NYS 2023 Final Rates Approved
Breaking: #NYS 2023 Final Rates Approved!
Small group rates increase 7.9% & 9.7% for individuals. Almost 850,000 New Yorkers are enrolled in small group plans, which cover employers with up to 100 employees.
#oxford notably, got only a 6% rate increase approved for next year.
Premium main drivers are increases in pricing by hospitals, consolidated IPA groups, and pharmaceuticals. Plus a spike in elective surgeries postponed due to COVID-19.
Learn about a PEO before you renew. Let’s review today (855)667-4621 or info@medicalsolutionscorp.com.
Healthy NY
Are you a start-up? Can’t afford health coverage? Is your NY Group Policy increasing 15% in 2023?
The Health Care Reform Act of 2000 introduced the Healthy NY program to provide more affordable health insurance to New Yorkers who need it most. Healthy NY insurance program was designed to promote and provide affordable insurance coverage to eligible small businesses without health insurance coverage for their employees and, also, for eligible working uninsured.
The Healthy NY program includes benefits that cover essential health needs including:
- Inpatient and outpatient hospital services
- Emergency and Urgent Care
- Office Visits: Primary Care and Specialist
- Preventive Care
- Wellness
- Prescription Drugs
- Physician services
- Maternity care
- Preventative health services
- Diagnostic and x-ray services
- Mental Health and Substance Use Services: Inpatient and Outpatient
- Additional Services, Equipment & Devices: Autism Spectrum Disorder Diagnosis and Treatment, Hospice, Diabetic Equipment andSupplies, Durable Medical Equipment and Braces, Hearing Aids, Cochlear Implants, Medical Supplies and Prosthetics
- Pediatric Dental & Vision
| Metallic Level |
Gold
|
||||
| Product/Network/Gatekeeper | G HNY HMO Metro Gated OHP | ||||
| InNetwork Copayment | $25/$40 | ||||
| Out of Network Reimbursement | N/A | ||||
| InNetwork Coinsurance % | 80% | ||||
| InNetwork Maximum Out of Pocket | $4000/$8000 | ||||
| InNetwork Deductible | $600/$1200 | ||||
| Out of Network Coinsurance % | N/A | ||||
| Out of Network Maximum Out of Pocket | N/A | ||||
| Out of Network Deductible | N/A | ||||
| Deductible Accumulation Period | Contract Year | ||||
| Pharmacy | $10/$35/$70 | ||||
| Dependent Cutoff Age | 26 Dependent – Standard | ||||
ELIGIBILITY:
30% of the small employer’s eligible employees must earn $45,450 or less in annual wages and those small employers must offer Healthy NY to all employees who work 20 or more hours per week and earn $45,450 or less in annual wages. Additionally, at least one employee who earns $45,450 or less annually must enroll in Healthy NY.
Tax Advantages and Benefits of Providing Health Insurance
Significant tax advantages may be available to your business by offering health insurance coverage. Health insurance premiums that businesses pay on their employees’ behalf are generally 100% tax deductible. Providing health insurance coverage may also result in reduced payroll taxes. Additionally, if a business establishes a Section 125 plan, employees’ share of the premiums can be paid with pre-tax dollars, resulting in tax savings for both employees and the business.
Applicants may now also choose a benefit package with a limited prescription drug benefit or a benefits package without a prescription drug benefit.
APPLICATION & RECERTIFICATION: Healthy NY will only be available to groups with 1-50 FTE’s in 2022 per guidance from the NYS DFS. Please see the attached guidance released. It is important to note that while the definition of “small employer” is increasing from an employer with 50 or fewer employees to an employer with 50 to 100 employees as of January 1, 2022, only employers with 50 or fewer employees will be eligible for Healthy NY. Please see on page 2 of the attached here
MONTHLY RATES for 2022
Plan Type |
Rate |
|---|---|
| Individual | $809.52 |
| Two Adult | $1,619.04 |
| Parent & Child(ren) | $1,376.18 |
| Family | $2,307.13 |
For more rates and eligibility
For more information on how HNY can make difference for your small business please contact us at info@medicalsolutionscorp.com or 855-667-4621.
When to Choose Urgent Care
Should the cut on your hand or the chest pain send you to the ER or an urgent care center? It’s difficult to be sure. Urgent care centers provide fast, noncritical health care on a walk-in basis. A visit is generally around the same price or slightly more than a clinic visit but far cheaper than a trip to the emergency room.
But how do you know when you may need urgent care or when to choose another treatment option?
Oxford Liberty National Network Changes
Starting with September 1, 2022 plan effective dates, Oxford members of a Liberty Network plan will have the UnitedHealthcare Core Network for out-of-area coverage. They will no longer use the UnitedHealthcare Choice Plus Network for national network access. This change applies to all Oxford Liberty members.
Winter Action Plan to Battle COVID-19
The Biden administration issued a nine-pronged plan to combat COVID-19 as the winter months approach and the new Omicron variant poses risk of new infections. Click below to learn about the aspects of the plan that will affect employers and group health plans.
2022 NY Small Group Health Plans
2022 NY Small Group Health Plans-See latest plans for SMB offering plans w/national ranked Providers.Call 855-667-4621 info@medicalsoluionscorp.com
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