good choice for employees who want the lowest premiums, are in relatively good health and don’t go to the doctor very often. The plan offers free generic drugs, 2 free primary care visits, free preventive care and free lab services before the deductible must be met. The Bronze plan also provides dental and vision coverage for adults and children.

2. Silver Value S (with adult dental & vision)

This HMO plan is a good choice for employees who regularly go to doctor or a specialist but want lower out of pocket costs. The Silver Value plan has deductibles of $5,800 for singles and $11,600 for families. Once the deductible is met, the plan offers unlimited specialist visits and urgent care visits. In addition, it covers 3 free primary care visits, free generic drugs, free telehealth, free preventive care and free lab services.  This plan also provides dental and vision coverage for adults and children.

3. Emblem HMO 40/60 (Gold)

This nonstandard Gold HMO plan offers low deductibles of $250/single and $500/family. It’s a good choice for people who go to the doctor frequently, but want lower out of pocket expenses for medical care. Doctor visits are $40 and $60 for specialists. Before the deductible, this plan includes free telehealth and free preventive care.

4. Emblem HMO 15/35 (Platinum)

This is no-deductible HMO plan which has the lowest out-of-pocket costs but also has the highest monthly premiums. It’s a good choice for people who need a lot of medical care and want to pay the least amount of money for medical expenses. Plus, it offers free telehealth and free preventive care.

Emblem Large Business Health Plans

For large companies with more than 100 employees, Emblem offers a variety of PPO and EPO plans as well as an HMO plan which is still branded under the old HIP company of New York.

Emblem’s PPO plans offer coverage for in network and out-of-network medical services. National coverage is provided through the MultiPlan network. No referrals are needed to see a specialist or go out of network. These plans provide the highest amount of medical coverage, including prescription benefits.

There are 3 PPO plans to choose from:

  1. Emblemhealth PPO
  2. InBalance PPO
  3. Consumerdirect PPO
Large Group EPO Plans

EPO plans offer in-network coverage only but no referrals are needed to a specialist. EPO plans also provide National coverage through the Emblem network.

There are 5 EPO plans available for your business:

  1. Emblemhealth EPO
  2. CompreHealth EPO
  3. InBalance EPO
  4. ConsumerDirect EPO
  5. HealthEssentials Plus
EmblemHealth Insurance For Your Business

If you are looking for a group health plan, Emblem is definitely a company you should consider. If you have 2 employees or 200, we can design a plan that meets the needs of your small business.

As independent agents, we offer unbiased advice and will not try to push you to one particular insurance company.

We work the best health insurance companies in New York, New Jersey and Connecticut. And we work for you, our client! If you would like a free group health consultation, give our office a call at: 800-514-3513

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There are more than 800 life insurance companies in the industry and finding the best group term life insurance companies for your small business can be overwhelming. Just because you have your group health insurance or business insurance with one particular company, it does not necessarily mean that company will be the best choice for term life insurance or have the lowest rates.

Since we work with dozens of the top rated life insurance companies, we can help take the mystery out of finding the best term life provider for your business. The biggest benefit to representing multiple carriers is that we can find the best company for you based on your specific business needs.

Our list of best group term life insurance companies can change at any given time depending on which companies are currently offering the best products and pricing.  Click the links below to learn more about the companies that offer the best group term life insurance rates:

MetLife
Prudential
Cigna
Hartford
Lincoln Financial
SunLife

But let’s first discuss what group term life insurance is, how it works and why it’s important in your overall benefit package for your employees.

What is Group Term Life Insurance?

Group term life insurance is a benefit offered by employers to help employees have easy access to life insurance coverage. It is a single contract or policy that covers an entire group of employees and is often provided in addition to other group benefits such as group health insurance, dental insurance and disability insurance.

Group life is normally offered to the employee free of charge and a standard maximum death benefit of 1X salary or up to $50,000 of death benefit. Policies are offered on a guaranteed issue basis, meaning no medical exam is required from any of the employees who will be insured.

How Does Group Term Life Insurance Work?

