- What is HealthPass New York?
- HealthPass New York is an affordable way for New York City (5 boroughs), Long Island, Westchester, Rockland, Orange, Dutchess, Putnam, Ulster & Sullivan counties and their small businesses to offer a variety of health benefit options to their employees at no extra cost to the employer. When a small business offers HealthPass, each employee gets to choose from multiple health benefit options from 3 leading health carriers - EmblemHealth, HIP, and Oxford, plus Dental, Vision and EverGuard through Guardian. HealthPass provides employers and employees CHOICE, just like a Fortune 500 company. Rates vary based on the plan design and coverage level.
- What is a health insurance exchange?
- An innovative concept based on economist Alain Enthoven’s theory of managed competition and supported by stakeholders on both sides of the political aisle, a health insurance exchange creates a structured marketplace where employees can chose their health insurance based on quality and value.
Individuals who work for a small business are typically given very limited choice – usually only one or two options – when it comes to health insurance. Exchanges change that dynamic by creating an organized and competitive marketplace that offers employees and individuals a choice of health benefit designs, health insurance carriers, and provider networks. They also provide the small business owner with a comprehensive set of “back office” services that streamline employer-based health benefits administration while also supplying employees with personalized support and information to help them navigate their healthcare from sign-up to renewal.
The federal health reform legislation that became law in 2010 charges each State with establishing two health insurance exchanges by 2014, one for individuals and another for the employees of small businesses. This nationwide system of Exchanges is expected to dramatically alter the private health insurance market, especially the segment that serves small businesses.
- An innovative concept based on economist Alain Enthoven’s theory of managed competition and supported by stakeholders on both sides of the political aisle, a health insurance exchange creates a structured marketplace where employees can chose their health insurance based on quality and value.
- How does the HealthPass commercial health insurance exchange model work?
- Through HealthPass, each employee can choose a different carrier and plan design using one universal enrollment form.
After electing HealthPass as their group coverage, employers select the premium tier structure, set a defined dollar contribution, and designate which ancillary offerings – such as dental and a bundled security product for instance – will be made available to employees.
Employees then choose their medical carrier, health benefit plan, and from the ancillary products made available by their employer.
The employer receives one consolidated list bill from HealthPass and writes only one check per month regardless of the number of different plan options chosen by employees.
Throughout the plan year, members can take advantage of robust in-house member services as well as health and medical cost advocacy services.
- Through HealthPass, each employee can choose a different carrier and plan design using one universal enrollment form.
- Which carriers and plans?
- With HealthPass, small businesses are able to choose from EmblemHealth, HIP and Oxford for medical and Guardian for Dental, EverGuard and Vision.
In-Network Only plans offer comprehensive benefits from participating doctors, hospitals, labs and x-ray facilities. Services rendered by In-Network providers are usually covered at no additional cost or a copay. Most HealthPass plans do not require a referral to see an in-network specialist.
In-Network Cost-Sharing plans are designed to lower premiums by sharing more of the cost of services with members. Most plans cover preventive care at 100%. Doctor office visits are usually covered at a copay. Services rendered outside of the doctor's office are usually covered at a deductible and coinsurance.
- With HealthPass, small businesses are able to choose from EmblemHealth, HIP and Oxford for medical and Guardian for Dental, EverGuard and Vision.
- How will HealthPass help me save money?
- There are several ways HealthPass saves small employers money. By setting a Defined Contribution amount for each employee, employers can fix a benefits budget. Also with HealthPass, employees can choose a plan which meets their needs without overspending for unused benefits. And with access to over 200,000 providers, employees are more likely to find their doctors in one of our networks, thus reducing potential out of pocket costs.
- Is there a membership fee?
- No. Any eligible employer may choose to purchase health benefits through HealthPass.
- Do the plans cover prescription drugs?
- Yes, select from a variety of copays for generic brand-name drugs, non-formulary or discount coverage. You determine the right option to offer your employees
- Who can enroll?
- Small businesses and non-profits with a business address in New York City (5 boroughs), Long Island, Westchester, Rockland, Orange, Putnam, Dutchess, Sullivan or Ulster counties can enroll. Employees of those companies who live in New York State, New Jersey, Connecticut and Bucks County, Pennsylvania are eligible to enroll. In addition, up to 20% of the eligible employees who live outside these areas can be enrolled in HealthPass New York.
Sole Proprietors with a business address in the New York (five boroughs), and Long Island. Oxford medical plans and a Guardian dental plan options are available.
- Small businesses and non-profits with a business address in New York City (5 boroughs), Long Island, Westchester, Rockland, Orange, Putnam, Dutchess, Sullivan or Ulster counties can enroll. Employees of those companies who live in New York State, New Jersey, Connecticut and Bucks County, Pennsylvania are eligible to enroll. In addition, up to 20% of the eligible employees who live outside these areas can be enrolled in HealthPass New York.
