BackPro EPO and Pro Plus EPO Plans
Healthfirst offers comprehensive health insurance plans for New York small businesses (1–100 employees), available in various levels (Platinum, Gold, Silver, and Bronze) to fit your employees’ needs. Whether they’re full-time, part-time, or both, we'll make sure they’re enrolled in a health plan that’s right for them. Call us to get a quote today.
Plan Highlights:
- No-cost annual checkups
- Hospital stays, emergency room, urgent care, and retail health clinic visits
- Lab tests (blood tests and X-rays)
- Hearing, vision, and dental*
- Maternity and newborn care
- Prescription drug coverage
- 24/7 access to care with telemedicine (Teladoc)
- Unlimited acupuncture visits
- HSA-compatible plans
- Annual gym membership reimbursement**
- 2021
- 2020
Plans
Tier
Platinum Pro
Platinum Pro Plus
Summary of Benefits and Coverage (PDF)
Premium
Eligible Service Areas
Within New York City's five boroughs (the Bronx, Brooklyn, Manhattan, Queens, and Staten Island), and Long Island
Other Eligibility Requirements
Small business with 1–100 employees
Dental Cleanings
Pediatric – $20 copay
Adult – not covered
Pediatric – $20 copay
Adult - $20 copay
Vision Exams
Pediatric – $10 copay
Adult – not covered
Pediatric – $10 copay
Adult - $10 copay
Telemedicine (Teladoc)
$0 copay
$0 copay
More Plan Information
Tier
Gold Pro
Gold Pro Plus
Summary of Benefits and Coverage (PDF)
Premium
Eligible Service Areas
Within New York City's five boroughs (the Bronx, Brooklyn, Manhattan, Queens, and Staten Island), and Long Island
Other Eligibility Requirements
Small business with 1–100 employees
Dental Cleanings
Pediatric – $25 copay
Adult – not covered
Pediatric – $25 copay
Adult – $25 copay
Vision Exams
Pediatric – $10 copay
Adult – not covered
Pediatric – $10 copay
Adult – $10 copay
Telemedicine (Teladoc)
$0 copay
$0 copay
More Plan Information
Tier
Gold 25/50/0 Pro
Gold 25/50/0 Pro Plus
Summary of Benefits and Coverage (PDF)
Premium
Eligible Service Areas
Within New York City's five boroughs (the Bronx, Brooklyn, Manhattan, Queens, and Staten Island), and Long Island
Other Eligibility Requirements
Small business with 1–100 employees
Dental Cleanings
Pediatric – $25 copay
Adult – not covered
Pediatric – $25 copay
Adult – $25 copay
Vision Exams
Pediatric – $10 copay
Adult – not covered
Pediatric – $10 copay
Adult – $10 copay
Telemedicine (Teladoc)
$0 copay
$0 copay
More Plan Information
Tier
Silver Pro
Silver Pro Plus
Summary of Benefits and Coverage (PDF)
Premium
Eligible Service Areas
Within New York City's five boroughs (the Bronx, Brooklyn, Manhattan, Queens, and Staten Island), and Long Island
Other Eligibility Requirements
Small business with 1–100 employees
Dental Cleanings
Pediatric – $35 copay
Adult – not covered
Pediatric – $35 copay
Adult – $35 copay
Vision Exams
Pediatric – $10 copay
Adult – not covered
Pediatric – $10 copay
Adult – $10 copay
Telemedicine (Teladoc)
$0 copay
$0 copay
More Plan Information
Tier
Silver 40/75/4700 Pro
Silver 40/75/4700 Pro Plus
Summary of Benefits and Coverage (PDF)
Premium
Eligible Service Areas
Within New York City's five boroughs (the Bronx, Brooklyn, Manhattan, Queens, and Staten Island), and Long Island
Other Eligibility Requirements
Small business with 1–100 employees
Dental Cleanings
Pediatric – $40 copay
Adult – not covered
Pediatric – $40 copay
Adult – $40 copay
Vision Exams
Pediatric – $10 copay
Adult – not covered
Pediatric – $10 copay
Adult – $10 copay
Telemedicine (Teladoc)
$0 copay
$0 copay
More Plan Information
Tier
Bronze Pro
Bronze Pro Plus
Summary of Benefits and Coverage (PDF)
Premium
Eligible Service Areas
Within New York City's five boroughs (the Bronx, Brooklyn, Manhattan, Queens, and Staten Island), and Long Island
Other Eligibility Requirements
Small business with 1–100 employees
Dental Cleanings
Pediatric – 50% coinsurance after deductible
Adult – not covered
Pediatric – 50% coinsurance after deductible
Adult – 50% coinsurance after deductible
Vision Exams
Pediatric – $10 copay after deductible
Adult – not covered
Pediatric – $10 copay after deductible
Adult – $10 copay after deductible
Telemedicine (Teladoc)
$0 copy after deductible
$0 copy after deductible
More Plan Information
Tier
Bronze 6850 Pro
Bronze 6850 Pro Plus
Summary of Benefits and Coverage (PDF)
Premium
Eligible Service Areas
Within New York City's five boroughs (the Bronx, Brooklyn, Manhattan, Queens, and Staten Island), and Long Island
Other Eligibility Requirements
Small business with 1-100 employees
Dental Cleanings
Pediatric – 0% coinsurance after deductible
Adult – not covered
Pediatric – 0% coinsurance after deductible
Adult – 0% coinsurance after deductible
Vision Exams
Pediatric – 0% coinsurance after deductible
Adult – not covered
Pediatric – 0% coinsurance after deductible
Adult – 0% coinsurance after deductible
Telemedicine (Teladoc)
$0 copy after deductible
$0 copy after deductible
More Plan Information
Tier
Bronze 8150 Pro
Premium
Eligible Service Areas
Within New York City's five boroughs (the Bronx, Brooklyn, Manhattan, Queens, and Staten Island) and Long Island.