Term life insurance is the most common form of group life insurance however, some employers do offer group whole life or group universal life programs as well. Term insurance is temporary coverage and eventually expires when the term is over.

Group life coverage can usually continue until the employee reaches age 65 or age 70. After age 65, the death benefit will decrease each year until the employee reaches age 70. Then most companies will not offer coverage to any employee over 70. The reason for this is simple; most group policies do not require medical background checks so insurance companies feel offering life insurance coverage to older employees without a medical history review is risky business.

Typically, an employer that offers $50,000 of coverage at no charge to the employee can expect to pay a life rate per $1000 of .026 to .055 per month per employee. Premium costs also depend on the industry you are in, the number of employees, their ages and their genders.

If your employees want more than $50,000 of coverage you can add voluntary group life or supplemental group life, which allows employees to buy more coverage at their own expense. However, depending on the insurance company and the amount of death benefit being offered, your employees may have to submit to a medical exam or answer medical questions to qualify.

Supplemental or Voluntary Group Term Life Insurance

Supplemental life insurance is paid by the employee and allows employees to purchase additional coverage. Employees can buy more coverage in multiples of their annual salary up to a maximum amount being offered by the insurance carrier.

Spousal coverage is also available and paid for by the employee. Most group life providers will not offer more than $100,000 coverage for a spouse and $500,000 for the employee since insurers do not collect health risk data from everyone under the policy.

Is Group Term Life Insurance Taxable?

According to the IRS; IRC section 79 provides an exclusion for the first $50,000 of group-term life provided under a policy carried directly or indirectly by an employer. There are no tax consequences if the total amount of such policies does not exceed $50,000. The imputed cost of coverage in excess of $50,000 must be included in income. Using the IRS Premium Table, excess coverage amounts are subject to social security and Medicare taxes.

Should You Offer A Group Life Insurance Program?

According to LIMRA (Life Insurance Research and Marketing Association), group life insurance covers more than 45% of the U.S. population. If it weren’t for group life policies, most Americans would have no life insurance coverage at all. A group life program along with other available benefits are widely sought after by many employees. Group benefits help employers to attract and retain the highest caliber of candidates for employment.

Group health insurance and a retirement program are the top 2 requested benefits requested by many employees. Life insurance is also one of the most requested benefits. For a business owner to keep their benefits package competitive, it’s important to include life insurance.

Best Group Term Life Insurance Companies

As an employer, you will probably find most insurance carriers that offer group health or group dental plans, also offer a group life insurance program. The number of companies participating in the arena is exhaustive. However, there are a handful of group life providers that stand out among the crowd.

The following list is in no particular order but they are some of the best group life insurance companies to consider.

How We Rate The Top Group Life Insurance Companies

Customer Service: Many business owners are too busy running their business and don’t have time to deal with servicing or billing problems. Insurance companies that do not provide excellent customer service did not make the list.

Financial Ratings: The financial strength of an insurance company should always be considered when looking for any type of insurance. It’s important that the company will be able to pay claims and be in business for the long term. The rating agencies we follow are:

A.M. Best: Provides objective opinion regarding an insurer’s, issuer’s, or financial obligation’s relative creditworthiness. Their top rating is A++ – Superior
Standard and Poors (S&P): Measures the credit quality of an insurer and the ability to meet their financial obligations. Top rating is AAA – Extremely Strong
Moodys: Provides opinion of future creditworthiness of an insurers ability to pay claims in relation to the investments and current book of business. Top rating is Aaa – Highest
Fitch: Fitch credit ratings provide an opinion on the relative ability of a company to meet their financial commitments, such as interest, repayment of principal, and insurance claims. Fitch’s’ highest rating is AAA – Exceptionally Strong

Competitive Pricing: While financial stability is essential, competitive pricing is just as important. You don’t want to pay more to one company when another company is offering the same coverage at a lower price.

The 6 Best Group Term Life Insurance Providers MetLife

MetLife is a leader in the group benefits field. They are one of oldest and largest life insurance companies in the world and holds a 32.65% total market share of all group life insurance policies in force.  They specialize in the large group marketplace for companies with more than 100 employees. The company also works with smaller businesses but you must have at least 5 employees to qualify for their group life plan. Their policy pricing is competitive but it is not the lowest.

