Health Insurance for Members in New York
Questions? Health Insurance F.A.Q.s • Email Us • (888) 692-7878
Getting Insured through Fractured Atlas
Getting health insurance should be simple and painless. And it can be!
We've done the homework for you. We've translated insurance lingo and researched for the best options out there. We'll walk you through the process and help you out if you run into trouble.
Don't procrastinate. Get insured.
Step by Step
- Join Fractured Atlas. It's free, quick, and easy.
- Review plan options. We've highlighted some important details.
- Download an application.
- Fill it out.
- Send it in.
- That's it! Rest easy.
Start dates are only available on the 1st of the month. We need to receive your application a few weeks in advance, so don't wait until the last minute!
If you get stuck, don't worry. Personalized guidance is available via phone or email.
Oh and by the way, we serve all types of artists and creative freelancers. Like who? Like the aerial performing artist, musician, theatre techie, sound engineer, graphic designer, blogger, and more.
Join the Revolution
We believe that everyone, including artists and independent creative workers, have the right to:
- Equal access to affordable, quality, health insurance
- Coverage that can be kept from job to job
- Protection from crippling medical debt
The arts community deserves the same economic security other professional industries enjoy. We are committed to reducing the ranks of the uninsured in our community, one person at a time.
Need Serious Help?
No worries. Members who enroll in EmblemHealth plans through Fractured Atlas are automatically enrolled in Health Proponent at no additional charge.
Let's Get Started!
- Check out coverage options for Individuals or small groups.
There are two health insurance plans available from EmblemHealth. Both offer very affordable coverage with high deductibles. The main differences are that the first has a higher deductible and the second comes with a health savings account.
EmblemHealth EPO
How it Works
This plan is extremely affordable but comes with a $10,000 annual deductible. You pay for all your medical expenses up to the annual deductible. Then, EmblemHealth covers 100% of all additional in-network expenses. No catch-22s. No extra copays or hidden out of pocket costs (like coinsurance). Straightforward, pure, and simple insurance when you need it most, at the cheapest rates possible.
The monthly cost is very low, since you'll be assuming responsibility for any healthcare expenses (if there are any) each year up to the deductible.
| Monthly premium | |
|---|---|
| Individual | $197.11 |
| Family | $552.60 |
| * Rates include $10 administrative fee and are guaranteed until August 1, 2011 | |
| Important Deets | |
|---|---|
| Copay | $0 (after deductible) |
| Policy Year In-Network Deductible | $10K individual / $20K family |
| Out of Pocket Maximum | $10K individual / $20K family |
| Calendar Year Max. Benefit | Unlimited |
| In-Network Benefits | |
|---|---|
| Regular Office Visit | You pay $0 after deductible |
| Specialist Visit | You pay $0 after deductible |
| Hospital Admission | You pay $0 after deductible |
| Emergency Room | You pay $0 after deductible |
| Lab/X-Ray | You pay $0 after deductible |
| Prescriptions | You pay $0 after deductible |
| Annual Preventive Benefits (Deductible WAIVED) | |
|---|---|
| Annual Physical | You pay $0, no deductible |
| Annual Gynecological Exam | You pay $0, no deductible |
| Full Summary of Benefits | |
|---|---|
| Download Summary of Benefits |
EmblemHealth EPO w/ Health Savings Account
How it Works
This plan is a lot like the first one, but it has a $5,000 deductible and comes with a health savings account. You pay for all your medical expenses up to the annual deductible. Then, EmblemHealth covers 100% of all additional in-network expenses. No catch-22s. No extra copays or hidden out of pocket costs (like coinsurance). Straightforward, pure, and simple insurance when you need it most, at the cheapest rates possible.
