In 2000 the NY Legislature enacted regulations in response to the Governor’s proposal to make available comprehensive insurance coverage for New York workers and their families who are uninsured. The name of the program is Healthy NY.

This program helps the small business owners (businesses with 50 or fewer employees) to provide health insurance to their employees and their families. Additionally, Workers who are unable to purchase insurance through their employer because the employer doesn’t offer insurance and the sole proprietor may purchase coverage directly though Health NY.

All HMO’s in the state of New York offer standardized health benefit package that is made affordable through the sponsorship of NY State. This makes it more affordable for small employers and uninsured employees.

There are certain eligibility requirements for each section:

Small Employer

Business must be located in New York
The business must have 50 or less eligible employees
30% of employees must earn $34,000 or less
The business must not have provided group health insurance to employees in last 12 months (with certain stipulations)
50% of eligible employee participation and at least one earns $34,000 or less
Employer must contribute 50% of premium
The employer must offer plan to employees working 20 hours or more and earning $34,000 or less

Individual and Sole Proprietor guidelines:

The individual must live in the state of New York
Must be currently employed or have been within the last 12 months
Employer does not provide health insurance
Have not health insurance for past 12 month period
Ineligible for Medicare
The annual household income must meet the Healthy NY Income Guidelines

View our Recommended Health Insurance Company in New York, a simple site that has an easy to fill out application. It also has a lot of great info about Home Owners Insurance and Car Insurance Quotes

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HMOs in New York are required by law to offer both standardized HMO plans and point of service (POS) to those who seek to purchase individual health insurance. An HMO is a health insurance provider that works directly with a particular network of doctors, hospitals, and other medical professionals. This means your medical care must be from someone in the network and your insurance most likely will not cover medical care from those who are not in the network. If you need to visit a specialist covered in the network you will need a referral.

HMO/POS plans are a bit more flexible because you can obtain medical care from both the HMO network and out-of-network medical professionals. Although, with an HMO/POS plan you will most likely pay more and the number of services offered is lower. You will still need a referral in order to visit a specialist covered in the network.

With individual health insurance in New York, you will be able to choose either type of plan (HMO or HMO/POS) at any time and not be denied coverage due to health reasons. If you have a pre-existing health condition that was diagnosed and treated within the six month period before you applied for individual health insurance coverage, you may be required to wait up to a year before your health insurance will cover the pre-existing health condition. However, if you have a pre-existing health condition but you were previously insured, the waiting period will most likely be reduced as long as you reapply for health insurance within 63 days of the time your previous coverage expires. This is why it is important to keep up with the expiration dates of your health coverage and prevent any time lapses between coverage periods.

View our Recommended Health Insurance Company, a simple site that has an easy to fill out application. It also has a lot of great info about Home Insurance and Car Insurance

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