Atlantis Health Plan

Atlantis Health Plan is focused and flexible enough to meet your client's needs. Our goal is to deliver, "Sensible Healthcare at a Sensible price" now and upon renewal.

We are dedicated in helping you better serve your clients by giving you the correct information in a timely manner. Our highly qualified people work with you to keep your current clients satisfied while helping you generate more business.

New York State has recently changed their laws regarding dependent coverage, so this means that your covered dependent child who loses coverage before age 30 because he or she reaches the plan’s limiting age may now be eligible to continue coverage until their 30th birthday.

In order to be eligible for coverage, young adults must meet the following requirements:

Be unmarried;
Be 29 years of age or under;
Not be insured by or eligible for health insurance through his or her own employer;
Live, work or reside in New York State or the health insurance company’s service area;
Not be covered under Medicare; and
Their parent (the subscriber) must maintain coverage with Atlantis through their employer.

Coverage for these dependents will end on the first to occur of the following:

The date the dependent no longer meets the dependent requirements.
Failure to pay premium for the dependent coverage.
Date on which the group or subscriber policy is terminated.

The law has 2 segments: (1) a Make Available Option and (2) a Mandatory Right of Election – Young Adult Option. To learn more about these options and eligibility, please read the applicable notice:

Attention Atlantis Group Brokers!
Please review the following notifications regarding recent changes to Federal and State COBRA.

	Atlantis Health Plan Low Option 25/40/500/NG (HMO)	Empire Blue Cross Blue Shield Prism EPO 1(EPO)	Oxford Metro Liberty Metro 25/50/300/NG (EPO)	Emblem EPO EPO 30/100/500/250 (EPO)

Prescription Drug Card	$0/30/50/Yes/0	10/35/70/Yes/50	10/25/50/Yes/50	0/30/50/0

Office Co-pay	$25 Co-pay	$25 Co-pay	$25 Co-pay	$30 Co-pay/$0 dep child
DXL/Lab Fees	$25 Co-pay	No Charge	No Charge	$30 Co-pay/$0 dep child
Specialist Co-Pay	$40 Co-pay	$40 Co-pay	$50 Co-pay	$30 Co-pay/$0 dep child
Lifetime Maximum	Unlimited	Unlimited	Unlimited	Unlimited

Hospital In-Patient	$500 Co-pay	$500/admission $1,250 max/cal year	$300/day $1,500 max/admission	$500/admission
Emergency Room	$50 Co-pay	$100 Co-pay	$75 Co-pay (waived if admitted)	$100 co-pay (waived if admitted)
Private Nursing	Not covered	Not covered	Not covered	Not covered

Surgical In-Patient	$500 Co-pay	No Charge	$300/day $1,500 max/admission	$500/admission

Mental Nervous In-Patient	$500 Co-pay 30 Days/cal year	$500/admission $1,250 max/cal year 30 days/cal year	$300/day $1,500 max/admission 30 days/cal year	$500/day 30 days/cal year Unlimited bio-based
Substance Abuse In-Patient	$500 Co-pay Detox: 7 days/cal year	$500/admission $1,250 max/cal year Rehab: See riders Detox: 7 days/cal year	$300/day $1,500 max/admission Rehab: 30 days/cal year Detox: 7 days/cal year	$500/day Rehab: 30 days/cal year Detox: 7 days/cal year

Single	$392.19	$534.94	$532.21	$553.66
EE with Spouse	$784.38	$1,069.88	$1,170.86	$1,328.77
EE with Child(ren)	$788.70	$962.89	$984.59	$1,028.04
Family	$1,270.16	$1,604.82	$1,649.85	$1,664.96

Monthly Cost	$3,172.43	$4,172.53	$4,337.51	$4,576.43
Annual Cost	$38,069.16	$50,070.36	$52,050.12	$54,917.16
*Rates are not available to individuals

The rates and benefits in this report are for discussion and estimated purposes only and are not valid without approval from the insurance carrier.