Pro 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
  • Urgent care visits and hospital stays
  • 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
  • Unlimited acupuncture visits
  • HSA-compatible plans
  • Annual gym membership reimbursement**
  • 2020
  • 2019
Tier
Platinum Pro
Platinum Pro Plus
Summary of Benefits and Coverage (PDF)
English
English
Comprehensive Formulary
Premium
Monthly premium costs depend on household size. Get a Quote
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
Teladoc
$0 copay
$0 copay
More Plan Information Plan table dropdown arrow
Tier
Gold Pro
Gold Pro Plus
Summary of Benefits and Coverage (PDF)
English
English
Comprehensive Formulary
Premium
Monthly premium costs depend on household size. Get a Quote
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
Teladoc
$0 copay
$0 copay
More Plan Information Plan table dropdown arrow
Tier
Gold 25/50/0 Pro
Gold 25/50/0 Pro Plus
Summary of Benefits and Coverage (PDF)
English
English
Comprehensive Formulary
Premium
Monthly premium costs depend on household size. Get a Quote
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
Teladoc
$0 copay
$0 copay
More Plan Information Plan table dropdown arrow
Tier
Silver Pro
Silver Pro Plus
Summary of Benefits and Coverage (PDF)
English
English
Comprehensive Formulary
Premium
Monthly premium costs depend on household size. Get a Quote
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
Teladoc
$0 copay
$0 copay
More Plan Information Plan table dropdown arrow
Tier
Silver 40/75/4700 Pro
Silver 40/75/4700 Pro Plus
Summary of Benefits and Coverage (PDF)
English
English
Comprehensive Formulary
Premium
Monthly premium costs depend on household size. Get a Quote
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
Teladoc
$0 copay
$0 copay
More Plan Information Plan table dropdown arrow
Tier
Bronze Pro
Bronze Pro Plus
Summary of Benefits and Coverage (PDF)
English
English
Comprehensive Formulary
Premium
Monthly premium costs depend on household size. Get a Quote
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
Teladoc
$0 copy after deductible
$0 copy after deductible
More Plan Information Plan table dropdown arrow
Tier
Bronze 6650 Pro
Bronze 6650 Pro Plus
Summary of Benefits and Coverage (PDF)
English
English
Comprehensive Formulary
Premium
Monthly premium costs depend on household size. Get a Quote
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
Teladoc
$0 copy after deductible
$0 copy after deductible
More Plan Information Plan table dropdown arrow
Tier
Platinum Pro
Platinum Pro Plus
Summary of Benefits and Coverage (PDF)
English
English
Comprehensive Formulary
Premium
Monthly premium costs depend on household size. Get a Quote
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
Teladoc
$0 copay
$0 copay
More Plan Information More plan information dropdown arrow
Tier
Gold Pro
Gold Pro Plus
Summary of Benefits and Coverage (PDF)
English
English
Comprehensive Formulary
Premium
Monthly premium costs depend on household size. Get a Quote
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
Teladoc
$0 copay
$0 copay
More Plan Information More plan information dropdown arrow
Tier
Gold 25/50/0 Pro
Gold 25/50/0 Pro Plus
Summary of Benefits and Coverage (PDF)
English
English
Comprehensive Formulary
Premium
Monthly premium costs depend on household size. Get a Quote
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
Teladoc
$0 copay
$0 copay
More Plan Information More plan information dropdown arrow
Tier
Silver Pro
Silver Pro Plus
Summary of Benefits and Coverage (PDF)
English
English
Comprehensive Formulary
Premium
Monthly premium costs depend on household size. Get a Quote
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
Teladoc
$0 copay
$0 copay
More Plan Information More plan information dropdown arrow
Tier
Silver 40/75/4700 Pro
Silver 40/75/4700 Pro Plus
Summary of Benefits and Coverage (PDF)
English
English
Comprehensive Formulary
Premium
Monthly premium costs depend on household size. Get a Quote
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
Teladoc
$0 copay
$0 copay
More Plan Information More plan information dropdown arrow
Tier
Bronze Pro
Bronze Pro Plus
Summary of Benefits and Coverage (PDF)
English
English
Comprehensive Formulary
Premium
Monthly premium costs depend on household size. Get a Quote
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
Teladoc
$0 copy after deductible
$0 copy after deductible
More Plan Information More plan information dropdown arrow
Tier
Bronze 6650 Pro
Bronze 6650 Pro Plus
Summary of Benefits and Coverage (PDF)
English
English
Comprehensive Formulary
Premium
Monthly premium costs depend on household size. Get a Quote
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
Teladoc
$0 copy after deductible
$0 copy after deductible
More Plan Information More plan information dropdown arrow
Tier
Bronze 8150 Pro
Summary of Benefits and Coverage (PDF)
English
Comprehensive Formulary
Premium
Monthly premium costs depend on household size. Get a Quote
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
Teladoc
$0 copy after deductible
More Plan Information More plan information dropdown arrow

Additional Benefits

  • 24/7 Access to Telemedicine with Teladoc<sup>*</sup>

    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

    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

    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

    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!

Additional Benefits

  • 24/7 Access to Telemedicine with Teladoc*

    Additional plan dropdown arrow
  • Urgent Care Center Network

    Additional plan dropdown arrow
  • Active & Fit Direct

    Additional plan dropdown arrow
  • Rewards for Working Out

    Additional plan dropdown arrow

Frequently Asked
Questions

See All
  • What will my plan cover? FAQ dropdown arrow
  • Is my doctor part of the network? FAQ dropdown arrow
  • When will I receive my ID card? FAQ dropdown arrow

Support When You Need It

We're happy to answer your questions.

Learn about enrollment

1-855-949-3668

Monday to Friday, 9am—5pm

Member Services

1-855-789-3668

Monday to Friday, 9am—5pm

TTY English: 1-855-779-1033

Can't talk right now?

Request a callback and we’ll get back to you within one business day.