The monthly cost is very low, since you'll be assuming responsibility for any healthcare expenses (if there are any) each year up to the deductible. This is why it's a good idea to use a health savings account (HSA) to set aside savings for these expenses. Many people fund their HSA with the money saved on the monthly premiums on this plan.
| Monthly premium | |
|---|---|
| Individual | $294.62 |
| Family | $835.41 |
| * Rates include $10 administrative fee and are guaranteed until August 1, 2011 | |
| Important Deets | |
|---|---|
| Copay | $0 (after deductible) |
| Policy Year In-Network Deductible | $5K individual / $10K family |
| Out of Pocket Maximum | $5K individual / $10K family |
| Calendar Year Max. Benefit | Unlimited |
| In-Network Benefits | |
|---|---|
| Regular Office Visit | You pay $0 after deductible |
| Specialist Visit | You pay $0 after deductible |
| Hospital Admission | You pay $0 after deductible |
| Emergency Room | You pay $0 after deductible |
| Lab/X-Ray | You pay $0 after deductible |
| Prescriptions | You pay $0 after deductible |
| Annual Preventive Benefits (Deductible WAIVED) | |
|---|---|
| Annual Physical | You pay $0, no deductible |
| Annual Gynecological Exam | You pay $0, no deductible |
| Full Summary of Benefits | |
|---|---|
| Download Summary of Benefits |
About Health Savings Accounts
A Health Savings Accounts (HSA) is a powerful tool for saving towards future healthcare expenses. With this plan, you can set up an HSA with your bank (or financial institution of your choice).
An HSA is a tax sheltered bank account for healthcare expenses. Any contributions you make are tax-deductible up to the annual maximum allowable amount determined by the IRS. In 2009, you may contribute up to $3,000 in your account. With an HSA, you can withdraw money -tax-free- whenever you need to pay for qualified medical expenses. For instance, you can:
- Pay for medical expenses that strictly apply towards your annual deductible.
- Pay for qualified healthcare expenses that insurance doesn't cover, such as non-prescription drugs, contact lenses, dental care, and certain types of alternative medicine.
- Slowly save up to the deductible, and leave it there as a rainy day fund for unexpected healthcare expenses. Unused account fund balances roll over from year to year indefinitely (and can even grow in interest!)
Your health savings account is your money, and you retain full rights to it even if you terminate the health insurance plan or your Fractured Atlas membership.
Under the age of 65, funds withdrawn for non-qualified expenses are subject to income tax and a 10% penalty fee by the IRS. After you reach age 65, accumulated funds can be used for medical expenses not covered by Medicare (or can be used for non-qualified expenses subject to income tax, but without a penalty fee).
Obviously we're not accountants and can't provide tax advice, so please consult your own if you have complex questions. Information on tax benefits is provided solely as a friendly heads up!
Why These Plans?
Access to healthcare and protection from crippling debt are two distinct, important matters. The purpose of insurance is to protect you from large, unexpected medical bills that can lead to financial ruin. But over the years, insurance companies started bundling additional services - like managing payments for routine doctor visits - into their plans. Sounds great, right? The problem is that this results in much higher insurance premiums and bloated profits for the insurance companies.
Here's the deal. The average negotiated fee for a basic doctor's office visit ranges from $65 to $150. Do you really need to be paying $400/month so that you can save $65/year? For most of us, especially if you're basically healthy, the math just doesn't make sense. With tools to save on the routine stuff, wouldn't it be better to pay rock-bottom prices for insurance that protects you from financial ruin? We think so, too.
Fractured Atlas has specialized in low-cost, high deductible health insurance since 2001. The EmblemHealth plans represent our strongest offerings to date.
Find a Doctor or Hospital
- Visit the EmblemHealth Provider Search.
- Ensure that the EPO/PPO tab is highlighted (NOT the HMO/Comprehealth one).
- Choose to search by "Location" or "Name." Click the appropriate tab.
- Enter Zip and Type of "Provider"
You should always access care from EmblemHealth Doctors in combination with EmblemHealth Hospitals / Facilities for maximum coverage.
The Fine Print on Eligibility (in a reasonably large font)
To be eligible you must:
- Be a Fractured Atlas member.
