Empire Blue Cross Blue Shield Vs United Healthcare

Here are the Best New York health insurance companies we represent as well as some good reasons to do business with them.  Since we are independent insurance brokers, our reviews are unbiased and based on our history of doing business with all the companies listed here and more. If you need a customized quote or have any questions, feel free to contact us at: 800-234-3702

Some of the Best New York Health Insurance Companies we represent are:

(Click the links below to jump directly to the company)

Aetna
Cigna
Emblem Health
Empire Blue Cross
Healthfirst
HealthPass
MVP
Oxford
Oscar

Oxford Health Plans

Oxford (OXHP.com) is owned by The UnitedHealthcare Company, which is one of the largest health insurance companies in the U.S. Their health plans are available to small businesses with as few as 2 employees and for businesses with over 100 employees. If you have 1099 employees and have been having trouble finding health coverage for them, Oxford will cover them!

Oxford is one of our premier providers with some of the most widely accepted health plans in the tri-state area. 8 out of 10 downstate small businesses rely on Oxford for their health plan.

Oxford offers a variety of plans within their 3 networks; The Freedom Network, The Liberty Network and the "new" Metro Network. The Freedom and Liberty plans also provide National coverage for your employees with their "Choice Plus network," offered through parent company, UnitedHealthcare.

Within the 3 networks, Oxford offers several different health plan designs to fit just about any organization; EPO Plans (Exclusive Provider Organization) PPO Plans (Preferred Provider Organization), HMO Plans (Health Maintenance Organization) and HSA's (Health Savings Accounts).

All plans provide coverage to doctors and hospitals in NY downstate counties including the 5 boroughs. Upstate coverage includes Westchester, Duchess, Orange and Sullivan Counties.

Oxford offers more than 42 health plans for their small business customers. Two of their most popular plans are the "Zero Deductible Plans."

Oxford Zero Deductible (ZD) Plans

No referral EPO plans:

1. Oxford Liberty Non-gated EPO (Gold)
2. Oxford Metro Non-gated EPO (Silver)

Plan Features:

•$0 deductible
•100% plan coinsurance
•Benefits are subject to fixed copay amounts
•Oxford Liberty Non-Gated EPO plan design includes national network access

Oxford Freedom Network

The Freedom Network is their largest network and has the largest participation of doctors and hospitals. Employers enrolled in the Freedom Network have access to 20,324 individual medical providers and 28 hospitals in the New York State.

Health plans within this network have the highest quality of benefits but also they are also the most expensive. This network would be a good fit for a business owner who wants the most comprehensive health plan and is willing to pay more for the highest level of coverage.

Oxford Liberty Network

The Liberty Network has a very comprehensive network of health care providers but has an estimated 25% less participants than the Freedom Plan. Employers enrolled in the Liberty Network have access to 20,070 health care providers and 28 hospitals in New York State.

Liberty HMO plans have no employee participation requirements so you could utilize this plan with only 1 employee (not your spouse) on payroll. For their PPO and EPO plans a 60% minimum employee participation is required. Valid health plan waivers such as spousal, Medicaid and Medicare waivers are also required to meet participation.

Oxford Metro Network

The Metro Network is their newest network and has the smallest participation of doctors and hospitals. The Metro network has a network about 25% smaller than the Liberty network. For instance, the Metro Network does not include Northwell Health (one of the largest medical providers in New York), New York University Hospital or Stonybrook, just to name a few.

The network is growing but it takes time and much negotiations to convince doctors or hospitals to join a new network. Metro health plans are the least expensive of all their health plans but also require doctor referrals. CVS Pharmacy and North Shore LIJ to name a few, have yet to participate in this network.

Oxford is also unique in a way that you can choose more than one health plan to meet the needs of your employees. For instance; if you have minimum wage earners who can only afford basic coverage, they can choose a lower cost plan with higher deductibles. For executives or higher paid employees, they can choose a health plan with better coverage and less out of pocket expenses. To read our full review, go to: Oxford Health Plans Review.

Empire Blue Cross NY

Empire operates under its parent company Anthem Inc. Anthem is one of the largest health benefits companies in the United States. Empire Blue Cross has been serving New York since 1934 and has provided health insurance coverage to individuals, small and large businesses for almost 90 years. The company also offers other insurance services such as: dental, vision, group disability, group life insurance and Medicare.

Empire is one of the largest group health insurance providers in NY. The company operates across the entire state of New York. Upstate and downstate. They have a strong network of more than 85,000 participating doctors and 160 hospitals across New York State. If members live or work across the country, they have access to doctors and hospitals through one single electronic network: BlueCard.

The BlueCard® PPO is the nation's leading PPO network with more than 96% of participating U.S. hospitals, 95% of U.S. physicians. The BlueCard program allows employees to use providers almost everywhere in the U.S. and in almost 170 countries.

The company offers a wide variety of health plans for both small and large businesses; CDHP Plans (Consumer Driven Health Plans) EPO Plans (Exclusive Provider Organization) PPO Plans (Preferred Provider Organization), HMO Plans (Health Maintenance Organization) and HSA's (Health Savings Accounts). All plans can be used nationally and do not require referrals with the exception of the GateKeeper EPO.

