Marketplace SHOP Plans 2018

MetroPlus Health Plan offers four Small Business (SHOP) health plans through the NY State of Health, The Official Health Plan Marketplace. These plans  - the only SHOP plans offered on the NY State of Health Marketplace for NYC in 2018 - are available to businesses with 100 or fewer employees. Some businesses with 25 or fewer employees may qualify for a federal tax credit of as much as 50% of employer's contribution. 
 

Learn if you qualify

Our cost treatment calculator is intended for individuals who are uninsured or covered by private insurance. Cost estimates reflect health care professional fees and are not the negotiated rates which may be available through insurance plan networks. 

Calculate Costs 

 

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Small Business (SHOP)*
Product  BronzePlus B4 SilverPlus S4 GoldPlus G4 PlatinumPlus P4
Product Type Small Business (SHOP) Small Business (SHOP) Small Business (SHOP) Small Business (SHOP)
Premium $453.53 $516.33 $604.00 $708.43
Deductible $4,000 $2,000 $600 $0
Max out of Pocket $7,150 $6,750 $4,000 $2,000
PCP 50% $30 $25 $15
Specialist 50% $50 $40 $35
Prescription Drug** $10/$35/$70 $10/$35/$70 $10/$35/$70 $10/$30/$60
Adult Dental/Vision No No No No
Pediatric Dental / Vision Yes Yes Yes Yes
Mail Order RX Yes Yes Yes Yes
Exercise Facility Reimbursement Yes Yes Yes Yes

* This chart is a brief description of benefits for plan. 
** Prescription Drug: Generic / Formulary Brand / Non-Formulary Brand
 Deductible must be met first before cost sharing begins. Family cost is multiplied by (2).

Premiums listed are example base rates for individuals. Rates may differ based according to family size, income level, and eligibility for tax credits.

 

Tax Credits

Small Businesses can qualify for tax credits of up to 50% of the employer cost of premiums.

To be eligible, your business must:
  • Have fewer than 25 full-time equivalent employees (FTEs), who have average wages of $50,000 or less per year.
  • Pay at least 50 % of the cost of single (not family) health care coverage for each of your employees.
  • Purchase insurance through the Small Business Marketplace to be eligible for the credit for tax years 2018 and beyond. If your business did not owe tax during the year, the credit can be carried forward or applied back to other tax years.

If your business is tax-exempt, the credit is refundable. You may be eligible to receive the credit as a refund, if it does not exceed your income tax withholding and Medicare tax liability.

 

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Certificate of Coverage
Small Business (SHOP) English Español
BronzePlus B4 Download Download
SilverPlus S4 Download  Download
GoldPlus G4 Download Download
PlatinumPlus P4 Download Download
 

To learn more about the drugs covered by our Marketplace SHOP Plans, please visit the MetroPlus Formulary Page 

To search our provider network for our Marketplace SHOP Plans, please visit the MetroPlus Provider Directory Page.


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Additional Member Resources
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Marketplace Small Business (SHOP)
Young Adult Rider
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