- Live and work as a creative freelancer in NY State.
How do you document this?
- Submit last year's tax return, a 1040 with a Schedule C (no minimum or maximum income requirement)
- or - - Submit a new business certificate and a CPA Attestation Form verifying sole proprietor status, if you are a new freelancer. Download the CPA form here. Contact us for more details.
You Should Know That...
- The annual deductible resets each August 1 (regardless of your start date) when your plan renews. That's because the annual deductible is based upon the policy year of the association. For Fractured Atlas, this lasts from each August to August.
- Monthly coverage rates include a $10 administration fee and are guaranteed until August 1, 2011. On that date, your plan renews and is subject to new rates (as set by the insurance company and state insurance laws).
Questions? Contact us.
Ready to Enroll?
Download an enrollment packet and send it in. Complete applications are due no later than the 10th of each month.
New York State arts organizations with 2-50 regular employees are eligible for small group health insurance through Fractured Atlas.
There are two health insurance plans available from EmblemHealth. Both offer very affordable coverage with high deductibles. The main differences are that the first has a higher deductible and the second comes with a health savings account.
EmblemHealth EPO
How it Works
This plan is extremely affordable but comes with a $10,000 annual deductible. You pay for all your medical expenses up to the annual deductible. Then, EmblemHealth covers 100% of all additional in-network expenses. No catch-22s. No extra copays or hidden out of pocket costs (like coinsurance). Straightforward, pure, and simple insurance when you need it most, at the cheapest rates possible.
The monthly cost is very low, since you'll be assuming responsibility for any healthcare expenses (if there are any) each year up to the deductible.
| Monthly premium | |
|---|---|
| Employee | $172.72 |
| + Family | $481.89 |
| * Rates include $10 administrative fee and are guaranteed until August 1, 2011 | |
| Important Deets | |
|---|---|
| Copay | $0 (after deductible) |
| Policy Year In-Network Deductible | $10K individual / $20K family |
| Out of Pocket Maximum | $10K individual / $20K family |
| Calendar Year Max. Benefit | Unlimited |
| In-Network Benefits | |
|---|---|
| Regular Office Visit | You pay $0 after deductible |
| Specialist Visit | You pay $0 after deductible |
| Hospital Admission | You pay $0 after deductible |
| Emergency Room | You pay $0 after deductible |
| Lab/X-Ray | You pay $0 after deductible |
| Prescriptions | You pay $0 after deductible |
| Annual Preventive Benefits (Deductible WAIVED) | |
|---|---|
| Annual Physical | You pay $0, no deductible |
| Annual Gynecological Exam | You pay $0, no deductible |
| Full Summary of Benefits | |
|---|---|
| Download Summary of Benefits |
EmblemHealth EPO w/ Health Savings Account
How it Works
This plan is a lot like the first one, but it has a $5,000 deductible and comes with a health savings account. You pay for all your medical expenses up to the annual deductible. Then, EmblemHealth covers 100% of all additional in-network expenses. No catch-22s. No extra copays or hidden out of pocket costs (like coinsurance). Straightforward, pure, and simple insurance when you need it most, at the cheapest rates possible.
The monthly cost is very low, since you'll be assuming responsibility for any healthcare expenses (if there are any) each year up to the deductible. This is why it's a good idea to use a health savings account (HSA) to set aside savings for these expenses. Many people fund their HSA with the money saved on the monthly premiums on this plan.