Empire Blue Cross Blue Shield Group Health Plans

Empire health plans include their largest EPO/PPO networks or The Blue Priority Network and their slightly smaller network called Blue Access. Blue Access uses the old Pathway Network which has a limited network of providers and participating hospitals. Small business customers who were using the Pathway network will now be participating in the new Blue Access network. The Pathway Network will be utilized for Empire members who purchase individual insurance plans on the New York State of Health marketplace, or the Health Exchange.

In January 2020, Empire introduced a new network called Connection. It is their smallest network of doctors and hospitals but offers the greatest premium savings to small business clients. Empire Connection joins their 2 other existing networks: Empire PPO/EPO (Blue Priority) and Blue Access. It's important to note that employers can offer any combination of their 3 networks as part of their benefit plan.

Blue High Perfomance Network (HPN) for Employers.

The HPN network was introduced in January 2021 and gives employees in-network access to medical care through an national network that offers more than 10 percent cost savings compared to the BlueCard PPO. Employees will pay less in co-pays, co-insurance and etc. provided they use the carefully selected network providers who are committed to enhancing quality care with Blue Cross.

HPN offers medical care across 55+ major U.S. markets and is the only high-performance network with a presence in all of the top 10 U.S. cities.

We work with Empire Blue Cross and if your company would like to explore Empire group health plan options, please contact us. For more information about the company, read our Empire Blue Cross Blue Shield Review.

Cigna

Cigna is one of leading health insurance providers in the world. Their roots go back over 200 years of providing insurance solutions to consumers. The company we know today was formed in 1982 when Connecticut General Life Insurance Company and the Insurance Company of North America (INA) merged. See our full Cigna review for more detailed information about the company and plan offerings.

Cigna provides health insurance to individuals and companies across the United States and throughout the world. Other insurance services provided are, dental and vision care benefits, group disability and group life insurance. Cigna is headquartered in Philadelphia, but they also operate in 30 other countries. Cigna health insurance has more than 90 million customers worldwide.

Cigna Health Insurance Company specializes in providing group benefits to the small, medium and large business marketplace. They require a minimum of 51 eligible employees – 100 in New York – for a business to utilize their benefits programs.

Like Oxford and Aetna, Cigna has one of the largest networks of doctors and hospitals in the tri-state area. They offer several different health plan designs to fit just about any organization; PPO Plans (Preferred Provider Organization), HMO Plans (Health Maintenance Organization) and HSA's (Health Savings Accounts). Just about every type of health care coverage you can imagine.

Cigna makes our list as one of the Best New York Health Insurance Companies that we represent. If you are a business with more than 51 employees, we can help you implement a group benefits plan with Cigna.

Aetna

Aetna was founded in 1853 and is headquartered in Hartford, CT. Aetna has one of the largest health care networks in the Country, coming in 2nd to United Health Care. The Aetna network includes over 1 million health care professionals, 690,000 primary care doctors and specialists, and more than 5,700 hospitals.   This company has one of the best networks of doctors and hospitals, both locally and nationally. See our Aetna Review for more about the company.

In 2018, Aetna was purchased by CVSHealth with a transaction cost valued at $69 Billion. The company serves approximately 22 million medical members. Aetna Dental is one of the most popular and widely accepted dental programs in the Country with over 12 million members. The company also offers Vision plans, Medicare, Accident, Critical illness and Hospital Indemnity Plans.

Aetna Group Health Plans

The company does not offer any Platinum plans in New York. Only Gold, Silver and Bronze. Their group health plans include PPO (Preferred Provider Organization) plans, EPO Exclusive Provider Organization) plans, HSA (Health Savings Accounts) and now their new Aetna Saving Plus plans. Savings Plus plans will have reduced rates and are designed to compete directly with the Oxford Metro plan. All Aetna plans are available everywhere in New York State.

Aetna Open Choice PPO Plan:

Employees can visit any provider, in network or out-of-network, without a referral. But when they stay in network, claims are handled at the lower, contracted rates.

Aetna Open Choice POS 2 Plan:

This plan allows employees to visit any doctor, hospital or facility, in or out of network, with no referrals. But depending on their plan, if they choose a primary care physician (PCP) and stay in network health care costs will be less.

Aetna Managed Choice Plan:

These plans are a type of health insurance that have contracts with health care providers and medical facilities to provide care for members at reduced costs. Members can select a network PCP to guide their care. Or they can go out of network for a higher cost.

Aetna Open Access Managed Choice Plan:

This plan takes some of the "managed" out of managed care, while keeping the savings. Members can visit any provider. And while employees are not required to choose a PCP, savings are offered by staying in network.

Aetna requires 60% enrollment after valid waivers, (spousal, parental, individual, Medicare and Medicaid) for your employees to enroll in their health plans. Aetna also allows business owners to offer more than one of their health plans to your employees. A "high-low option" which lets executives choose a more comprehensive plan while lower paid workers can elect a basic, more affordable plan.

HealthPass

This is a private health exchange that was created by the Giuliani administration in the 1990's. They offer more than 40 different health plans under 1 billing program to small businesses in the downstate NYC area and even some areas in upstate New York.

