Oxford Health Plans > Brokers Resources > New York Individual/Mandated Plans

New York Individual/Mandated Plans

Individual Plan

We offer individual health insurance plans in New York to people who are self-employed or otherwise ineligible for group coverage. Please call 800-216-0778 for specific plan details, or write to:

    Oxford Health Plans
    Attn: Inside Sales
    14 Central Park Drive
    Hooksett, NH 03106

RATES

New York Personal POS Plans

New York Personal HMO Plans

How To Enroll

New York Individual Enrollment Form

Healthy New York

Healthy New York is a unique program designed to encourage small group employers to offer health insurance to their employees by creating a standardized benefits package made more affordable by state sponsorship. This program is also available to individuals and sole proprietors.

ELIGIBILITY REQUIREMENTS

State mandated HMO product offered to New York small groups who meet the following requirements:

•  HNY is available to small groups that have not provided comprehensive health insurance to their employees during the past 12 months but a small employer may still qualify if
•  the business provided only "limited" health insurance benefits.
•  the business arranged for group coverage but did not contribute more than $50 per employee per month towards the premium.
•  50 or fewer eligible employees
•  One-third of the employees must earn wages of $32,000 or less
•  Employer must certify that they have not provided group health insurance coverage to their employees within the 12-month period preceding application
•  50% of the eligible employees must participate in the program and at least one participant must earn annual wages of $32,000 or less
•  Employer and employee share equally in the cost of premium (though the employer may choose to pay more than 50% of the premium)
•  Business must be located within New York State
•  Persons working 20 or more hours weekly are considered employees for the purpose of this program. Furthermore, all employees earning $32,000 or less, who work 20 or more hours weekly, must be offered coverage through Healthy New York
•  Small employers who offer coverage to part-time workers may choose the level of premium contribution on behalf of part-time workers.
•  Businesses enrolled in the New York State Health Insurance Partnership Program (NYSHIPP) during the past 90 days prior to the application effective date are automatically eligible.
•  The business arranged for group coverage but did not contribute more than $50 per employee per month towards the premium.

Note: If the group provided comprehensive health coverage (including both medical and hospital coverage) in the 12 months preceding the application effective date and the group contributed toward the premium, then the group is not eligible

RATES

Summary of Coverage & Monthly Premium Rates Healthy New York

FORMS

Healthy New York Application for Small Group Employers
Healthy New York Application for Individuals and Sole Proprietors
Healthy New York Group Enrollment Agreement
Healthy New York Member Enrollment Form
Healthy New York Re-certification for Small Employers
Healthy New York Re-certification for Individuals and Sole Proprietors
Student Verification Information Form