New York Group Health Insurance & Health Benefit Plans

Taylor Benefits has more than 25 years experience providing group healthcare insurance plans for residents of New York State. We provide custom healthcare plans to groups, as we do not operate restricted by insurance providers or existing healthcare plans. We operate outside these restraints, allowing us to tailor health care to our clients and their needs.

New York group health benefits and employee insurance plans

Get the coverage you need and want with a custom healthcare plan. We provide the following health care insurance options for all our plans.

For a free consultation, with no obligation to buy, contact Taylor Benefits today. We can assess your health care insurance needs, and match specific services to you. Our knowledgeable staff will research every angle to find the health care policies, laws, mandates, and more, that apply to your group and to your needs.

New York Large Group Health Insurance Plans

Under the ACA, health insurance plans are required to cover certain services considered essential. These are:

  1. Ambulatory patient services (outpatient care)
  2. Emergency services
  3. Hospitalization, including surgical and medical
  4. Maternity and newborn care, including delivery
  5. Mental health and substance use disorder services
  6. Prescription drugs
  7. Rehabilitative services and devices
  8. Laboratory services
  9. Preventative and wellness services, including chronic disease management
  10. Pediatric services, including dental and vision care for children under the age of 19

No matter the type of service delivery system, it must accommodate the subscriber’s access to these vital components. In New York, there is an additional list of required services that an insurer must offer. The list varies depending on whether the delivery is via an individual or commercial plan or an HMO:

  • Blood products and services – for individual direct-pay HMO contracts
  • Breast reconstruction – for individual commercial, group commercial, and group HMO
  • Chiropractic care – for individual and group commercial and group HMO
  • Diabetes care management – supplies, equipment, and self-management education – for individual and group commercial and group HMO
  • Dialysis – for individual direct pay HMO contracts
  • Durable medical equipment – for individual direct-pay HMO contracts
  • Emergency transportation/ambulance services – for individual direct pay HMO contracts
  • Home health care services – for individual and group commercial, individual direct pay HMO contracts, and group HMO
  • Infertility treatment – for individual and group commercial and group HMO
  • In-patient end of life care – for individual direct-pay HMO contracts
  • Post-mastectomy reconstruction – for individual and group commercial and group HMO
  • Private duty nursing – for individual direct pay HMO contracts
  • Rehabilitative in-patient physical therapy – for individual direct pay HMO contracts
  • Second medical opinion for cancer diagnosis – for individual and group commercial and group HMO
  • Skilled nursing facility – individual direct-pay HMO contracts

New York Small Business Health Insurance Plans

Small companies in a competitive market like New York may want to consult a broker at Taylor Benefits Insurance for guidance on establishing a health insurance program for employees. While the ACA doesn’t mandate participation, health insurance is a desired benefit that can help attract the top talent your company needs. In addition, small businesses are entitled to use the SHOP platform to access specially designed programs and apply for tax credits.

New York Employee Benefit Plans and Employee Benefit Packages

New York private employers must provide time off for illness to employees. Some employees are eligible for paid time while others are not. The distinction and the amount of time available depend partly on the company’s size and net income.

New York workers are also entitled to ten weeks of family leave during any 52 weeks, paid at sixty percent of their average weekly wage. Employees can take family leaves in connection with childbirth, adoption, or other family reasons.

New York has a new Secure Choice Savings Program Act to promote IRA participation, but it has not yet been implemented.

New York and Group Insurance

New York state is more accommodating to group health care insurance plans than other states. Some other states require groups of 50 or more to purchase group plans. New York state allows group plans for groups of up to 100 individuals. Since you can have twice the amount of individuals on a group plan, the increased pool of money allows for a more diverse plan with broader, and deeper, coverage, depending on the needs of the group.

Group insurance is available for groups of 2-100 New York residents. All group insurance plans provide essential health benefits like outpatient care, maternity care, rehabilitative devices, preventive services, and more. Although many individuals seeking group health care insurance are employers looking for small business and employee plans, you do not need to be an employer to purchase a group plan.

With affordable, quality health care plans available on the state exchange from the New York Department of Health, which can be viewed here, Taylor Benefits can compile a group insurance plan that works for you, and your wallet. Group plans provide more coverage for less money, a winning combination that will take care of the health care needs of you and your group.

To view essential plan information for New York residents, please see this resource provided by the New York State Department of Health.

Frequently Asked Questions About Health Insurance And Employee Benefit Plans in New York

An employer-sponsored or employee-sponsored group health plan covers the health care needs of employees and their dependents.

In New York, What Is Considered a Large Group for Health Insurance Plans?

It’s considered a large group health plan if it covers a business or organization with 51 or more employees.

Small uninsured organizations are exempt from the law’s requirement that large group health insurers spend less money on profit management and marketing. A large group health plan must pay 85 percent of premiums on medical treatment and quality efforts, leaving only 15 percent of premiums to cover administrative, marketing, and profit expenses.

How Much Do Small Business Groups Insurance Plans Cost on Average?

The cost of offering health insurance to employees is partly influenced by the plans available to small business owners. According to a study by the Kaiser Family Foundation, annual premiums for individual coverage will be $7,470, and for a family plan, $21,342. Small firms routinely ask their employees to contribute to the cost of group health insurance because the employer usually covers it. Last year, employees contributed an average of 17% of the cost of single coverage and 27% of the family coverage.

Ensuring your small business varies depending on how much you want to spend on your employees’ premiums. The less your company has to pay in benefits, the better it is for everyone. There are other managerial and basic involvement charges when considering small company health insurance prices.

What Are the Different Types of Benefits Offered in New York?

Small businesses and giant corporations may benefit from offering employees a comprehensive benefits package. Benefits for employees may be expected or required by law in your industry. In addition, these other incentives can help you stand out from your competitors and attract superior personnel.

There are six basic types of employee benefit packages:

  • Benefits that are required by law
  • Disability insurance
  • Medical insurance
  • Retirement plans
  • Life insurance
  • Fringe benefits

How Much Do Employee Benefits Cost on Average?

It’s impossible to estimate the cost of your benefits plan without meeting with a professional and discussing your specific requirements. However, in general terms, the price of your health and employee benefits package will be determined by the size of your company and the breadth of your plan.

First and foremost, the size of your firm and the number of employees receiving benefits will determine the cost of your insurance plan. Secondly, it is essential to have a well-thought-out strategy in place. You’ll have to spend more per employee for a plan with better coverage and benefits.

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