How to Find the Right Small Business Health Insurance Plan in NYC

If you want your New York City based small business to thrive, that includes finding the right health insurance for your employees. But how can you navigate among all the health care plans to find the right one?

Today, we’re taking a look at the best ways to find the right small business health insurance plan in New York City. We’ll cover the options you need to be aware of, tips on what to consider, and some specific plans you might want to take a look at.

What is NYC Group Health Insurance?

New York is a unique state when it comes to group health insurance. If you employ 2 to 100 employees, you are considered a small group employer. This size determines the kind of health insurance policy and plans you can offer to your employees.

Generally, most insurance companies will only let you choose 1 or 2 health plans for your employees and the premiums that are set by the insurance company are non negotiable. NY Small group health plans are known as “community rated” plans. Which means, every employee pays the same rate regardless of their age, health or gender.

If you are a large group employer in New York (100 or more employees), group health plans are negotiated between the employer and the insurance company. Large group rates are determined by an underwriting evaluation.

Premiums are based on several factors including minimum employee eligibility (some companies require 60% participation), health of your employees or claim history and the location of your business. Large group employers generally pay less than small group employers and if your employees are young and healthy, you will pay less.

Types of Small Businesses Health Insurance Plans in NYC

Health Maintenance Organization (HMO) Plans

HMO plans are a popular choice for many businesses. They usually cost less than other types of plans. Under an HMO, your employees will choose a primary care physician (PCP) from a list of doctors in the network.

This doctor coordinates all their care and refers them to specialists within the network as needed. The catch? If your employees see a doctor outside of the network, the costs might not be covered.

Preferred Provider Organization (PPO) Plans

PPO plans are more flexible than HMOs. Employees don’t need to choose a primary care doctor and can see specialists without a referral.
These plans cover both in-network and out-of-network providers, but visiting doctors within the network will save money. The downside is that PPO plans often come with higher premiums.

Exclusive Provider Organization (EPO) Plans

EPO plans are a mix between HMO and PPO plans. They offer the flexibility of seeing any doctor in the network without a primary care physician or referrals.
But, like HMO plans, there is no coverage for out-of-network care, except in an emergency. These plans can be a good middle ground, offering lower costs than PPOs but more freedom than HMOs.

Point of Service (POS) Plans

POS plans combine elements of both HMO and PPO plans. You’ll choose a primary care doctor who can refer you to other doctors within or outside the network.  Services inside the network cost less, but you have the option to see doctors outside the network for a higher fee. These plans offer a balance between cost and flexibility.

Best Group Health Insurance Companies in NYC

Let’s explore some specific insurance companies and the plans they offer in New York City.

Anthem Blue Cross

Anthem, formally known as Empire Blue Cross, features one of the broadest networks in the nation. As a Blue Cross card holder, your employees will have access to a network that includes 95% of doctors and 96% of hospitals in the U.S. One in three Americans carries a BCBS card — over 106 million members.

In New York City, Anthem has one of the largest network of doctors and hospitals. They offer a broad range of benefits, HMO’s, PPO’s, POS plans and Health Savings Accounts (HSA). They also offer a broad range of small group dental and vision plans. There are 3 networks to choose from: Blue Priority Network, Blue Access and Connection Network

If you want the best health coverage for your employees and willing to pay a little more, Anthem Blue Cross is for you. For more information, see our Blue Cross Review.

Aetna Health

Aetna offers some of the most competitive health plans in NYC. The company does not offer any Platinum plans in New York. Only Gold, Silver and Bronze. Their group health plans include PPO (Preferred Provider Organization) plans, EPO Exclusive Provider Organization) plans, HSA (Health Savings Accounts). The Aetna Saving Plus plans, have reduced rates and are designed to compete directly with other carriers such as Oxford and Anthem Blue Cross.

All Aetna plans are available everywhere in New York State and Nationally in all 50 States. See our Aetna Health Plan Review for more information about the company.

