Your Choice of Affordable Health Insurance.

Looking for more out of your group health insurance? Well, you have come to the right place! HealthPass offers employees choice through our menu of health benefits.

SIMPLE, SMART HEALTHCARE

HealthPass supports employers who empower their employees to make their own health insurance decisions. After an employer sets a defined contribution (DC) amount, each employee chooses plans that are right for their personal and family's medical needs and budget. Our robust menu of benefit options, from leading industry carriers, ensures everyone has access to plans that are right for their unique needs.

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Why Choose HealthPass

Since 1999, our choice model has empowered employees to personally select their plans based upon their unique needs and budgets. We offer a well-rounded menu of options offered through industry leading insurance carriers with choices including medical, dental, vision, life, disability, accident and ID theft protection.

Brokers, employers and members benefit from the state-of-the-art technology and extensive support provided by the HealthPass team including a streamlined administrative process, member-claims advocacy, COBRA administration and knowledgeable Client Services.

HealthPass is available to companies with 1-100 full-time equivalent employees. Companies must be located in the five boroughs of NYC, Long Island, Westchester, Rockland, Orange, Putnam, Dutchess, Ulster or Sullivan counties to be eligible.

FREQUENTLY ASKED QUESTIONS
What is HealthPass New York?

HealthPass is a private insurance exchange offering employers in the New York Metropolitan area flexible cost effective solutions for their employees needs. Since 1999, the HealthPass choice model has empowered members to personally select their plans based upon their unique needs and budgets.

HealthPass offers a well-rounded menu of options offered through industry leading carriers with choices including medical, dental, vision, life and disability, accident coverage and ID theft protection. Agents, employers and members benefit from the state of the art technology and extensive support provided by the HealthPass team including a streamlined administrative process, member-claims advocacy, COBRA Administration and knowledgeable Client Services.

What is a health insurance exchange?

Health insurance exchanges are an innovative concept based on economist Alain Enthoven’s theory of managed competition and supported by stakeholders on both sides of the political aisle. A health insurance exchange creates a structured marketplace where employees can chose their health insurance based on quality and value.

Employees of a small and medium size business are typically given very limited choice – usually only one or two options – when it comes to health insurance. Exchanges transform that dynamic by creating an organized and competitive marketplace that offers a choice of health benefit designs, health insurance carriers and provider networks. Exchanges also provide the business owner with a comprehensive set of “back office” services that streamline employer-based health benefits administration while simultaneously supplying employees with personalized support to help them navigate their healthcare from initial sign-up to renewal. 

How does the HealthPass private insurance exchange model work?

After electing HealthPass as their group coverage, employers set a defined dollar contribution and designate which product offerings will be made available to employees. Through HealthPass, each employee can choose a different insurance carrier and health plan design through the HealthPass Online Portal (HOP) or by using one universal enrollment form. Employees then choose a medical carrier, health plan and ancillary products (if made available by their employer). The employer receives one consolidated list invoice from HealthPass and makes one payment per month regardless of the number of different plan options chosen by employees. Throughout the plan year, members can take advantage of our robust in-house Client Services.

Who can enroll?

Businesses and non-profits with a company address in one of the five boroughs of NYC (Manhattan, Brooklyn, Queens, Bronx or Staten Island), Nassau, Suffolk, Westchester, Rockland, Orange, Putnam, Dutchess, Ulster or Sullivan counties.

Do the plans cover prescription drugs?

Yes, all plans cover prescription drugs with benefits varying by plan. All of our medical carriers offer a mail order program to receive certain medications conveniently at your home.

How many employees must participate in the medical plan?

HealthPass Participation Requirements: 75% of the eligible employees must either enroll in HealthPass or submit a valid waiver. 20% of the total eligible employees must enroll with a HealthPass medical plan.

To include Oxford – Liberty
Liberty Participation Requirements: 75% of the eligible employees must either enroll in HealthPass or submit a valid waiver. 60% of the total eligible employees, after valid waivers, must enroll in Oxford – Liberty and/or Oxford – Metro plans.

