NY State of Health (NYSOH), the state’s
official health plan Marketplace, announced
in October the insurers offering health and
dental plans to individuals and small business
owners in 2016.
NYSOH also announced the insurers that
will be offering the new Essential Plan to
eligible, lower income New Yorkers. The Essential
Plan has no annual deductible and offers
the same essential benefits as other plans,
including free preventive care. Consumers pay
just $20 a month per adult or nothing at all
depending on their income.
Individuals who are currently enrolled
in the Marketplace will receive information
about renewing their coverage for 2016
directly from the Marketplace. Consumers
who are new to the Marketplace will be able
to enroll in coverage for 2016. The enrollment
period began on Nov. 1.
“More than 2.5 million New Yorkers have
already enrolled in affordable coverage
through the NY State of Health Marketplace
since its start two years ago,” said NYSOH
Director Donna Frescatore. “We’re urging
individuals who have not already enrolled in
coverage to visit the Marketplace to see what
it has to offer in 2016.”
The New York State Department of Financial
Services had previously announced
the approved health insurance plan rates for
insurers seeking to offer coverage in New
York’s marketplace on July 31.
The insurers that will offer Qualified
Health Plans on the Individual Marketplace
in 2016 are: Affinity Health Plan, Capital
District Physicians Health Plan, Crystal Run
Health Plan, Empire BlueCross and Empire
Blue Cross Blue Shield, Excellus (Excellus
Blue Cross Blue Shield in Central NY and
Univera in Western NY), Fidelis Care, Health
Insurance Plan of Greater New York (Emblem-
Health), Healthfirst New York, HealthNow
New York, Inc. (BlueShield of Northeastern
NY; BlueCross BlueShield of Western NY).
Independent Health, MetroPlus Health
Plan, MVP Health Plan, Inc., North Shore LIJ
(CareConnect), Oscar Insurance Corporation;
United Healthcare of New York, Inc.,
and Wellcare.
The insurers that will offer the new Essential
Plan in 2016 are:
Affinity Health Plan, Amerigroup (Empire
BlueCross BlueShield HealthPlus), Crystal
Run Health Plan.
Excellus (Excellus Blue Cross Blue Shield
in Central NY and Univera in Western NY),
Fidelis Care. Health Insurance Plan of Greater
New York (EmblemHealth), Healthfirst, Inde-
pendent Health, MetroPlus Health Plan, MVP
Health Care, United Healthcare, WellCare of
New York and YourCare Health Plan.
NY State of Health’s Small Business Marketplace
offers flexible options for small
businesses with 100 or fewer employees.
Employers can select the amount they want to
contribute toward the cost of their employee’s
coverage and offer their employees a choice of
health plan options without the administrative
hassle, said Frescatore.
The insurers that will be offered on the
Small Business Marketplace, or SHOP, in 2016
are: Capital District Physicians Health Plan,
Inc., Excellus (Excellus Blue Cross Blue Shield
in Central NY and Univera in Western NY
,Health Insurance Plan of Greater New York
(EmblemHealth), HealthNow (Blue Shield of
Northeastern NY; Blue Cross Blue Shield of
Western NY), Independent Health, MetroPlus
Health Plan, MVP Health Plan, Inc. and North
Shore LIJ (CareConnect).
The Marketplace will also offer the following
stand-alone dental plans: Delta Dental
Insurance Co., Dentcare, Dentegra Insurance
Co., Emblem, Empire BlueCross and Empire
Blue Cross BlueShield, Guardian (expanded
to the Individual Marketplace in 2015),
HealthNow New York, Inc. (Blue Shield of
NENY; Blue Cross Blue Shield of Western NY),
Healthplex, MetLife (offered on the Small
Business Marketplace only) and Solstice.
Health Republic, a CO-OP that was offered
on the Marketplace in 2014 and 2015 will not
be offered in 2016 . Persons enrolled in Health
Republic will receive a renewal notice providing
information about how to select another
plan for 2016. NYSOH and Department of
Financial Services staff will be available to
assist Health Republic consumers with this
transition to new coverage.
Officials said all health plans offered on
the Marketplace will cover doctor’s visits;
hospital stays; emergency care; maternity and
newborn care; mental health and substance
abuse disorder services; prescription drugs;
rehabilitative and habilitative services and
devices; laboratory services; preventive and
wellness services; chronic disease management
and pediatric dental and vision. Some
plans will offer additional benefits such as
adult dental and vision.
For additional information, visit the NY
State of Health website at https://nystateofhealth.ny.gov.
Maps of the 2016 Health and
Dental Plans are available at: http://info.nystateofhealth.ny.gov/PlansMap
and http://info.nystateofhealth.ny.gov/EssentialPlan.