NYS health exchange opens for business



SPECULATOR - New York state's health benefit exchange, dubbed NY State of Health, opens for enrollment Oct. 1, with coverage beginning Jan. 1, 2014.

The exchange is a marketplace to provide "quality, affordable health insurance for individuals and small businesses across the state," according to Department of Health Commissioner Nirav R. Shah.

According to the NY State of Health website, plans are available in four tiers: platinum, gold, silver and bronze. They cover doctor visits, hospital stays, emergency care, maternity and newborn care, mental health and substance abuse 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 offer additional benefits such as adult dental and vision coverage.


The NYS Department of Financial Services has approved 17 health insurance plan rates for insurers who want to offer coverage through NY State of Health, ranging from an average of $170 for the cheapest plan to $965 for the most expensive. Not all are available here.

In Hamilton County, individual plans are being offered by CDPHP, Excellus Blue Cross Blue Shield, Fidelis Care, Freelancers Co-op (Health Republic Insurance) and MVP.

Small business (50 or fewer employees) plans are being offered by CDPHP, Excellus Blue Cross Blue Shield, Freelancers Co-op and MVP.

Businesses with 25 or fewer employees and average wages of $50,000 or less per year may qualify for tax credits.

An interactive map showing qualified health plans by county is available at www.nystateofhealth.ny.gov/PlansMap. Those who are not online can call 1-855-355-5777 to get help choosing and enrolling in the right plan.


NY State of Health is part of the Patient Protection and Affordable Care Act, commonly called Obamacare.

Individuals and families with incomes below certain levels ($45,960 for individuals and $94,200 for a family of four, for example) may be eligible for financial assistance in the form of federal tax credits available through NY State of Health. Federal tax credits limit the amount a person pays for insurance each month.

According to NY State of Health Executive Director Donna Frescatore, monthly payments will be far below the cost of buying insurance previously. For example, if a silver level plan is selected, an individual with an annual income of $17,000 will pay $55 a month; a family of four with an income of $35,000 will pay $114 a month.

_A calculator on the NY State of Health website can estimate eligibility for tax credits; go to www.nystateofhealth.ny.gov/PremiumEstimator.

For more information visit the NY State of Health website at nystateofhealth.ny.gov or on Facebook, Twitter or Google+.