MetLife offers basic group term life and group basic group whole life. Additional coverage includes: supplemental life, dependent life, Voluntary Retiree Life and accidental death and dismemberment (AD&D). MetLife makes our list for financial strength and a vast array of group life options.

MetLife Financial Ratings:

A.M Best rating – A+
Moody’s rating – Aa3
Fitch rating – AA-
S&P rating – AA-

Prudential

Prudential is one of the best-known insurance companies in the world (The Rock). The company has a 15.85% market share of the group life insurance field making them number 2. Founded in 1875 it has over 100 years experience in the group marketplace and insures more than 20 million people.

Prudential offers basic employer-paid and employee paid term Life, whole and universal life as well as:

Spousal and Dependent Term Life
Waiver of Premium
Conversion to permanent insurance
Accelerated Death Benefit

With very high financial ratings and very competitive pricing, Prudential is one of the best group life insurance companies in the business.

Prudential Insurance Financial Ratings:

A.M Best– A+
Moody’s – A1
Fitch– A+
S&P– AA-

Cigna

Cigna is a global health benefits leader and provides medical, dental, disability, life and accident insurance to consumers and businesses. The company has a total market share of 9.64% of group life insurance policies in force making them number 3.

Cigna offers employer paid and employee paid group term life insurance and in 2016 it was the sixth largest health insurance provider in the world calculated by earned revenue. Learn more here: Cigna Health Insurance Company Review.

Cigna Financial Ratings

Standard & Poor’s – AA-
Fitch – A+
A.M. Best – A
Moody’s – A1

Hartford

The Hartford Life Insurance Company is part of The Hartford Financial Services Group, which was established in 1810. The company is one of the world’s largest insurance and investment companies. The company has been providing group benefits for more than 60 years and protects the lives of over 12 million people. They offer a full line of flexible group life options but most notably they are probably one of the most competitive when it comes to pricing.

Hartford’s Financial Ratings:

A.M Best – A-
Moody’s – Baa2
S&P – BBB+

Lincoln Financial

Lincoln Financial was founded in 1905 and the company specializes in financial services, individual insurance and is one of the top providers of group life insurance in the industry. The company holds a 2.83% total market share of the group life insurance industry. They are not the largest provider but they are a very solid financial insurance company.

Lincoln Financial offers a wide range of group life benefits and their pricing is very competitive. Some notable options of their program are:

Waiver of Premium
Accelerated Death Benefit
Portability lets employees keep their coverage, even if they leave their company.
Conversion privilege to permanent insurance without Evidence of Insurability (EOI).

Lincoln Financials’ Ratings:

A.M Best – A+
Moody’s – A1
S&P – AA-
Fitch – A+

Sunlife

SunLife Financial makes our list because they have been providing insurance solutions to consumers for more than 150 years. They are a leader the benefits marketplace and hold a 2.31% market share of the group life insurance industry. Sun life is our front-runner for being the most competitive in group life pricing.

Sun Life offers a variety of solutions for employers and business owners can customize the best plan for their company:

Basic Life and Accidental Death & Dismemberment (AD&D)
Optional Life and AD&D
Dependent Life
Voluntary Life and AD&D
Voluntary AD&D

SunLife Financial Ratings:

A.M Best – A+
Moody’s – Aa3
S&P – AA-

Group Term Life Insurance Quotes For Your Small Business

If your small business is looking for group life insurance quotes, we can help. We represent more than 35 insurance companies and can provide you with competitive pricing from the insurance companies on this page and many more.

We can help you compare pricing, benefits and features side by side so you can make an educated decision about which carrier would be the best fit for your business as well as your employees. Just call our office at: 800-514-3513

The post Best Group Term Life Insurance Companies appeared first on Healthplansny.

