Plans for Individuals and Families

GHI Healthy NY EPO High Deductible Health Plan

Hospital and medical coverage, with or without prescription drug coverage

In-network coverage in our tri-state network of over 142,000 provider locations in New York counties

No gatekeepers or referrals required

Available for uninsured small businesses, and individuals

Coverage for: Bronx, Kings (Brooklyn), Nassau, New York (Manhattan), Queens, Richmond, Rockland, Suffolk and Westchester

See if you are eligible for Healthy NY coverage with this handy
eligibility screener.

GHI Healthy NY HMO High Deductible Health Plan

Hospital and medical coverage, with or without prescription drug coverage

Coverage in our HMO network of close to 44,000 provider locations in 28 New York counties

Available for uninsured small businesses, and individuals

Coverage for: Albany, Bronx, Broome, Columbia, Delaware, Dutchess, Fulton, Greene, Kings (Brooklyn), Montgomery, Nassau, New York (Manhattan), Orange, Otsego, Putnam, Queens, Rensselaer, Richmond, Rockland, Saratoga, Schenectady, Schoharie, Suffolk, Sullivan, Ulster, Warren, Washington, and Westchester

See if you are eligible for Healthy NY coverage with this handy
eligibility screener.

GHI Brooklyn HealthWorks High Deductible Health Plan

Hospital and medical coverage, with or without prescription drug coverage

In-network coverage in our tri-state network of over 142,000 provider locations in New York counties

No gatekeepers or referrals required

Available for uninsured small businesses, and individuals located in Brooklyn, NY only

See if you are eligible for Healthy NY coverage with this handy
eligibility screener.

HIP Healthy NY HMO High Deductible Health Plan

Hospital and medical coverage, with or without prescription drug coverage

In-network coverage in our 10 New York County Service network of over 27.000 provider locations

Available for uninsured small businesses, and individuals

Coverage for: Bronx, Kings (Brooklyn), Nassau, New York (Manhattan), Orange, Queens, Richmond, Rockland, Suffolk and Westchester

See if you are eligible for Healthy NY coverage with this handy
eligibility screener.

Alliance Value Plan

The Alliance Value Plan is a top choice for individuals and families.

Basic hospital, medical and prescription drug coverage

In-network coverage in our PPO network of over 98,000 provider locations

Coverage for out-of-network services

No gatekeepers or referrals required

Open enrollment; open any time to New York State residents

Coverage across all of New York State

GHI Direct Pay HMO

Complete hospital, medical and prescription drug coverage.

Coverage in our HMO network of over 44,000 provider locations in
28 NY counties

GHI Direct Pay HMO POS

Complete hospital, medical and prescription drug coverage

HMO network of over 44,000 provider locations

HIP HMO Direct Pay Governor’s Bill

Member is required to select a primary care physician

Referrals are required

100% coverage after copay for most in-network services

Little or no paperwork

In-network coverage only

Participating providers in the following 10 New York counties: Bronx, Kings (Brooklyn), Nassau, New York (Manhattan), Orange, Queens, Rockland, Staten Island, Suffolk and Westchester

HIP Choice Plus Direct Pay Governor’s Bill

Member is required to select a primary care physician for in-network services

Referrals are required for in-network services. Member can self-refer for out-of-network services

100% coverage after copay for most in-network services

In- and out-of-network coverage

Participating providers in the following 10 New York counties: Bronx, Kings (Brooklyn), Nassau, New York (Manhattan), Orange, Queens, Rockland, Staten Island, Suffolk and Westchester

Health Coverage Tax Credit (HCTC) EPO

Complete hospital, medical and prescription drug coverage.

Our CBP network coverage, offering access to many leading doctors, other medical professionals and acute care hospitals in the tristate area and beyond.

No gatekeepers, no referrals required.

Coverage across all of New York State

Out-of-pocket cost for most covered medical services received in-network is a $20 copayment. Higher copayment amounts apply for some services.

Available for purchase by eligible individuals.

This plan is underwritten by Group Health Incorporated (GHI), an EmblemHealth company.

See Eligibility Requirements

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Health Coverage Tax Credit (HCTC) EPO plan – Eligibility Requirements:

To be eligible for enrollment in the HCTC EPO plan, you must be:

• A Trade Impacted Worker receiving Trade Adjustment Assistance (“TAA”) benefits, or
• A Pension Benefit Guaranty Corporation (“PBGC”) recipient

Trade Impacted Workers are individuals certified to receive Trade Adjustment Assistance (“TAA”) or Alternative TAA benefits because they have lost their jobs due to the effects of international trade.

Pension Benefit Guaranty Corporation (PBGC) recipients are individuals receiving PBGC pension benefit payments and who are 55 years of age or older.

HCTC is a federal program that pays 65 percent of certain health insurance premiums and eligible individuals pay the remaining 35 percent. Our HCTC EPO is a qualified health plan under this program. If you are eligible for enrollment in our HCTC EPO plan, you are likely eligible for this tax credit. More detailed information about this tax credit is available at http://www.irs.gov/hctc.

For more information about enrolling in our HCTC EPO plan, call our Sales Department at 1-800-444-2333.