Our Plans

Small Group Plans

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Savings and Service for Small Groups

Lower premiums and easy access to top-rated hospitals and doctors in the New York metro area — that’s healthier insurance.

Our Plans: Better for Business, Better for Employees

CareConnect plans:

  • Save money for your business and your employees

    We could save you up to 20% or more on premiums, compared with what big-name insurance companies charge.

  • Provide easy access to superior health care

    From Montauk to Manhattan and Staten Island to Westchester, we partner with doctors and hospitals that have earned top ratings and local and national honors for the quality of their care. Our network also includes walk-in clinics across the United States.

  • Help your employees stay well

    All plans provide free preventive care. We also help members manage medical conditions such as diabetes or high blood pressure, connect them to wellness programs and reward them for exercising.

† Based on a comparison between CareConnect offerings and publicly available rates for similar plans

Extra Access, Extra Value

We’ve added new plans for 2016 to meet your needs.

  • Want customer service and affordability, but need national coverage? Our Access plans offer a provider network that stretches across the country.
  • Looking for the most affordable option? Our Value plans offer low premiums, first-dollar coverage for most services and zero-copay generic drugs.

See how much your business could save!

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Picking the Right Plan for Your Small Business 

(1 to 100 full-time-equivalent employees)

No two businesses are alike, so our plans are designed to satisfy differences in needs and price points. CareConnect is an exclusive provider organization (EPO), which means we’ll help pay your employees’ bills when they use the doctors, hospitals and other medical providers in our network. Bills from out-of-network providers are not covered, with the exception of emergency care and other specific circumstances.

Most of our plans fall into one of four categories: Bronze, Silver, Gold or Platinum.

  • Bronze
    Bronze plans have the lowest monthly premiums. They cover, on average, about 60% of the member’s health care costs.††
    • $ Monthly Cost
    • $$$$ Cost When Getting Care
  • Silver
    Silver plans have the second-lowest monthly premiums. They cover, on average, about 70% of the member’s health care costs. ††
    • $$ Monthly Cost
    • $$$ Cost When Getting Care
  • Gold
    Gold plans have higher monthly premiums than Bronze and Silver plans. They cover, on average, about 80% of the member’s health care costs. ††
    • $$$ Monthly Cost
    • $$ Cost When Getting Care
  • Platinum
    Platinum plans have the highest monthly premiums. They cover, on average, about 90% of the member’s health care costs.††
    • $$$$ Monthly Cost
    • $ Cost When Getting Care

††Actual percentage will depend on services the member uses during the year.

Each category includes different types of plans, with some variations in the monthly payment (premium) and the amount the plan will pay toward the cost of medical services and prescription drugs.

We also offer some high-deductible plans with a health savings account (HSA) option. These plans allow members to set up an HSA at their bank; their tax-deductible contributions earn tax-free interest. The money in the account is theirs to keep, with no “use it or lose it” deadline. Members can withdraw money from the HSA to pay their share of medical bills and prescription drug costs, or the bank that administers the HSA may give them a debit card or checks to use to pay those expenses.

See plan options, and learn how much your business could save!

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Health Plans in Plain English

Deductible

The amount a member or member’s family must pay out of pocket before insurance starts helping to pay medical costs. The plan may pay for some kinds of medical services before the deductible is met. (Not all plans have a deductible. If a member has a no-deductible plan, it will start helping to pay for all covered medical costs right away.) Plans vary on whether and how the deductible applies to prescription drug purchases.

Copay

A fixed dollar amount, such as $15 or $25, that a member may be required to pay to share the cost of an office visit or other medical service. The member will pay the full cost of most covered medical services until the deductible is met; after that, he or she may be responsible only for a copay or another form of cost-sharing. (If the plan doesn’t have a deductible, the member may be responsible for a copay right away.) The copay is typically higher for an appointment with a specialist than it is for one with a primary care physician.

Coinsurance

A fixed percentage of the bill, such as 20%, that a member may be required to pay to share the cost of medical services. The member will pay the full cost of most covered medical services until the deductible is met; after that, he or she may be responsible only for the coinsurance or another form of cost-sharing. (If the plan doesn’t have a deductible, the member may be responsible for the coinsurance right away.)

Maximum out-of-pocket expense

The most a member or member’s family will have to pay in deductibles, copays and coinsurance for in-network covered services during each plan year. Once that maximum is reached, insurance will pay 100% of the bill for in-network care until the next plan year. 

Prescription drug tiers

Insurance companies place medications in different “tiers” that determine a member’s share of the prescription’s cost. CareConnect uses three prescription drug tiers. Tier 1 drugs have the lowest copays; many are generic medications. Many common brand-name drugs are in Tier 2. Tier 3 drugs include some specialty drugs and some medications for which lower-cost alternatives are available; these have the highest copays.

Making It Easy

We want you and your employees to get the care you need without the hassle. Most plans we sell gives our members:

  • Free preventive care, including checkups, well-woman visits, birth control* and many vaccinations and screening tests
  • Vision and dental coverage for children until their 19th birthday
  • Coverage for pregnancy (prenatal) and newborn care
  • Access to urgent care centers in the New York area and nearly 1,000 walk-in clinics across the country
  • A high-quality network of more than 30 hospitals and 17,000 physicians
  • Direct access to in-network specialists — no referral needed
  • A pharmacy network that makes it easy to pick up prescriptions, plus an option for lower-cost mail-order delivery 
  • Unlimited access to our highly trained Service Connectors, who can find members the right doctor, make their appointments, explain their costs, handle their paperwork, and more
  • Access to free phone and video consults with board-certified physicians from the comfort of your own home with our new Teladoc service

Get started on savings for superior care!

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* There may be an exception to the free birth control coverage on group plans for groups that meet the requirements for a religious exemption.