Paul Zane Pilzer

  

  




State-by-State Guide to       

Individual/Family Health Insurance

 
New York Insurance Department
(212) 480-6400
www.ins.state.ny.us
Guaranteed Issue   
Community Rated   

NY



 

Average Cost for an Individual Policy Sold in 2004: $295/month*
(single, average age 40, healthy)
*From 82,000 policies sold nationally online in 2004, see first page of Appendix A.

Typical Healthy Individual/Family Coverage
 

Traditional Co-Pay
Policy*

HSA/High-Deductible
Policy
  Single Family Single Family
Monthly Premium $302 $734 NA NA
Annual Deductible $250 $500 NA NA
Annual Out-of-Pocket Max $10,000 $10,000 NA NA
Doctor Visit Co-Pay Not covered Not covered -- --
Prescription Co-Pay $10 + $50 ded $10 + $50 ded -- --
Lifetime Maximum $1 million $1 million NA NA
*GHI Alliance Value Plan; single applicant (M/35); family applicant (M/35), spouse (F/35), children (F/8, M/5) from Albany, NY 12202; quoted 5.2.05.

State-Guaranteed Coverage for
People with Preexisting Conditions

Representative Policy*
Monthly Premium Annual Deductible Annual OOP Max Doctor Visit Co-Pay Prescription Co-Pay Lifetime Maximum
$302 $250 $10,000 Not covered $10 with $50 ded $1 million

*GHI Alliance Value Plan; Single Applicant (M/35); family applicant (M/35), spouse (F/35), children (F/8, M/5) from Albany, NY 12202; quoted 5.2.05.

New York does not have a state risk pool—every policy sold in New York is effectively a state risk pool policy because all citizens must be accepted (“guaranteed issue”) at the same premium (“community rated”) regardless of their health. Both HIPAA-eligible applicants and applicants who are not HIPAA-eligible are guaranteed a policy at the same community rate.

Excerpted from The New Health Insurance Solution

 
 
  ADDITIONAL RESOURCES FOR THE NEW HEALTH INSURANCE SOLUTION
   



New Health Insurance Solutions for individuals, families, self-employeds, and businesses.

  



View the basic chapter table, expanded topical table, and pdf table of contents.

  



View the html or download a pdf version of the October 2005 press release.

    



Read excerpts on each topic discussed in The New Health Insurance Solution.



Read full reviews of The New Health Insurance Solution by Newsweek, The Wall Street Journal, Forbes, etc.



Read selected portion of reviews by Newsweek, CNN, The Wall Street Journal, Forbes, etc.
   



Read endorsements of The New Health Insurance Solution.

  



View other books written by New York Times best-selling author Paul Zane Pilzer.

  



View contact information including phone numbers and email addresses for book publicist, author, etc.