As you will be hearing via Radio, TV, and Newspapers in the coming months, NY \u00a0\u00a0\u00a0NY State of Health Insurance Exchange Updates As you will be hearing via Radio, TV, and Newspapers in the coming months, NY has set up 2 exchanges: the Small Business Health Options Plan (SHOP Exchange) and the Individual Exchange. The SHOP Exchange is to be used exclusively for small businesses, whereas the Individual Exchange is […]<\/p>\n","protected":false},"author":6,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"mc4wp_mailchimp_campaign":[],"footnotes":""},"categories":[339,1679],"tags":[6,19,20,34,21,35,5,23,24,25,26,27,28,30,17,31,32,33],"class_list":["post-982","post","type-post","status-publish","format-standard","hentry","category-small-business-health-insurance","category-small-business-health-insurance-ny","tag-business","tag-health","tag-health-care","tag-health-care-reform","tag-health-insurance","tag-individual","tag-insurance","tag-insurance-premiums","tag-long-island","tag-medford","tag-medford-ny","tag-medicaid","tag-medicare","tag-ny","tag-ny-state-of-health-insurance","tag-senior","tag-suffolk","tag-suffolk-county"],"yoast_head":"\n
\nhas set up 2 exchanges: the Small Business Health Options Plan (SHOP Exchange)<\/strong>
\nand the Individual Exchange<\/strong>. The SHOP Exchange is to be used exclusively for
\nsmall businesses, whereas the Individual Exchange is for the use of individuals
\nand sole proprietors.
\nThe NY State of Health Insurance Exchanges<\/strong> are set up to provide individuals and companies with increased access to health care and introduce new protections for people who already have
\nhealth insurance. Starting in 2014, all individuals are required to purchase
\nhealth insurance that represents ‘minimum creditable coverage’ or face a
\npenalty. While the exchanges will begin allowing enrollments on the exchange
\nas of 10\/1\/2013, the coverage will not begin until 1\/1\/2014.<\/span>
\nAs a Certified Producer on BOTH the Individual and SHOP exchanges<\/strong>, we will be
\navailable to assist all of our current clients, as well as many new individuals
\nand businesses in obtaining coverage thru the new exchanges if it is in their
\nbest interest.
\nAs a business owner, you are NOT required to offer health benefits, and you are
\nNOT required to pay for health benefits for your employees. If you do offer
\ncoverage, you must make the coverage available to your employees, but you do
\nNOT have to pay towards it.
\nYou are NOT required to purchase your insurance thru the exchange<\/span><\/strong>…you
\ncan continue to obtain your insurance directly from your current insurance
\ncompany as before, or thru private exchanges such as Health Pass. In fact, we
\nare suggesting to most businesses to wait until your normal renewal time to
\nlook into the feasibility of the exchange, as with any new endeavor there is
\nlikely to be some bumps in the road since the exchange is still new and the
\nwebsite is still only being developed.
\nRates in the exchange will be based on 4 ‘metal’ tiers: Bronze, Silver, Gold,
\nand Platinum. There will be a ‘catastrophic’ plan offered ONLY on the
\nindividual exchange for members under 30 years old. While benefits are still
\nnot knows for these plans, they are based on Actuarial Value. Bronze plans are
\nexpected to pay 60% of health costs (40% paid by member), Silver plans are
\nexpected to pay 70% of health costs (30% by member), Gold plans are expected to
\npay 80% of health costs (20% by member), and Platinum\u00a0plans are expected to
\npay 90% of health costs (10% by member). Plans in the Gold and Platinum tiers
\nhave premiums at or above current typical group plan rates. Only Silver and
\nPlatinum plans will offer Out of Network benefits.
\nTo participate in the NYHBE SHOP Plan, employers will have to have 2-50 Full
\nTime employees, be a valid business, offer QHP (qualified health plan) options
\nto employees, and have a business address in NY.\u00a0All other individuals would be eligible to join the Individual exchange.
\nWhile so much is still being determined regarding the NYHBE, we are committed
\nto continuing to\u00a0assist you in advising and servicing your health insurance needs. We
\nare proud to be Certified Producers on both the individual as well as SHOP
\nexchanges in NYS.<\/span><\/strong> As we continue to update you as we get information from the State and NYHBE, please know that your current insurance plan should remain in place until your next normal renewal date. We will be contacting groups directly in situations where we feel a change prior to renewal might benefit them.
\nThe NYHBE does not expect a large influx of group business, with studies
\nshowing between 10-20% of groups moving to the NYHBE. We expect to see larger
\nnumbers moving to the individual exchange where currently those members are
\npaying exorbitant rates in the individual market. \u00a0While we wait to see
\nwhat might transpire, we just wanted to keep you updated and let you know that
\nno matter what direction\u00a0your insurance might take you, we will be able to
\nservice and advise you in both instances.<\/p>\n","protected":false},"excerpt":{"rendered":"