| Monthly premium | |
|---|---|
| Employee | $257.55 |
| + Family | $727.88 |
| * Rates include $10 administrative fee and are guaranteed until August 1, 2011 | |
| Important Deets | |
|---|---|
| Copay | $0 (after deductible) |
| Policy Year In-Network Deductible | $5K individual / $10K family |
| Out of Pocket Maximum | $5K individual / $10K family |
| Calendar Year Max. Benefit | Unlimited |
| In-Network Benefits | |
|---|---|
| Regular Office Visit | You pay $0 after deductible |
| Specialist Visit | You pay $0 after deductible |
| Hospital Admission | You pay $0 after deductible |
| Emergency Room | You pay $0 after deductible |
| Lab/X-Ray | You pay $0 after deductible |
| Prescriptions | You pay $0 after deductible |
| Annual Preventive Benefits (Deductible WAIVED) | |
|---|---|
| Annual Physical | You pay $0, no deductible |
| Annual Gynecological Exam | You pay $0, no deductible |
| Full Summary of Benefits | |
|---|---|
| Download Summary of Benefits |
About Health Savings Accounts
A Health Savings Accounts (HSA) is a powerful tool for saving towards future healthcare expenses. With this plan, you can set up an HSA with your bank (or financial institution of your choice).
An HSA is a tax sheltered bank account for healthcare expenses. Any contributions you make are tax-deductible up to the annual maximum allowable amount determined by the IRS. In 2009, you may contribute up to $3,000 in your account. With an HSA, you can withdraw money -tax-free- whenever you need to pay for qualified medical expenses. For instance, you can:
- Pay for medical expenses that strictly apply towards your annual deductible.
- Pay for qualified healthcare expenses that insurance doesn't cover, such as non-prescription drugs, contact lenses, dental care, and certain types of alternative medicine.
- Slowly save up to the deductible, and leave it there as a rainy day fund for unexpected healthcare expenses. Unused account fund balances roll over from year to year indefinitely (and can even grow in interest!)
Your health savings account is your money, and you retain full rights to it even if you terminate the health insurance plan or your Fractured Atlas membership.
Under the age of 65, funds withdrawn for non-qualified expenses are subject to income tax and a 10% penalty fee by the IRS. After you reach age 65, accumulated funds can be used for medical expenses not covered by Medicare (or can be used for non-qualified expenses subject to income tax, but without a penalty fee).
Obviously we're not accountants and can't provide tax advice, so please consult your own if you have complex questions. Information on tax benefits is provided solely as a friendly heads up!
Why These Plans?
Access to healthcare and protection from crippling debt are two distinct, important matters. The purpose of insurance is to protect you from large, unexpected medical bills that can lead to financial ruin. But over the years, insurance companies started bundling additional services - like managing payments for routine doctor visits - into their plans. Sounds great, right? The problem is that this results in much higher insurance premiums and bloated profits for the insurance companies.
Here's the deal. The average negotiated fee for a basic doctor's office visit ranges from $65 to $150. Do you really need to be paying $400/month so that you can save $65/year? For most of us, especially if you're basically healthy, the math just doesn't make sense. With tools to save on the routine stuff, wouldn't it be better to pay rock-bottom prices for insurance that protects you from financial ruin? We think so, too.
Fractured Atlas has specialized in low-cost, high deductible health insurance since 2001. The EmblemHealth plans represent our strongest offerings to date.
Find a Doctor or Hospital
- Visit the EmblemHealth Provider Search.
- Ensure that the EPO/PPO tab is highlighted (NOT the HMO/Comprehealth one).
- Choose to search by "Location" or "Name." Click the appropriate tab.
- Enter Zip and Type of "Provider"
You should always access care from EmblemHealth Doctors in combination with EmblemHealth Hospitals / Facilities for maximum coverage.
The Fine Print on Eligibility (in a reasonably large font)
To be eligible you must:
- Be a Fractured Atlas member.
- Have employees in NY State.
How do you document this?
- Submit a copy of your NYS-45
- Provide W-4 plus pay stub for new employees
You Should Know That...
- The annual deductible resets each August 1 (regardless of your start date) when your plan renews. That's because the annual deductible is based upon the policy year of the association. For Fractured Atlas, this lasts from each August to August.
- Monthly coverage rates include a $10 administration fee and are guaranteed until August 1, 2011. On that date, your plan renews and is subject to new rates (as set by the insurance company and state insurance laws).
Questions? Contact us.
Ready to Enroll?