To be eligible for small group coverage through HealthPass, a group must have at least 1 but not more than 100 FTE employees. Group size is to be determined based on the federal “Full-Time Equivalent” (FTE) employee counting method (26 U.S.C. 4980H(c)(2), which is the same calculation used to determine employer liability under the “Shared Responsibility for Employers” provisions of the Affordable Care Act (ACA) and Internal Revenue Code (IRS). For each month of the prior year, the employer counts its employees working an average of 30 or more hours per week as full-time employees and, if it has employees working less than that, adds the number of full-time equivalents (determined by simply adding up the hours that are worked by these less than-full-time employees for the month, but no more than 120 hours per employee, and then dividing by 120). Then, the resulting totals for each month in the prior year are added together and then divided by 12 to get an average for the prior year.

Who is eligible?

  • Groups must have at least one common law employee and the common law employee cannot be a spouse or a relative with ownership.
  • Partnerships with no common law employee(s) are not considered a group.
  • Corporations (LLCs, S and C Corporations) do not require a common law employee(s) so long as the corporation has at least two owners who are not married to each other.
  • Full-time employees must work a minimum of 20 hours per week. The employer may choose to raise the minimum standard up to 40 hours per week but must remain consistent for all employees.
  • Domestic Partners (DP) who are 18 years or older and who live together and have been living together on a continuous basis for at least six months. The domestic partnership must involve a close and committed personal relationship. Neither you nor your domestic partner may be married or related by blood in a manner that would bar marriage in New York State.

Can husband and wife only businesses be considered eligible?

No, there must be another eligible and enrolling in medical common law employee in the group.

How many plans can I offer my employees?

All of them! Through HealthPass, each employee can choose a different plan using the HealthPass Online Portal (HOP) or one universal enrollment form. You get one invoice and make only one payment a month, regardless of the number of plans your employees choose.

Will my employees and I be able to keep our current doctors?

Yes! Through the HealthPass exchange, employees are able to choose a carrier and provider network that works for them. To search each carriers network of doctors and hospitals click here. Additionally, each medical carrier offers a suite of discount and wellness programs. These programs may include discounts for local gyms, diet centers, LASIK surgery and other vision benefits, acupuncture, massage therapy, dieticians, smoking cessation, hearing discounts and more.

When can I start coverage for my business?

You can start the first of any month. Enrollment materials must be received by the 20th day of the preceding month.

What is HealthPass Dental?

HealthPass offers DHMO, EPO or PPO dental plans available through Guardian, Solstice and UnitedHealthcare.

What is HealthPass Vision?

HealthPass offers three PPO vision insurance plans through Guardian, Solstice and UnitedHealthcare.

What is HealthPass EverGuard?

EverGuard and EverGuard Plus are bundled security products offered by HealthPass through Guardian. The EverGuard family of products make it easy to offer your employees the personal protection they need at affordable rates. No medical exam is required and no industry is excluded.

What is HealthPass AccidentGuard?

HealthPass offers Guardian AccidentGuard Adv to help cover out-of-pocket medical expenses in the event of an accident. Benefits are paid directly to the member and they are free to use them to cover whatever expenses they deem fit.

What is HealthPass ID Theft Protection?

HealthPass offers ID Theft Protection plans through Allstate and LifeLock. ID Theft Protection defends employees and their families from evolving cyber threats that cause data breaches and financial losses.

What is HealthPass FSA & Commuter Benefits?

Through HealthPass employers can offer OCA FSA & Commuter Benefits which affords employees the opportunity to enroll in any or all of the following four plans: Flexible Spending Account (FSA), Dependent Care Account (DCA), Parking Plan and Transit Plan.

What is a POP Kit Section 125?

A Premium Only Plan is one of the simplest benefits an employer can offer and it delivers real savings to employers and their employees. By allowing employees to pay their portion of premium costs BEFORE taxes, employees typically save 25% or more, and the employer benefits from nearly 8% in FICA savings. Get your POP Kit today!

What is health advocacy?

All employees enrolled in medical coverage, excluding COBRA members, have access to health advocacy. Health advocacy help members solve problems and find solutions. They can help with finding specialists, resolving insurance claims and obtaining approval for needed services.

With so many plans what is the right choice for us?

By consulting a licensed NYS insurance broker or HealthPass directly, together we will take the time to review your current benefits package and evaluate how to best structure HealthPass as a solution for your business.  If you are in need of assistance, please call us at 888-313-7277.

How do I get a quote?

It's easy! Just click here or call 888-313-7277 to speak with a HealthPass representative or contact your broker.