Looking for the best New York City health insurance plan? Read on to learn some of the basics of health insurance in NYC and then compare free New York City health insurance quotes online at the top of the page.
New York City, commonly known as “The Big Apple”, is not just the largest city in New York State, but it is the largest city in the United States. Over eight million people populate this over-crowded, yet incredibly admired, city. New York City is unusual in that there are no clear boundaries of the classes based on residential areas. For example, Manhattan has some of the wealthiest people living there as well as some of the poorest.
Many people think of New York City as wealth and glamour, largely in part due to the fashion and entertainment industry that enriches the city’s culture. However, the unemployment rate recently reached its highest peak at 9% in July of 2009. In addition to finding employment in a rough market and budgeting finances to make it through these tough times, newly unemployed individuals may suddenly find themselves without health insurance or forced to afford the full premium amounts themselves.
New York City COBRA Health Insurance
Employees facing job loss do not necessarily have to lose their insurance as well. COBRA (Consolidated Omnibus Budget Reconciliation Act) is a federal program that requires certain employers to offer extended health care for their employees after termination. Under COBRA, the former employee retains the full benefits of his health insurance plan, but is also responsible for the full amount of the premiums. The employer is no longer responsible for making contributions on the former employee’s behalf.
While this plan is frequently quite costly, it is also oftentimes better than being without any insurance at all. In order to qualify for COBRA, you must elect the plan within 60 days of your termination date. If you plan on forgoing COBRA and opt for a private New York City health insurance plan instead, you must do so within 63 days of your termination date in order to eliminate the pre-existing condition waiting time. To start shopping for individual health insurance now, use an online quote tool that will retrieve options from the most appropriate providers for your needs.
Until early 2009, employers were obligated to allow COBRA coverage for 18 months, with the exception of certain disabled persons, who were allowed to maintain COBRA for 29 months. However, a recent new law went into effect in July of 2009 which extends COBRA coverage to now include 36 months. This new law applies to federal COBRA as well as to the New York State Continuation Coverage plan, also known as “mini-COBRA.” The New York State Continuation Coverage plan was established for employers with fewer than 20 employees because federal COBRA only applied to companies with more than 20 employees.
This new law does not apply to any self-funded or private health care plans since COBRA does not apply to those. Nor does COBRA apply to plans that are only for dental, vision, or prescriptions. If a group plan is comprehensive and includes one of the aforementioned plans along with medical coverage, then this new law applies as part of COBRA. This extension does not supersede COBRA’s early termination policy which is based on late payments of premiums, the cessation of all group health plans by the former employer, eligible coverage through a new employer, or becoming eligible for Medicare.
Entertainers and New York City Health Insurance
Entertainers make up a large core of New York City’s population, and because of the varied nature of their industry, they oftentimes work sporadically with bouts of in-between jobs or they may work steadily but with a frequent change in employer. To offer some health insurance to what some people call the heart of New York City, New York State offers a Continuation Assistance Demonstration Program for Entertainment Industry Employees.
Eligible entertainers can receive state assistance of 50% of their COBRA premium for up to 12 months of a period. To be eligible, you must be a resident of New York State and be eligible for COBRA through an entertainment industry plan. Furthermore, you cannot be receiving assistance from the Department of Health nor be eligible for Medicare. You will also be denied coverage if you are eligible for health insurance through an employer group health plan.
Household income requirements vary depending on how many people live in your household. For 2009, a family of one cannot have a monthly income greater than $2257 in order to qualify. For each additional family member, the income limit increases by approximately $780, so a family of four can earn up to $4594 and a family of six can earn $6153. For household calculations, the state of New York counts a pregnant woman as two people. An increase in income will not affect your eligibility in the program once you are enrolled.
Additional assistance is available for some entertainers through President Barak Obama’s American Recovery and Reinvestment Act (ARRA). This program pays 65% of a COBRA premium up to nine months for eligible participants. Eligibility requirements are simple: you must be COBRA eligible and be involuntarily terminated between 9/1/2008 and 12/31/2009 and you must also choose to participate in COBRA.
Entertainers that qualify for ARRA and the New York State Continuation Assistance Demonstration Program for Entertainment Industry Employees can either enroll in both programs simultaneously or one after the other. If an entertainer chooses both programs together, then ARRA will pay 65% of the premium and New York State will pay the remaining 35% of the premium for nine months. Once ARRA is complete, New York State will then pay 50% for the remaining three months unless the plan is terminated prematurely by the participant. If the entertainer elects to enroll at different times, then ARRA will pay 65% for nine months and then New York State will pay 50% for twelve months.
You will only lose your eligibility when your program ends naturally or if you move out of New York State, become Medicare eligible, or become eligible for insurance through an employer. However, this program has limited funding through the Insurance Department, so even if you meet all of the eligibility requirements there is no guarantee you will be accepted. An application will be denied if funding is not available for its entire twelve month period.
Healthy NY
Healthy NY was introduced during the Health Care Reform Act of 2000 to provide health insurance coverage for small businesses, sole proprietors, or individuals who are not offered insurance through their employers. The benefits cover basic needs such as doctor and hospital services, maternity, preventive screenings, x-rays, and emergencies. There is also an optional prescription drug benefit plan. Plan choices include an HMO, a high deductible health plan, and Family Health Plus and Child Health Plus.
In addition to income guidelines, eligibility criteria for individuals require New York State residency and current or recent employment. Additional requirements are that your employer does not offer you coverage and that you have not had coverage in twelve months or you lost coverage for specific reasons. Eligibility requirements for small businesses include location in New York State, they must employ less than 50 people, pay 30% of wages at less than $40,000, and not offer group health coverage.Sole Proprietors must live in New York State, be currently or recently employed, and must not have had health insurance during the previous year unless it was terminated for specific reasons.
There is also a pilot program that is being developed and administered by Benefit Specialists of NY, which is a subsidiary of the Greater Syracuse Chamber of Commerce. The program is called Healthcore and is being offered by United Healthcare in select villages and counties of central New York. The plan currently pays a 15% subsidy for insurance premiums to its participants, who can earn an additional 5% for completing a health risk assessment. This is the second pilot program so far, and more may be planned through Healthy NY.
Compare New York City Health Insurance Quotes!
New York has taken several measures to ensure health insurance is available for its residents. You can find these options online, with quote tools like the one above, or by contacting the state. Whether you’re an entertainer, a small business owner, or an individual raising a family, there are options available that may help you retain or obtain NYC health insurance coverage. Enter your zip code above to compare NYC health insurance quotes online today!