Plans include quality providers such as Oxford, HealthFirst, EmblemHealth, Oscar, Guardian and Soltice. Programs available are; Medical insurance, dental insurance, Vision, life insurance, disability insurance, as well as Section 125 Plans and COBRA administration.

HealthPass is an excellent program for small business owners who want to offer several health plan options to his or her employees without the hassle of multiple bills. See our HealthPass review.

No matter how many health plans your employees choose or how many plans you offer, it all comes under one bill making the administration of your health care program simple.

Emblem Health

In 2005, EmblemHealth merged with 2 major New York insurance companies: Group Health Incorporated (GHI) and Health Insurance Plan of New York (HIP). Emblem offers health insurance coverage to small groups (1-100 employees) and large groups (101 or more employees) with very competitive pricing compared to most other providers. Employers would utilize the "Prime Network" in New York, QualCare Network in New Jersey and ConnectiCare Network in Connecticut. The Prime Network gives employees access to over 130,000 providers across the tri-state region.

The Prime Network covers the five boroughs of New York City (the Bronx,* Brooklyn, Manhattan, Queens, and Staten Island), plus Nassau, Suffolk, Orange, Rockland, and Westchester counties, and upstate areas that stretch north of Albany.

The ConnectiCare HMO Network covers all eight counties in the state of Connecticut and the QualCare HMO Network covers all 21 counties across the state of New Jersey.

In the Fall of 2020, Emblem announced that their EPO and PPO plans now include National coverage through FirstHealth making them competitive with other top providers such as Oxford, Blue Cross Aetna and Cigna. For more information, see our full EmblemHealth Insurance Company Review.

MVP

MVP (Mohawk Valley Physicians) was founded in 1986 by by a group of doctors in upstate New York. They are located in Schenectady NY but only offer insurance plans in New York, Vermont and New Hampshire. The company boasts more than 500,000 health care providers and if you live in New York State, you will not have trouble finding a doctor or hospital in their network. MVP offers health plans to small businesses, groups and individuals.

MVP has an extensive network of doctors throughout northern New York but has been making an effort in the past few years to grow its network in southern New York locations such as: Westchester, Putnam and Rockland Counties as well as New York City.

MVP offers EPO, PPO health plans and high deductible Plans. If you get injured or become sick out of New York State, you have access to their national network through Cigna PPO. MVP currently has no minimum enrollment requirements for small businesses and groups with 2 or more employees can enroll with only 1 employee – as long as there are at least 2 employees on payroll.

If you own a business or live in the Hudson Valley, you should check out MVP for your health insurance needs.

Healthfirst

Healthfirst is not-for-profit managed care organization and has more 1.2 million members in the New York City area. The company entered the small business arena in 2017 but has been providing quality health care plans to individuals and families for more than 23 years.

This insurance company is affiliated with some of the most recognized hospitals and medical centers in New York. Hospitals such as Montefiore, Mount Sinai and Long Island Jewish Medical Center, just to name a few. Healthfirst's network is focused primarily in the downstate New York region so if your business is located in New York City or Long Island, you will find a strong network of doctors and hospitals to provide coverage for your employees.

Healthfirst offers EPO (Exclusive Provider Organization) plans only through their "Pro Plus Small Business Program." Their health plans are in-network coverage and do not require referrals from your PCP (Primary Care Physician).

Along with providing quality health care plans to small businesses, they also offer:

Vision and dental benefits
$0 copay for access to 24/7 telemedicine
Up to $600 in exercise rewards
Coverage for acupuncture visits

Healthfirst's health plans are compliant with The Affordable Care Act (ACA) covering all metal tiers: Platinum, Gold, Silver and Bronze. Their small business plans are competitively priced and slightly less expensive than Oxford or Aetna but nowhere near the vast provider networks offered by these 2 insurance companies.  You can learn more by reading our HealthFirst Insurance Company review.

OSCAR

This company is a new-comer to the small business market. Oscar started offering group health plans January 1st, 2017 and provides coverage to businesses with less than 100 employees.

"If Jeff Bezos of Amazon was to start an insurance company, he would probably build it like Oscar."

Oscar is one of the first insurance companies to utilize a technology oriented platform to bring insurance plans to their customers.

Almost everything regarding their health plans can be accomplished online: quotes, enrollment, billing, booking doctor appointments and even licensing for brokers like us. They have an easy-to-use phone app for employees to access all their benefits, prescriptions and more. If Jeff Bezos was to start an insurance company, he would probably build it like Oscar.

Oscar health plans are EPO plans (Exclusive Provider Organization), which means your employees can only see doctors in network. No referrals are needed to see a specialist. Their health plans can be customized to different classes of employees, meaning you can offer more than one plan design to your employees.

Oscar's physician network is relatively small compared to other New York health care providers but they are working hard to grow their network. It's not easy when you are "the new kid on the block."  If you have a small business in the 5 boroughs and Long Island, you will probably find a good network of doctors, medical facilities and hospitals.

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Source: https://www.healthplansny.com/insurance-companies-represent/

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