New York Group Health Insurance | Health Insurance for New Yorkers | Best Health Plans for New Yorkers

Taylor Benefits has more than 25 years of experience providing group healthcare insurance plans for residents of New York State. We provide customized group health plans using a variety of insurance providers. Our independence enables us to offer health insurance coverage to suit our clients’ 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 healthcare insurance options with any health plan.

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

Get a personalized quote now to see what is available for your company.

New York Large Group Health Insurance Plans

Under the ACA, health insurance plans are required to cover certain services designated to serve your personal needs. 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
  • Inpatient 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 or a special enrollment period, 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 small business health plans and apply for tax credits.

New York Employee Benefits Plans and Employee Benefits Packages

New York’s 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 employees 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.

Relevant Statistics

  • Over 90% of businesses in New York offer group health insurance plans to their employees.
  • Approximately 85% of New Yorkers covered by employer-sponsored health insurance are enrolled in group plans.
  • The average monthly premium for a New York group health insurance plan is $475 per employee.
  • Group health insurance covers around 2.6 million individuals in New York.
  • More than 80% of small businesses with 50 or more employees provide group health insurance benefits.

General Facts

  • Group health insurance in New York provides coverage for a group of individuals, such as employees of a company or members of an organization.
  • It is mandatory for employers in New York with at least one employee to offer group health insurance.
  • Group health insurance plans in New York must cover essential health benefits, such as preventive care, emergency services, and prescription drugs.
  • The cost of group health insurance premiums in New York can be shared between the employer and employees.
  • New York State offers options for small businesses to access more affordable group health insurance through programs like the Small Business Marketplace.

Small Business Health Insurance Tax Credits for New Yorkers

Small business health insurance tax credits are available to help small businesses afford health insurance coverage for their employees. These tax credits are designed to make it easier for small businesses to provide health insurance benefits to their employees and can help offset the cost of coverage. To be eligible for these tax credits, small businesses must meet certain criteria, such as having fewer than 25 full-time equivalent employees, paying average annual wages below a certain threshold, and contributing a certain percentage of employee premiums. The tax credit amount can vary based on these factors and can be claimed when filing taxes. Small businesses should consult with a tax professional or insurance provider to determine their eligibility and how to take advantage of these tax credits. 

Small Business Health Insurance Tax Penalties for New Yorkers

Small businesses that do not offer health insurance to their employees may face tax penalties under the Affordable Care Act. The penalties vary depending on the business size and whether or not they meet certain requirements. Small businesses with fewer than 50 full-time employees are not required to provide health insurance but may qualify for tax credits if they choose to do so. However, businesses with 50 or more full-time employees may face penalties if they do not offer affordable health insurance that meets certain minimum standards. Small businesses need to understand their obligations under the law and seek guidance from a tax professional to avoid potential penalties.

What are the key benefits of New York Group Health Insurance for small businesses?

Key benefits of New York Group Health Insurance for small businesses include cost savings through group rates, attracting and retaining top talent, improving employee morale and productivity, and providing comprehensive coverage for employees and their families. 

How does New York Group Health Insurance comply with state regulations?

New York Group Health Insurance must adhere to state regulations by offering coverage for essential health benefits, complying with premium rate regulations, and providing access to an external appeals process for disputes. 

How can companies reduce their premiums for New York Group Health Insurance?

Companies can reduce their premiums for New York Group Health Insurance by implementing wellness programs, offering high-deductible plans, negotiating with insurance providers, and encouraging employees to participate in cost-saving initiatives. 

How does New York Group Health Insurance support mental health services?

New York Group Health Insurance typically covers mental health services such as therapy, counseling, and psychiatric care. This support allows individuals to access necessary treatment for mental health conditions, promoting overall well-being and productivity. 

How does New York Group Health Insurance handle emergency care coverage?

Group Health Insurance typically covers emergency care as part of its plans. This coverage includes ambulance transportation, emergency room visits, and urgent care visits for sudden and serious medical conditions. Members may need to pay a copayment or coinsurance for emergency care services.

New York and Group Insurance

New York State is more accommodating to group healthcare insurance plans than some other states. Some other states require groups of 50 or more to purchase group plans.  In contrast, 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. One advantage to the New York stance on group eligibility is that it allows smaller groups to benefit from access to group coverage.

With affordable coverage available on the state exchange from the New York Department of Health, which can be viewed here, Taylor Benefits can create a group insurance plan that works for you and your wallet. Group plans provide health insurance coverage at the best prices, 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.

Learn more about employee benefit packages.

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

An employer-sponsored or employer-sponsored group health insurance plan covers the healthcare needs of New York employees and their dependents.

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

Large group health plans are available for any business or organization with 50 or more full-time 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 spend 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.

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 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 benefits 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 many 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. In New York State, the average annual employer contribution to the cost of group healthcare coverage is $6,500 per employee.

Written by Todd Taylor

Todd Taylor

Todd Taylor oversees most of the marketing and client administration for the agency with help of an incredible team. Todd is a seasoned benefits insurance broker with over 35 years of industry experience. As the Founder and CEO of Taylor Benefits Insurance Agency, Inc., he provides strategic consultations and high-quality support to ensure his clients’ competitive position in the market.

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