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New Year, New Mandates

The beginning of a new year also means state mandated changes to some of our plans.

  • The Healthy NY wage level for small employers is now in line with federal poverty guidelines. Read more about the increase and eligibility criteria.
  • NYS now requires insurers to cover the diagnosis and treatment of infertility, including the coverage of prescription drugs. Learn more about what’s covered.

 

Updated Small Employer Wage Level  
Effective immediately, the Healthy NY wage level for small employers is being updated to be commensurate with increases in the federal poverty guidelines. The wage level for small employer eligibility criteria is being increased to $44,075.  

This means that at least 30% of the small employer’s eligible employees must earn $44,075 or less in annual wages. Also, small employers must offer Healthy NY to all employees who work 20 or more hours per week and earn $44,075 or less in annual wages. In addition, at least one employee who earns $44,075 or less annually must enroll in Healthy NY.

We will no longer be accepting the old forms after February 1, 2020.  Please begin using the following revised forms immediately.

Learn more about Healthy NY

 

Reminder Regarding IVF and Fertility Preservation Mandate
Beginning January 1, 2020, NYS requires insurers to cover the diagnosis and treatment of infertility, including the coverage of prescription drugs.

In-Vitro Fertilization - this can be surgical benefit 

  • Large groups only- up to three (3) cycles of IVF
  • Note: Applies to group policies that have been issued, renewed, or modified on or after January 1, 2020 

Fertility Preservation - this can be a lab benefit

  • Provides coverage for standard fertility preservation services when a medical treatment will directly or indirectly lead to iatrogenic infertility. Applies to both male and females.

 

 
 
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