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Excellus was formed by Central New York ,Rochester & Utica-Watertown  Blue Cross/Shield as a holding company for the three firms.  Excellus also purchased  Support Service Alliance (SSA) in the Spring of 2002.  In many areas Blue Cross and Blue Shield are separate corporations with one forming an alliance with the medical practitioners and the other with hospitals in the area.  In many areas they have joined forces as a way to save costs in the marketing of their contracts.

These two New York Blue Cross Blue Shield organizations have formed an alliance under the holding company named Excellus

Support Service Alliance originally was formed as a "non-profit" program, primarily for dairy farmers in New York State. It was funded by the Rockefeller foundation, with a gentleman by the name of Herbert Heaton it's main champion and proponent.  It caught on so well and so quickly that it soon became profitable and Mr. Heaton retired from the foundation and took the organization under his wing, guided it, and was one of the founders who helped with it's profitable formation.  It now has better than 15,000 different businesses with over 35,000 subscribers.  It is run very efficiently and continues to be one of the lowest cost health programs in New York State.  It was doing so well, that it was recently purchased by the Excellus holding company and now forms a part of the Central New York insurer.

Any legitimate business, with gross revenues of over $25,000 annually and the ability to prove when enrollment takes place by providing documents to that effect may have group health insurance.  This includes one life business groups.

SSA as it is known, bills it's subscribers, however: Blue Cross Blue Shield of Central New York allows "Third Party Administrators" (TPA's) to administer Association & Union plans. In this capacity the TPA provides information about the plans (there are over 20 different plans, as well as dental coverage's available). You are billed and will pay directly to SSA, Also: we as the TPA will enroll, terminate and assist with claims problems which are common when dealing with a large corporate entity such as Blue Cross Blue Shield.

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Blue Cross Blue Shield payments are made to the TPA who is responsible for administration and service to you the customer regarding payments and claim service.

A Co-Pay is a modest payment made at the time of service rendered either at the Doctor's office of Hospital.  The first dollar co-payment keeps costs down and stops frivolous visits to medical facilities.

Deductibles unlike Co-Pay's are usually more substantial in the area of cost from $100 annually to $2500.  The higher the deductible the less expensive the health plan is.

CNY Health Associates offers an automatic check plan.  Because it is automatic it affords you the subscriber a better cost.

Depending upon your frequency of payment (Mode) the savings can be up $70 annually.  If your payment is monthly the savings are well over $20 per year.

As stated above we have quarterly, semi-annual and annual premiums with greater savings for the "Annual" payment plan.

Maximum Lifetime Benefit is the total amount of benefits you can receive from your insurer in your lifetime.

Stop Loss refers to that dollar amount in an "indemnity" type plan after the deductible has been paid and the co-insurance maximum has been met when the insurer starts to pay 100% of the usual and customary charges.

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Co-insurance is reflected by a percentage that is paid by the insured after the deductible has been met.  Again, the co-insurance helps keep costs down for the health coverage.  Usually it is capped at a dollar amount.  An example would be the $100 deductible in the traditional point of service BCBS contract which when paid in full then starts a 80% - 20% co-insurance for the next $2000 of medical expense ($400) Insured would pay 20% and the insurer would pay 80%.  After both the deductible and the co-insurance amounts have been satisfied, you are considered to have met your "Stop Loss" amount.  You no longer have to pay additional funds as long as your services are being provided by a participating BCBS doctor or hospital.  In the case of a terrible illness or accident the maximum you would pay is $500 which is the $100 deductible and $400 for the percentage of co-insurance.  Again this is providing you are receiving your medical services from a BCBS participating physician or hospital.  Well over 90% of all medical professionals are participants.

Approval can take a few days.  But time is needed for applications to be filled in correctly, signed and mailed to the insurer.  Then because these applications when received must be input into the databank with the insurer (This part takes the longest) it will be approximately two weeks before your name and Social Security number are in the insurer's system and you are recognized as being enrolled and paid.  ID cards take from 4--6 weeks to arrive at your home address.

Receiving your ID cards will take from 4--6 weeks, due to the length of time for the physical card to be produced.

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For replacement ID cards, simply call our office or go online to www.bcbscny.org and follow instructions or call the insurer's customer service department (800-633-6066), get the name of who you are talking with and note the date and name and request a replacement set of ID cards.

A "Single" individual can qualify for group insurance with the proper insurer and if he or she fulfills the requirements.  Prices are higher for individuals so many firms will try to use a spouse of another employee in order to qualify for the lower cost two or more employee costs.

As stated above one single employee may qualify, however the cost is slightly higher.

Yes, we do have dental coverage.  It is provided by insurer's in varying plans which depend on how many employees your company has. CNY Health Associates can also design a self insured dental plan for your firm with savings of up to 40% lower than the insured plans.

CNY Health Associates represents 5 top quality Medigap insurers here in the CNY area.  Call us or write to us at "questions@cnyhealth.net".

Converage starts on the First of the month following enrollment.  For SSA subscribers paperwork must be in by the 10th of the previous month in order for coverage to start on the First of the following month.

PPO stands for "Preferred Provider Organization" and is a generic term for a group of physicians and/or hospitals who have negotiated prices with the insurer.  These plans will offer co-pay's and individually designed plans in order to keep costs lower.  (High deductibles with or without prescription coverage).

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HMO stands for "Health Maintenance Organization" and reflects the concept that if you will check with your medical professional twice a year for a check up, in most cases you will be able to identify potential health problems and costs will be lowered by catching the problem earlier in it's development.

Point of service refers generically to the traditional type of health plan where you incur a medical expense either with a doctor, hospital or miscellaneous expense such as prescription drugs, prosthetic device, ambulatory care etc.  They usually involve a deductible and co-insurance with a stop loss level and maximum.  One big feature is that you are free to choose your physician, which is usually limited in the PPO or HMO type plans.

We do have "catastrophic" types of plans featuring deductibles as high as $2500.  These plans are much lower in cost.  Also available is the NEW MSA savings plans which features premium savings of over 40%.  And, allowes you to use any funds not spent on medical costs, but deposited into the MSA account for your retirement.

HIGH Deductible plans are mentioned above.

We do offer VISION plans either "stand alone" or for lower costs  those which are included with health coverage.

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State "Mandates" and Prescription Drug costs are driving forces which recently have  increased  health care costs dramatically. Contact our office for details and examples. On the main page if you double click on that portion of the website titled "Hot news" you will get a more in depth discussion of this problem.  "Mandates" as well as increased prescription drug costs are the main problem. New York State insists that we live longer because we have "maintenance" drugs.  They DO cost money.  Also, a stay in the hospital for a week or two can run anywhere from $10,000 to $40,000 and when coupled with surgical expenses and miscellaneous expense it doesn't take long to total up a medical bill well in excess of $25,000--$60,000.  How many months of health insurance premium does that amount to?

You can reduce your costs by going with higher deductibles.  If you self insure the $1000 deductible plan you can come out reducing your costs by a whopping 20% - 25%.

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