Download a small group enrollment packet and send it in. Complete applications are due no later than the 10th of each month.
Dealing with health insurance companies and health care providers can be a gigantic pain. At Fractured Atlas we know this all too well. That's why we include Health Proponent as a free value-added service when you enroll in any qualifying health insurance plan through Fractured Atlas.
Health Proponent is an advocacy and assistance company (not affiliated with any insurance company) that provides critical patient advocacy support regardless of insurance status. Whether you're insured or not, you and your family can benefit from Health Proponent's services.
Advocacy Services
- Healthcare Coaching: Helping prepare for visits with physicians and understand serious or chronic conditions, provide information about medical terms, tests, and prescriptions.
- Physician Locator: Locate specialists, make appointments, locate mental health services, coordinating and making arrangements for diagnostic tests, find long-term care, assist with eldercare services.
- Information and Service Support: Sort through doctor's explanations, research treatment options, including alternative care, transfer records, and locate community resources.
- Claims and Billing Assistance: Untangle billing claims, negotiate provider charges, decode billing items, research out of pocket responsibilities, resolving errors in the application of deductibles and copays.
- Appeals Advice: Get to the bottom of coverage denials and advise about appeals rights.
- Senior Care Navigator: Assist with the transition of insurance coverage and benefits from private insurance to Medicare; coordinate coverage for home healthcare, locating alternative care facilities and home health aides.
Eligibility and Enrollment
Health Proponent is included as a free value-added service with your enrollment in certain health insurance plans through Fractured Atlas (see plan info for details). If you're not enrolled in a qualifying health insurance plan, you can still enroll directly in Health Proponent.
How does it work?
Whenever you have a health care or insurance-related issue, you can call Health Proponent at their toll-free number.
A Personal Health Proponent (PHP), typically a registered nurse supported by medical directors and insurance experts, will be assigned to work with you (and makes the necessary calls) until your issue is resolved, (whether it takes a couple of hours or ten days).
Your medical and personal information is fully protected and held confidential. You will be asked to sign an authorization form permitting Health Proponent to work on your behalf to help resolve your issue.
You and your family can call as often as you'd like 24/7. While normal business hours are Monday-Friday, 8am - 9pm Eastern Time, on call staff is always available during after hours and weekends for assistance during non-business hours.
About Health Proponent
The Health Proponent Program is not affiliated with any insurance or third party provider. Health Proponent is NOT health insurance coverage and is NOT a replacement for health insurance coverage. Health Proponent's business practices are in full compliance with applicable privacy requirements under the Health Insurance Portability and Accountability Act.
Health Proponent is a division of Health Advocate Inc., the nation's leading health care advocacy and assistance company founded in 2001.
Download a Health Proponent brochure with more information.
Share Your Experience
Did Health Proponent help you? Would you like to share your story with us and be featured as a case study? We want to hear about it from real artists at support@fracturedatlas.org!
How About a Little Plain English?
Confused by all the lingo? Don't sweat it! Here are the most important terms you need to understand:
- Claim
- Coinsurance
- Copay
- Deductible
- Formulary
- Health Savings Account (HSA)
- In-Network
- Lifetime Maximum
- Out of Pocket Maximum
- Out-of-Network
- Pre-existing Condition
- Pre-negotiated Reduced Rate (Network Rate)
- Premium
- Primary Care Physician (PCP)
- Provider
- Specialist
- Summary of Benefits
- Urgent Care Facility
Fractured Atlas is a non-profit artist service organization, not an insurance company. We try to provide our members with access to affordable, appropriate health insurance options. You are a grown-up and you are responsible for your own decisions regarding your own health insurance! We can't guarantee the availability, suitability, or sufficiency of any plan for any member. Seriously, we can't.
The benefit descriptions on this website are an attempt to summarize what we've been told by the insurance companies. If you enroll, your benefits will be determined by your actual agreement(s) with those companies.
(There, now the lawyers are happy.)