Other Eligibility Requirements
Small business with 1-100 employees
Dental Cleanings
Pediatric – 0% coinsurance after deductible
Adult – not covered
Vision Exams
Pediatric – 0% coinsurance after deductible
Adult – not covered
Telemedicine (Teladoc)
0% coinsurance after deductible
More Plan Information
Tier
Platinum Pro
Platinum Pro Plus
Summary of Benefits and Coverage (PDF)
Comprehensive Formulary
Comprehensive Formulary (List of Covered Drugs)
Premium
Other Eligibility Requirements
Small business with 1–100 employees
Dental Cleanings
Pediatric – $20 copay
Adult – not covered
Pediatric – $20 copay
Adult - $20 copay
Vision Exams
Pediatric – $10 copay
Adult – not covered
Pediatric – $10 copay
Adult - $10 copay
Telemedicine (Teladoc)
$0 copay
$0 copay
More Plan Information
Tier
Platinum Pro
Platinum Pro Plus
Summary of Benefits and Coverage (PDF)
Comprehensive Formulary
Comprehensive Formulary (List of Covered Drugs)
Premium
Other Eligibility Requirements
Small business with 1–100 employees
Dental Cleanings
Pediatric – $20 copay
Adult – not covered
Pediatric – $20 copay
Adult - $20 copay
Vision Exams
Pediatric – $10 copay
Adult – not covered
Pediatric – $10 copay
Adult - $10 copay
Telemedicine (Teladoc)
$0 copay
$0 copay
More Plan Information
Tier
Gold Pro
Gold Pro Plus
Summary of Benefits and Coverage (PDF)
Comprehensive Formulary
Comprehensive Formulary (List of Covered Drugs)
Premium
Other Eligibility Requirements
Small business with 1–100 employees
Dental Cleanings
Pediatric – $25 copay
Adult – not covered
Pediatric – $25 copay
Adult – $25 copay
Vision Exams
Pediatric – $10 copay
Adult – not covered
Pediatric – $10 copay
Adult – $10 copay
Telemedicine (Teladoc)
$0 copay
$0 copay
More Plan Information
Tier
Gold Pro
Gold Pro Plus
Summary of Benefits and Coverage (PDF)
Comprehensive Formulary
Comprehensive Formulary (List of Covered Drugs)
Premium
Other Eligibility Requirements
Small business with 1–100 employees
Dental Cleanings
Pediatric – $25 copay
Adult – not covered
Pediatric – $25 copay
Adult – $25 copay
Vision Exams
Pediatric – $10 copay
Adult – not covered
Pediatric – $10 copay
Adult – $10 copay
Telemedicine (Teladoc)
$0 copay
$0 copay
More Plan Information
Tier
Gold 25/50/0 Pro
Gold 25/50/0 Pro Plus
Summary of Benefits and Coverage (PDF)
Comprehensive Formulary
Comprehensive Formulary (List of Covered Drugs)
Premium
Other Eligibility Requirements
Small business with 1–100 employees
Dental Cleanings
Pediatric – $25 copay
Adult – not covered
Pediatric – $25 copay
Adult – $25 copay
Vision Exams
Pediatric – $10 copay
Adult – not covered
Pediatric – $10 copay
Adult – $10 copay
Telemedicine (Teladoc)
$0 copay
$0 copay
More Plan Information
Tier
Gold 25/50/0 Pro
Gold 25/50/0 Pro Plus
Summary of Benefits and Coverage (PDF)
Comprehensive Formulary
Comprehensive Formulary (List of Covered Drugs)
Premium
Other Eligibility Requirements
Small business with 1–100 employees
Dental Cleanings
Pediatric – $25 copay
Adult – not covered
Pediatric – $25 copay
Adult – $25 copay
Vision Exams
Pediatric – $10 copay
Adult – not covered
Pediatric – $10 copay
Adult – $10 copay
Telemedicine (Teladoc)
$0 copay
$0 copay
More Plan Information
Tier
Silver Pro
Silver Pro Plus
Summary of Benefits and Coverage (PDF)
Comprehensive Formulary
Comprehensive Formulary (List of Covered Drugs)
Premium
Other Eligibility Requirements
Small business with 1–100 employees
Dental Cleanings
Pediatric – $35 copay
Adult – not covered
Pediatric – $35 copay
Adult – $35 copay
Vision Exams
Pediatric – $10 copay
Adult – not covered
Pediatric – $10 copay
Adult – $10 copay
Telemedicine (Teladoc)
$0 copay
$0 copay
More Plan Information
Tier
Silver Pro
Silver Pro Plus
Summary of Benefits and Coverage (PDF)
Comprehensive Formulary
Comprehensive Formulary (List of Covered Drugs)
Premium
Other Eligibility Requirements