Cigna

Cigna is a large group provider and only available to NYC companies with more than 100 employees. The company has one of the largest networks of doctors and hospitals in the tri-state area and Nationally. They offer several different health plan designs to fit just about any organization; PPO Plans (Preferred Provider Organization), HMO Plans (Health Maintenance Organization) and HSA’s (Health Savings Accounts, including dental and vision plans too. Just about every type of health care coverage you can imagine.

Oxford Health Plans/ United Healthcare

Oxford is one of our best NYC health insurance companies because they are one of the most widely accepted health plans in the tri-state area. Eight out of Ten New York businesses rely on Oxford for their health plan.

Oxford has more than 1.5 million physicians and health care professionals and 6,200 hospitals Nationwide. The company offers a variety of health plans within their 3 networks; The Freedom Network, The Liberty Network and the “new” Metro Network.

The Freedom network offers National coverage through UnitedHealthcare’s “Choice Plus Network” while the Liberty Network provides National coverage for your employees with their “Core network.” Oxford’s Metro Network only provides coverage in New York, New Jersey and Connecticut.

Within the 3 networks, Oxford offers several different health plan designs to fit just about any organization; EPO Plans (Exclusive Provider Organization) PPO Plans (Preferred Provider Organization), HMO Plans (Health Maintenance Organization) and HSA’s (Health Savings Accounts). If you are a NYC business owner, Oxford should definitely on your list of insurance companies to consider.

HealthPass

Healthpass is a NYC health insurance private exchange and offers group health plans from various New York companies all under one platform. HealthPass provides small employers (1 to 100 employees), flexible and affordable benefits. You have access to over 45 health plans, dental, vision and term life from Anthem Blue Cross, Guardian, Oxford Health Plans and Emblem Health.

If you are looking for a flexible benefits program where your employees can choose the coverage they want. Healthpass is a great choice.

Evaluating Business Insurance Needs

When you’re running a small business in New York City, deciding on health insurance isn’t just about picking a plan. It’s about understanding what your business and your employees need.

Start by looking at your team. How many people are you covering? What kind of health services might they need? These questions are your starting point.
Next, think about your business itself. Every industry has its own risks.

For instance, a construction company might need plans that offer extensive physical therapy options, while a tech startup might prioritize mental health services.
Your budget also plays a big part in this decision. You want to offer your employees good coverage, but it has to be something your business can afford.

Understanding your employees’ coverage needs is vital too. This is not just about meeting legal requirements. It’s about making sure your team feels valued and taken care of.

When employees see that you’ve chosen a health insurance plan with their needs in mind, it boosts morale and loyalty. This, in turn, helps your business grow stronger.

So, take your time with this step. Talk to your employees. Get to know what health services are important to them.

Key Factors to Consider

While it’s essential to find something affordable, it’s just as important to make sure the plan covers the healthcare needs of your employees. A cheaper plan might not always be the best choice if it doesn’t offer the coverage your team needs.

Coverage is a big word when it comes to health insurance. You need to check what services are included in the plan.

Does it cover just the basics, or does it include extra services like dental and vision care? Make sure it matches what your employees need to stay healthy.

Also, check the plan’s network of doctors and hospitals. It’s important that your employees can easily access care without having to travel too far or pay extra.
Another factor to consider is how easy the plan is to use and manage. Some plans come with online portals that make it simple to check benefits and submit claims.
Others might offer helpful customer service that can guide you and your employees through any questions you might have.

Finally, think about the future. Your business and your team’s needs might change. Look for a plan that offers some flexibility. You might need to add more coverage or adjust your plan as your business grows.

Finding the Right Coverage

Selecting the right small business health insurance plan in New York requires careful consideration of various options. By understanding the unique needs of your business and employees, you can choose a plan that’s right for you!

Since 2005, Health Plans NY has been helping small business owners save money and improve their group insurance plans. Get in touch today to find out how we can help!