- Can husband and wife only businesses be considered eligible?
- Businesses where a husband and wife are the only 2 employees may enroll with HealthPass if:
- The business can provide the appropriate tax documents
- The employees in question meet the member eligibility requirements, and
- The employees enroll for coverage separately
- Businesses where a husband and wife are the only 2 employees may enroll with HealthPass if:
- How many employees must participate in the medical plan?
- 75% of eligible employees must be covered through HealthPass or have other coverage such as another employer-sponsored plan, COBRA coverage or any individual spousal coverage or government sponsored insurance plan. To offer HealthPass, a minimum of 2 full time employees must be eligible though only one must participate, if the other is waiving out due to other coverage.
- Who is eligible?
- A Partner, Owner, or Officer receiving a salary or a W2 employee who works from 20-40 hours per week as set by the employer, who satisfies the company waiting period, if any.
- How many plans can I offer my employees?
- All of them! Through HealthPass, each employee can choose a different plan using 1 universal enrollment form, while you get 1 bill and write only 1 check a month, regardless of the number of plans your employees choose.
- Will my employees and I be able to keep our current doctors?
- Yes! HealthPass gives employees the power to access one of 4 carriers that combined cover over 200,000+ providers. In addition, each employee will be able to select a plan with an out-of-network benefit if their physician does not participate in their chosen network. To find your physician, hospital or dentist, click here. Each of our partner carriers (EmblemHealth, HIP and Oxford) offer added value benefits and discounts. Your clients can take advantage of these discounts in addition to the comprehensive benefits included in their respective plan designs. Some of these added value benefits include, but are not limited to: discounts at participating vision centers, fitness clubs, weight loss centers, apparel and footwear retailers, massage therapy, child safety products, vitamin/ herbal supplements and much more! Please click here for additional information.
- When can I start coverage for my business?
- HealthPass has 2 effective dates each month, on the 1st and 15th. For 1st of the month effective dates enrollment materials must be received by the 21st day of the preceding month. Applications for 15th of the month coverage must be received by the 5th. If your group elects to enroll on the 15th of the month, the enrollment materials must be accompanied by a business check for 1 1/2 times the cost of monthly coverage.
- What is HealthPass Dental?
- HealthPass offers 4 outstanding dental insurance plans through Guardian: The Managed DentalGuard (DMO) and Managed DentalGuard Plus (DMO) plans offer a voluntary In-Network benefit which covers preventive care services at a $5 copay. In addition, the DMO plan(s) provide generous discounts for diagnostic and restorative treatments. The DentalGuard Preferred (Dual Option DMO/PPO) and DentalGuard Preferred Plus (Dual Option DMO/PPO) plans offer a choice of DMO or PPO coverage. With access to over 65,000 dentists without a referral, the PPO(s) offers coverage for any dentist you choose to visit.
- What is HealthPass Vision?
- Guardian VisionGuard provides access to the Davis Vision network. Exams and materials are covered and members can visit any doctor they wish using both In and Out-of-Network benefits. Members have access to to generous discounts including up to 25% off laser vision correction, discounts on glasses and cosmetic enhancements such as tints, special lenses and scratch-resistant coating.
- What is EverGuard?
- HealthPass offers two EverGuard options through Guardian:
EverGuard:- $1,000 per month of Disability Income
- $25,000 of Term Life Insurance
- $75,000 of Accidental Death & Dismemberment Insurance
- $1,500 per month Disability Income
- $50,000 of Term Life Insurance
- $100,000 of Accidental Death & Dismemberment Insurance!
EverGuard & EverGuard Plus make it easy to offer your employees the personal protection they need at an affordable rate. No medical evaluation is required! No industry excluded!
- HealthPass offers two EverGuard options through Guardian:
- What is Health Advocate?
- All small group medical members have access to Health Advocate. Health Advocate helps members solve problems and find solutions related to their healthcare and health insurance needs, such as finding the best doctors and hospitals, resolving insurance claims, and obtaining approval for needed services.
- What is a Premium Only Plans (POP Kit)?
- A Premium Only Plan is one of the simplest benefits an employer can offer, but it delivers real savings to employees and their company. By allowing employees to pay their portion of premium costs BEFORE taxes, employees typically save 25% or more, and the employer benefits from nearly 8% in FICA savings. Click here to start saving!
- With so many plans what is the right choice for us?
- By consulting a licensed insurance broker or HealthPass, together we will take the time to review your current benefits package and evaluate how to best structure HealthPass as a solution for your business. If you are in need of assistance, please call us at 888.313.7277.
- How do I get a quote?
- It’s easy. Just click here or call 888.313.7277 to speak with a HealthPass representative or contact your broker.
