With rates averaging 30% below market and reasonable benefits such as $20 Office Copays this was an important safety net for NYS Small Businesses. Since its inception 10 years ago the program has enrolled approx.180,000 members covering small groups, sole proprietors and working individuals. The program is not Medicaid and allows members to keep their Doctors and enroll in private insurance EPO/HMOs such as Empire Blue Cross, Oxford, Emblem GHI etc. One of the reasons the program is 30% less expensive is that the state has a pooled stop loss fund that reinsures health care companies. This fund has been underfunded with rapid growth and stagnant funding the past 3 years.
Currently, the less expensive Healthy NY HIgh Deductible Plan is $1200/single and $2400/family. Outside of preventive care, members must self insure on the entire deductible including Pharmacy. The good news is that this plan is a qualified HSA (Health Savings Account) and can be reinsured by members. For healthy members the HSA unspent money is not use it or lose and can be rolled over year to year.
Existing Healthy NY groups can still keep their plans as long as long they qualify. However, Healthy NY only allows 1st of the month effective date with only an 11.1.11 and 12.1.11 still available to prospective new groups looking to lock in the regular Healthy NY.