2021 NY Small Group Health Plans
Reward your employees with great health insurance and group benefits. See latest affordable plans for small businesses offering coverage with nationally ranked doctors in New York – plus perks that employees love.
Empire Blue Cross Blue Shield has added a 3rd network – Empire Connections to their 2021 roster. The Downstate Network will be the smallest of the 3 featuring top hospitals & providers. The discounts are 11% and 20% discount off of #1 Empire EPO/PPO and Blue Access networks respectively. The middle network Blue Access has expanded significantly adding Memorial Sloan Kettering. Blue Access shares 92% of #1 Empire EPO/PPO network. Empire Blue Cross New Network Trifecta_2020
Additionally, all 3 networks, Empire EPO/PPO, Blue Access, Empire Connections will offer access to the national BlueCard PPO program. As a result of Empire Blue Cross participation in the BlueCard PPO program members enjoy unparalleled national access network to 96% of hospitals and 93% of doctors across the country. This national program will be on 18 of 28 plans below.
EmblemHealth, formerly GHI and HIP, has recapitalized and reloaded dynamic plan offerings for 2021. They have had stable 3 years of single-digit increases. Emblem has added a new 3rd network, Millennium Network, to its stellar lineup of Hip Prime and Select Care Network. The discounts vary between 8% and 15% discount
1. Prime Network: Largest Emblem Network. – newly expanded 120,000 Providers Tristate.
All plans are non-gated and include Pediatric and Adult Dental and Vision.
NYS – EmblemHealth has expanded the small group Prime Network to include both the QualCare Network in New Jersey another ConnectiCare Network in Connecticut. This is in addition to the current HIP Prime Network in New York. Members can choose from over 90,000 private and group practice health professionals, facilities, and 144 hospitals in 28 New York State counties — all five boroughs of New York City (the Bronx, Brooklyn, Manhattan, Queens, and Staten Island), plus Nassau, Suffolk, Orange, Rockland, and Westchester counties, and upstate areas that stretch north of Albany.
CT – The ConnectiCare HMO Network has 17,000 primary care providers and specialists, and 33 hospitals in all eight counties in the State of Connecticut.
NJ – The QualCare HMO Network includes 26,000 primary care providers and specialists, and 76 hospitals in all 21 counties across the State of New Jersey.
Healthfirst has released affordable new 2021 plans for NY small businesses and not a moment too soon. The only non-profit Health Insurer owned by hospitals has kept market low rates with a modest 1.2% INCREASE for 2021. By integrating a Hospital/Provider medical approach Healthfirst has been successfully delivering value for the 5 boroughs.
- Members have access to a broad network of providers and dozens of industry-leading hospitals.
- Community locations throughout New York City, Long Island, and parts of Westchester.
- Dental and vision coverage, 24/7 telemedicine access, acupuncture, exercise reward programs.
All Metal Levels will be included for all size groups including 1-99 market. Referrals are NOT needed to visit a Specialist MD but one must select a Primary Care Physician on the enrollment form.
The Google of health insurance? Oscar entered the NY market on Jan 1, 2014, and had around 16,000 members. In 2015, it expanded coverage to New Jersey and grew to about 40,000 members. In 2016, Oscar had 145,000 members in New York, New Jersey, California, and Texas. Oscar’s cutting edge technology and pioneering benefits have simplified the consumer health insurance experience propelled easier access and understanding of health plans. Examples of success have been ease of physician locator, online appointment setting, and no-cost telemedicine 24/7. Additionally, some plans have $0 Copay generics and annual 3 free office visits
- NY based with 900+ employees
- 260,000 members across 6 states
- $890M raised from top investors (Fidelity, Goldman Sachs, Google, etc.)
- $375M investment from Alphabet Inc. (Google parent company)
- For more details, check out our CEO Mario’s interview in the Wired story: Health Care is Broken. Google Thinks Oscar Health Can Fix It)
- Delivered an underwriting profit in 2017
- Expecting $1B in revenues in 2019
- After doubling footprint for 2019, Oscar is on-track for 2x growth.
Oxford Metro 2021
Oxford has expanded on its successful Oxford Metro Network plan released in 2016. By 2021 the network has expanded 15% in NY and added NJ network last year. In 2020 most Metro plans stayed flat and for 2021 increasing single digits. The Garden State Network will be absorbed and renamed under the Oxford Metro banner.
Oxford Metro Network:
The NY network has grown to approx. 13,000 Primary Care Providers, 32,000 Specialists, and 85 hospitals. Furthermore, the Oxford Garden State network has been added as well onto the Metro Network. The Garden State network alone has access to 19,000 physicians and 67 hospitals.
All Metal Levels will be included for all size groups including 1-99 & 100+. The new Oxford Metro plan will be limited to NY and NJ Garden State Network Providers. Referrals will be needed to see Specialists. Importantly, most NY Hospitals will be participating with the EXCEPTION of NYU Health System, North Shore LIJ Health System (NorthWell Health), and Maimonides Medical Center. In addition, certain key medical IPA Groups such as Caremount, formerly Mt Kisko Medical Group, are NOT in the network.
Today’s largest networks with in-network only GOLD are priced at $12,000 /single annually. They typically are accompanied by $50 copays and non-office exposures of $1,000 deductibles and coinsurance percent in-network.
By comparison, the new Metro network is approximately 25% smaller than the NY Liberty network with up to 17% IN SAVINGS. For example, a popular Oxford Liberty HMO Gold is $980 vs.Oxford Metro Gold $816.
With over three decades of combined experience working with all of the major insurance companies, we put business owners in the driver’s seat to buy a company policy on their terms and their budget. Most business owners enjoy the transparency and the peace of mind of an affordable group health insurance policy that’s aligned with their needs and the needs of their employees.
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