Walczak Associates
Group Medical Insurance

Having to contend with the changing world of medical insurance is a most challenging task. For business owners, human resource professionals and employees alike, confusions about plan designs, benefits, doctor networks and referral requirements can be overwhelming. Choosing a plan and shopping the market is an annual event as insurance rates generally go up every year at renewal. Walczak Associates, Inc. has been successful in helping businesses in New York's 5 boroughs, Long Island, New York's northern counties (Westchester, Rockland and Orange) and New Jersey with their medical insurance needs.

How does the number of employees of a company affect medical insurance rates?
  • 2 - 50 employees: In New York, employer-sponsored plans are available for companies with 2 or more employees. All medical insurance plans available to employers with 2-50 employees are community rated. As such, age and gender of the employer's company does not specifically enter into the cost of the plan. In New Jersey, all companies with 2 or more employees require a census.

  • Over 50 employees: In New York and New Jersey, most insurance carrier rates are determined by an employee census. Census information along with the employer's SIC code (type of business) is reviewed by an insurance underwriter. Proposals from underwriting can vary quite extensively. For example, if your company has mostly young employees, it will receive a lower rate than a company with an older staff.
What types of plan designs and benefits are available?

Plan Designs
HMO Health Maintenance Organization
HMO Direct HMO Non-gatekeeper
POS Point of Service
POS Open Access POS Non-gatekeeper
EPO Exclusive Provider Organization
PPO Preferred Provider Organization


Benefits
Co-pay
Rx (Prescriptions)
Hospital costs
Co-insurance
Deductible
Out-of-pocket costs
UCR (usual, customary, reasonable)


Walczak Associates, Inc. represents all available state approved medical insurance carriers. We're happy to help you determine your wants and needs, review doctor networks, shop the market, conduct enrollment meetings, partake in employee education and provide ongoing support. Upon renewal of the policy, we help you determine the best options available for the following year.


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