Health Insurance Carriers in New York
Health Insurance regulations differ from state to state, and the carriers that offer health care coverage in New York have different plans and options. We hope you will find this resource informative and useful. First, review the list of carriers we recommend in New York and click the links to learn more about them. Second, review basic information about New York Health Insurance regulations and laws at the bottom of this page.
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Health Insurance Carriers in New York
Aetna
Assurant Health (Formerly Fortis)
Empire Blue Cross Blue Shield of New York
Excellus Blue Cross Blue Shield of Rochester
Group Health Incorporated (GHI)
Guardian and Health Net
HIP Health Plan of New York
Horizon Healthcare of New York
Oxford Health Plans
UnitedHealthcare
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Group Health Insurance in New York
- An eligible applicant may not be denied coverage or charged more due to health problems.
- Additional opportunities for group insurance may be available for life changes that include marriage, children, family problems, or job loss.
- Special considerations are offered to newborn or adopted, disabled, or full-time student children.
- A new employer may require a waiting period before offering group insurance. A new HMO may require an ‘affiliation period’.
- When applying for new insurance, insurance companies may review the six months immediately preceding application when looking for pre-existing conditions.
- In the case of a pre-existing condition, the provider may require an exclusion period of up to six months.
- Eligibility for creditable coverage occurs when previous coverage was continuously maintained with no breaks longer than 63 days.
Small Business Health Insurance in New York
- Small employers with fewer than 50 employees may not be denied small group health insurance.
- Coverage may not be cancelled because of sickness in the employee group.
- The Healthy New York program allows small businesses with low income employees to purchase group insurance.
- Small business premiums are determined by the community rating.
- A small business with fewer than 50 employees in Long Island, Brooklyn, Queens, Nassau, Suffolk Counties, Five Boroughs of New York City are permitted to purchase group health insurance coverage through a purchasing pool.
- Contact the New York Department of Insurance for rules governing associations that offer health coverage.
New York Department of Insurance
Empire State Plaza, Building No. 1
Albany, NY 12257
(518) 474-6600
www.ins.state.ny.us/nyins.htm
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Self-Employed Health Insurance in New York
The self-employed may purchase small group health insurance.
Individual Health Insurance in New York
- Insurance providers may not deny coverage due to health problems.
- Insurance providers must offer family coverage.
- HIPAA eligible individuals have equal rights to individual insurance.
- There are specific rules governing HMOs and POSs in the State of New York.
- Coverage may not be cancelled because of sickness.
- Those who have a pre-existing condition may be excluded from coverage for up to 12 months.
- Insurance providers may review the six months immediately prior to coverage application when a pre-existing condition exists.
- Pregnancy may be considered a pre-existing condition but exclusion may not last longer than 10 months.
- Creditable coverage may be applied if previous coverage for a pre-existing condition was maintained continuously with no breaks longer than 63 days.
- Premium prices are determined by community rating.
- Coverage may not be cancelled due to illness.
New York Health Care Programs
Medicaid, Child Health Plus, Family Health Plus, Healthy New York, and Cancer Services Program Partnership are available for those with low to moderate incomes.
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