Small business with 1–100 employees
Dental Cleanings
Pediatric – $35 copay
Adult – not covered
Pediatric – $35 copay
Adult – $35 copay
Vision Exams
Pediatric – $10 copay
Adult – not covered
Pediatric – $10 copay
Adult – $10 copay
Telemedicine (Teladoc)
$0 copay
$0 copay
More Plan Information
Tier
Silver 40/75/4700 Pro
Silver 40/75/4700 Pro Plus
Summary of Benefits and Coverage (PDF)
Comprehensive Formulary
Comprehensive Formulary (List of Covered Drugs)
Premium
Other Eligibility Requirements
Small business with 1–100 employees
Dental Cleanings
Pediatric – $40 copay
Adult – not covered
Pediatric – $40 copay
Adult – $40 copay
Vision Exams
Pediatric – $10 copay
Adult – not covered
Pediatric – $10 copay
Adult – $10 copay
Telemedicine (Teladoc)
$0 copay
$0 copay
More Plan Information
Tier
Silver 40/75/4700 Pro
Silver 40/75/4700 Pro Plus
Summary of Benefits and Coverage (PDF)
Comprehensive Formulary
Comprehensive Formulary (List of Covered Drugs)
Premium
Other Eligibility Requirements
Small business with 1–100 employees
Dental Cleanings
Pediatric – $40 copay
Adult – not covered
Pediatric – $40 copay
Adult – $40 copay
Vision Exams
Pediatric – $10 copay
Adult – not covered
Pediatric – $10 copay
Adult – $10 copay
Telemedicine (Teladoc)
$0 copay
$0 copay
More Plan Information
Tier
Bronze Pro
Bronze Pro Plus
Summary of Benefits and Coverage (PDF)
Comprehensive Formulary
Comprehensive Formulary (List of Covered Drugs)
Premium
Other Eligibility Requirements
Small business with 1–100 employees
Dental Cleanings
Pediatric – 20% coinsurance after deductible
Adult – not covered
Pediatric – 20% coinsurance after deductible
Adult – 20% coinsurance after deductible
Vision Exams
Pediatric – $10 copay after deductible
Adult – not covered
Pediatric – $10 copay after deductible
Adult – $10 copay after deductible
Telemedicine (Teladoc)
$0 copy after deductible
$0 copy after deductible
More Plan Information
Tier
Bronze Pro
Bronze Pro Plus
Summary of Benefits and Coverage (PDF)
Comprehensive Formulary
Comprehensive Formulary (List of Covered Drugs)
Premium
Other Eligibility Requirements
Small business with 1–100 employees
Dental Cleanings
Pediatric – 20% coinsurance after deductible
Adult – not covered
Pediatric – 20% coinsurance after deductible
Adult – 20% coinsurance after deductible
Vision Exams
Pediatric – $10 copay after deductible
Adult – not covered
Pediatric – $10 copay after deductible
Adult – $10 copay after deductible
Telemedicine (Teladoc)
$0 copy after deductible
$0 copy after deductible
More Plan Information
Tier
Bronze 6650 Pro
Bronze 6650 Pro Plus
Summary of Benefits and Coverage (PDF)
Comprehensive Formulary
Comprehensive Formulary (List of Covered Drugs)
Premium
Other Eligibility Requirements
Small business with 1-100 employees
Dental Cleanings
Pediatric – 0% coinsurance after deductible
Adult – not covered
Pediatric – 0% coinsurance after deductible
Adult – 0% coinsurance after deductible
Vision Exams
Pediatric – 0% coinsurance after deductible
Adult – not covered
Pediatric – 0% coinsurance after deductible
Adult – 0% coinsurance after deductible
Telemedicine (Teladoc)
$0 copy after deductible
$0 copy after deductible
More Plan Information
Tier
Bronze 6650 Pro
Bronze 6650 Pro Plus
Summary of Benefits and Coverage (PDF)
Comprehensive Formulary
Comprehensive Formulary (List of Covered Drugs)
Premium
Other Eligibility Requirements
Small business with 1-100 employees
Dental Cleanings
Pediatric – 0% coinsurance after deductible
Adult – not covered
Pediatric – 0% coinsurance after deductible
Adult – 0% coinsurance after deductible
Vision Exams
Pediatric – 0% coinsurance after deductible
Adult – not covered
Pediatric – 0% coinsurance after deductible
Adult – 0% coinsurance after deductible
Telemedicine (Teladoc)
$0 copy after deductible
$0 copy after deductible
More Plan Information
