Pres White represents many of the top group health insurance companies providing group health insurance to small and large businesses in the tri-state area.  Our marketplace is dominated by Health Maintenance Organization (HMO), Point of Service (POS) and Participating Provider Organization (PPO) plan designs. The central theme is using a network of participating doctors to coordinate the plan.  The biggest difference between the three types is the necessity of a primary care provider referral and the inclusion or exclusion of an out of network benefit.

To qualify for group medical insurance –

In New York, New Jersey and Connecticut in order to qualify for group medical insurance you must have a business domiciled in the applicable state with at least two eligible employees, and you have not have been cancelled by another group medical carrier for non payment.  An eligible employee is one who works a minimum required hours per week and at least minimum wage.  In New York, this minimum is 20 hours, in New Jersey it is 25 and in Connecticut it is 30.  Partners and Business owners who receive distributions from the business on a K-1 or 1120 S form are also considered full time eligible employees.  Partners and owners do not have a minimum wage requirement.

Securing a Group Health Insurance Policy -

Once an employer meets the criteria of qualifying for group health insurance, to secure coverage we need:

1. Completed carrier specific applications completed by the group and the enrolling and waiving employees
2. A business check in the amount of the first month’s premium made payable to the carrier
3. Tax documentation showing at least two eligible employees

Pres White represents a number of medical carriers which offer a variety of plan options including:

Health Insurance Carriers

• Aetna
• Cigna
• HIP of New York
• GHI
• Oxford Health Plans
• United Healthcare
• Atlantis
• Guardian

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Self-Insurance

Self-Insurance is an option for larger employers.  In a self-funded plan the employer assumes the risk of providing its employees' health benefits.  This is attractive for employers for a variety of reasons.  Plan designs are more flexible.  Self-funded plans do not have to comply with state mandates.  Premium tax does not have to be paid.  It accommodates multiple locations well.  Stop loss insurance is available to protect the plan.

Through our parent, The Maxon Company, one of the oldest independent Third Party Administrators in New York State, Pres White is able to assist with you with any of your clients self-insurance needs. From plan design and marketing of stop loss, Pres White is able to assist with you with any of your clients self-insurance needs. Pres White is able to provide all of the support necessary to establish and/or administer a self funded plan.   

Maxon's claim office is located in Sullivan County in Neversink , New York .  It is staffed by experienced claim examiners and nurse case managers and administers a variety of different kinds of benefit plans. Please contact us if you would like more information or contact The Maxon Company at 1-800-82-MAXON.

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