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If you’re looking for a comprehensive group health plan for your small business our Empire Blue Cross Blue Shield review explains why this company is one of the best. This insurer is probably one of the most admired insurance providers in the state of New York.  And for many reasons; Empire has one of the strongest provider networks of coverage across the entire state – only second to behemoth, Oxford.

The Empire BCBS network includes more than 90,000 participating doctors and over 160 hospitals making them one of the best health insurance companies in New York. And even though, the company only provides health insurance coverage to the New York City metropolitan area and selected counties in upstate New York, they are a solid choice for small business health insurance.

If your employees live or work out of New York State, they are given access to doctors and hospitals almost anywhere in the United States and 170 countries through Empire’s BlueCard Network.

Empire BCBS Small Business Group Health Plans

Empire offers a wide variety of health plan options for both small and large companies. In addition to health insurance, the company also offers group dental, vision, life and disability insurance. Their small business health plans are comprised of 3 different programs. Each program offers business owners different plan designs and options for providing health care to their employees.

Empire Blue Card Program

BlueCard, formerly known as the Prism plan is Empire’s premier health plan. It offers national access to EPO and PPO health insurance plans for small groups in New York. BlueCard has over 150 in-network hospitals and over 85,000 in-network physicians.

The BlueCard network is the largest provider network in the United States. More than 96% of hospitals and 93% of doctors across the country give your employees access to health care services with BlueCard,

Blue Priority Program

Blue Priority is an in-network only EPO plan. This is a smaller network than Blue Card however this program still boasts more than 85,000 physicians and more than 160 hospitals in the New York metro area.  Referrals are not required to see a specialist provided they are in network only. For small business owners, Empire requires 60% of full-time employees to enroll excluding valid waivers. Valid waivers include: Medicare, Medicaid, Spousal, Veterans, and Parental.

Pathway Program

After leaving the New York small group marketplace (1-50 employees) in 2012, Empire re-emerged in 2016 with their Pathway Program. Pathway is an HMO only plan and has the most limited network of doctors and hospitals of all the Empire programs. Empire’s Pathway Network has nearly 49,000 physicians and 83 hospitals that are considered in-network only providers. Referrals are required to see a specialist and 60% of full-time employees are required to enroll in a small group plan.

Product Types Offered Through Empire Blue Cross

Preferred Provider Organization (PPO)

PPO plans allow employees to receive care in-network and out-of-network. Members pay the negotiated rate for medical care at substantially less rates when they use a provider in the PPO network. But they also have the choice to go outside of the network for medical care and still receive reimbursement for services. There are no referrals needed to see a specialist.

Exclusive Provider Organization (EPO)

Empire EPO plans cover in network medical services only but do not require a referral from their Primary Care Physician (PCP).

Health Maintenance Organization (HMO)

HMO plans only cover services from providers in the HMO plan network. Employees are required to choose a PCP in the HMO network. If a specialist is needed, the PCP must provide a referral.

Consumer Driven Health Plans (CDHP’s)

CDHP’ are high deductibles plans and can be integrated with Health Savings Accounts (HSA’s) and Health Reimbursement Arrangements (HRA’s).  Empire CDHPs are available as an HMO, EPO and PPO plans.

Health Savings Accounts (HSA’s)

Health Savings Accounts allow employees pay for their health care expenses on a tax-free basis. Accounts are funded with pre-tax dollars usually through payroll deductions. Funds can be used for qualified medical expenses and prescriptions.

Empire Blue Cross For Your Business

If you are looking for a group health plan with flexibility, numerous plan options and a robust provider network, Empire should definitely be considered. Employers in New York can offer their employees a choice of 2 or 3 Empire plans to help keep health insurance costs under control.

For instance: employers can offer a platinum EPO plan for employees who are looking for the highest amount of coverage with the least out of pocket expenses. Other employees who want to maximize premium savings can opt for a high deductible plan or HSA plan to control their health care costs.

At Healthplansny, we are independent insurance advisers and we work with the top insurance carriers in the industry. We are not beholden to any insurance company and will never try to push you to one particular carrier. We work for you! For more information or if you would like a free group health consultation, give our office a call at: 800-514-3513

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