Tier
Bronze 8150 Pro
Comprehensive Formulary
Comprehensive Formulary (List of Covered Drugs)
Premium
Other Eligibility Requirements
Small business with 1-100 employees
Dental Cleanings
Pediatric – 0% coinsurance after deductible
Adult – not covered
Vision Exams
Pediatric – 0% coinsurance after deductible
Adult – not covered
Telemedicine (Teladoc)
$0 copy after deductible
More Plan Information
Tier
Bronze 8150 Pro
Comprehensive Formulary
Comprehensive Formulary (List of Covered Drugs)
Premium
Other Eligibility Requirements
Small business with 1-100 employees
Dental Cleanings
Pediatric – 0% coinsurance after deductible
Adult – not covered
Vision Exams
Pediatric – 0% coinsurance after deductible
Adult – not covered
Telemedicine (Teladoc)
$0 copy after deductible
More Plan Information
*Available with the Pro Plus Plan.
**Up to $200 per reward period. There are two reward cycles—January through June, and July through December.
The benefit information provided is a brief summary, not a complete description, of benefits. For more information, contact the plan.
Coverage is provided by Healthfirst Health Plan, Inc., Healthfirst PHSP, Inc., and/or Healthfirst Insurance Company, Inc. (together, “Healthfirst”). Plans contain exclusions and limitations.
Additional Benefits
-
24/7 Access to Telemedicine with Teladoc*
Talk to a doctor anytime—for a $0 copay. Connect with board-certified doctors through video chat or phone for prescriptions, help diagnosing and treating non-emergency conditions, and more. Access to dermatologists is also available.
-
Urgent Care Center Network
Get the care you need when you need it at an urgent care center in our network–no appointment needed. Urgent care centers offer late-night and weekend hours, often with faster service at a lower cost than the Emergency Room (ER).
Visit an in-network urgent care center to get help for non-emergency conditions like earache, upset stomach, sprains, stitches, and more.
-
Active & Fit Direct
Working out just got cheaper. For just $25/month plus a one-time enrollment fee of $25, you can get a standard membership to a fitness center in your area. Track your activity, monitor your progress, achieve your fitness goals, and so much more.
Please note: a three-month membership commitment is required up front. Learn more about Active & Fit Direct.
-
Rewards for Working Out
You can get rewarded for taking care of your health—up to $400 in a calendar year with the ExerciseRewards™ program**.
It’s easy! Work out at a qualifying gym or fitness facility at least 50 times in a six-month period and track your workouts. Your spouse or domestic partner can be reimbursed too—up to $200 in a calendar year when he or she works out at least 50 times each six-month period in a calendar year.†
Learn more about ExerciseRewards™ or start earning your reward now!
*Telemedicine isn’t a replacement for your Primary Care Provider (PCP). Your PCP should always be your first choice for care (both in-person and virtual visits)
**Up to $200 per reward period. There are two reward periods—January through June, and July through December.
†Up to $100 per reward period. There are two reward periods—January through June, and July through December.
Additional Benefits
-
24/7 Access to Telemedicine with Teladoc*
-
Urgent Care Center Network
-
Active & Fit Direct
-
Rewards for Working Out
Frequently Asked
Questions
See All
-
What will my plan cover?
-
Is my doctor part of the network?
-
When will I receive my ID card?
Support When You Need It
We're happy to answer your questions.
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You can also visit our Virtual Community Office to connect with a local Healthfirst representative or to find a community office near you.
We look forward to helping you!
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