Plans Available on the NYS Health Benefits Exchange

Insurance companies will offer their programs:

• On and Off the NYS Health Benefit Exchange
  
• Off the Exchange only
  
  

There are two Health Benefit Exchanges:

• Individual Marketplace
  
• Small Business Marketplace AKA the SHOP Exchange (up to 50 employees on the payroll)
  

Level of Plans on the Exchange (the Metallic Plans)

• Platinum
  
• Gold
  
• Silver
  
• Bronze
  
• Catastrophic: very inexpensive and only available to individuals under 30 years of age.

Individual Marketplace:

1. Affinity Health Plan
   
2. Empire BCBS
   
3. Fidelis
   
4. Freelancers Co-op dba Health Republic
   
5. Emblem
   
6. Healthfirst New York
   
7. MetroPlus Health Plan
   
8. Oscar Insurance
   
9. North Shore LIJ
   
10. United Healthcare
    

Small Business Marketplace:

1. Freelancers Co-Op dba Health Republic
   
2. MetroPlus Health Plan
   
3. North Shore LIJ
   
4. Oxford

Private Market Insurance Companies Offering Plans we know of so far.

1. Oxford
   
2. Aetna
   
3. Empire BCBS
   
4. Health Republic
   
5. Oscar
   

Please bear in mind that finding your provider will be a more daunting task than in the past.
Many insurance companies although not advertised and disclosed openly, to hold down costs have created smaller networks of doctors and hospitals. Those providers will be paid less. It is easy to see why the networks are smaller. Participants in the exchanges should be prepared for the much tighter narrower networks. The insurers say that with a smaller number of doctors and hospitals they can offer lower cost policies and have more control over the quality of the health care providers. They also say that this is better than no coverage.at all. Health plans having narrow networks that exclude many doctors, may discourage patients with expensive pre-existing conditions who have established relationships with doctors. Basically saying they do not want  patients who for medical reasons require a broad network of providers

We will be ble to help you navigate to see which insurance company’s networks and plan design best works for you.

We expect there to be a combination of large legacy insurance companies, new insurance companies and existing insurance companies looking to expand their geographical footprint all offering market rate plans. This comes about since everyone has to have health insurance or be fined.This should provide ample competition thus keeping rates stable.

Regards,
Vincent  

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