Top Group Health Insurance and Employee Benefits Options for New York

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

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Get the coverage you need and want with a custom healthcare plan. We provide the following healthcare insurance options with any health program.

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 staff and to your needs.

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

New York Large Corporate Health Insurance Plans

Under the ACA, medical coverage 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 and team commercial, and HMO
  • Chiropractic care – for individual and group commercial and HMO
  • Diabetes care management – supplies, equipment, and self-management education – for individual and group commercial and 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 crew commercial, individual direct pay HMO contracts, and HMO
  • Infertility treatment – for individual and group commercial and HMO
  • Inpatient end-of-life care – for individual direct-pay HMO contracts
  • Post-mastectomy reconstruction – for individual and group commercial and 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 team commercial and HMO
  • Skilled nursing facility – individual direct-pay HMO contracts

Small Business Health Protection Plans in New York

Small companies in a competitive market like New York may want to consult a broker at Taylor Benefits for guidance on establishing a healthcare protection program for staff members.

While the ACA doesn’t mandate participation or a special enrollment period, health assurance 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 programs and apply for tax credits.

Employee Provisions and Workplace Rewards Packages

New York’s private employers must provide time off for illness to workers. Some crew members 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.

NY 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.

NY 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 offer team healthcare protection plans to their staff members.
  • Approximately 85% of residents covered by employer-sponsored medical insurance are enrolled in collective packages.
  • The average monthly premium for business health benefits program is $475 per employee.
  • Group health protection covers around 2.6 million individuals in New York.
  • More than 80% of small businesses with 50 or more workers provide team health insurance benefits.

General Facts

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

Small Business Medical Coverage Tax Credits

Small business healthcare tax credits are available to help small businesses afford health insurance coverage for their team members. These tax credits are designed to make it easier for small businesses to provide healthcare benefits to their workers 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 workforce 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 policy provider to determine their eligibility and how to take advantage of these tax credits. 

Small Business Healthcare Protection Tax Penalties

Small businesses that do not offer medical 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 protection 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 coverage 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 Team Health Policy for small businesses?

Key benefits of Corporate Healthcare Programs 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 Corporate Health Protection comply with state regulations?

Collective Medical 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 Business Health Benefits?

Companies can reduce their premiums for Business Health Protections by implementing wellness programs, offering high-deductible plans, negotiating with assurance providers, and encouraging employees to participate in cost-saving initiatives. 

How does Corporate Healthcare Insurance support mental health services?

Corporate Health Protection 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 Group Medical Insurance handle emergency care coverage?

Staff medical coverage 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.

What type of insurance is group health insurance?

Group health insurance is a type of health coverage provided by an employer or organization to its employees or members. It typically offers medical, dental, and vision benefits, and the cost of premiums is often shared between the employer and the employees, making it more affordable than individual health insurance plans. 

Is group health insurance worth it?

Yes, group health insurance is often worth it. It typically offers lower premiums compared to individual plans, provides comprehensive coverage, and may include benefits for dependents. Employers often share the cost, making it more affordable. Additionally, it usually comes with simplified enrollment processes and broader coverage options. 

What are the most common group health insurance plans?

The most common group health insurance plans include Health Maintenance Organization (HMO) plans, Preferred Provider Organization (PPO) plans, Exclusive Provider Organization (EPO) plans, and Point of Service (POS) plans. Each type offers different levels of coverage, flexibility in choosing healthcare providers, and out-of-pocket costs. 

Who splits the premiums in a group health insurance plan?

In a group health insurance plan, the premiums are typically split between the employer and the employees. The employer often pays a portion of the premium, while the employees pay the remaining amount, usually through payroll deductions. The exact split can vary depending on the employer’s policies and the specific insurance plan. 

How is group insurance priced?

Group insurance pricing is determined based on the overall risk profile of the group, including factors like the age, health status, and occupation of its members. Insurers also consider the level of coverage and benefits provided. Premiums are then calculated to cover the projected costs of the group’s healthcare needs. 

Why is group health insurance cheaper?

Group health insurance is cheaper because it spreads the risk across a larger pool of individuals, allowing insurers to offer lower premiums. Additionally, employers often contribute to the cost, further reducing the amount employees pay. Bulk purchasing and negotiated rates with healthcare providers also contribute to lower costs. 

What is an example of a group health insurance plan?

An example of a group health insurance plan is a Preferred Provider Organization (PPO) plan offered by an employer, where employees have the flexibility to choose their healthcare providers within a network and receive higher coverage levels, with the employer covering a portion of the premiums. 

What is the best health insurance in NY?

The best health insurance in New York varies based on individual needs and preferences. However, companies like Taylor Benefits Insurance Agency, EmblemHealth, Empire BlueCross BlueShield, and UnitedHealthcare are often highly rated for their comprehensive coverage options, network size, and customer service. It’s important to compare plans to find the best fit for your healthcare needs. 

Can I deduct my group health insurance premiums?

Yes, if you are self-employed and pay for your own health insurance, you can typically deduct your group health insurance premiums. However, if your premiums are paid through a payroll deduction in a plan sponsored by your employer, you generally cannot deduct these premiums on your personal tax return.

New York and Workforce Insurance

New York State is more accommodating to team healthcare insurance than some other states. Some other states require teams of 50 or more to purchase these plans.  In contrast, assurance is available for groups of 2-100 New York residents.

All collective protection packages provide essential health benefits like outpatient care, maternity care, rehabilitative devices, preventive services, and more. Although many individuals seeking collective health care policy are employers looking for small business and employee benefits, you do not need to be an employer to purchase a program. One advantage to the New York stance on group eligibility is that it allows smaller teams to benefit from access to this coverage.

With affordable coverage available on the state exchange from the NY Department of Health, which can be viewed here, Taylor Benefits can create a team protection plan that works for you and your wallet. Corporate programs provide health protection coverage at the best prices, a winning combination that will take care of the health care needs of you and your crew.

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

Learn more about workforce benefit packages.

Frequently Asked Questions About Healthcare Insurance and Employment Incentives

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

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

Large team health plans are designed for businesses or organizations that have at least 50 full-time staff members.

Smaller uninsured entities are not subject to the legal stipulation that mandates reduced expenditure on profit management and marketing by large health insurers. Under a large health package, 85 percent of premiums must be allocated towards medical treatment and quality improvement efforts, while the remaining 15 percent of premiums can be used for administrative, marketing, and profit-related costs.

How Much Do Small Business Groups Protection 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 package, $21,342.

Small firms routinely ask their employees to contribute to the cost of team medical coverage 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?

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 policy
  • Retirement programs
  • 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 package.

First and foremost, the size of your firm and the number of employees receiving many benefits will determine the cost of your protection program. 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 team 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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