CULINTRO A Community for Restaurant Professionals
Culintro

Insurance FAQs

What is HealthPass?

Culintro has evaluated several medical and dental carriers in an effort to provide our members with the most flexible and competitive option available and HealthPass is the solution. Culintro has partnered with HealthPass as an affordable way for our member businesses to offer a variety of health benefit options to their employees at no extra cost to them. When a small business offers HealthPass, each employee gets to choose from over 20 health benefit options from 4 leading health carriers - EmblemHealth GHI, HIP, and Oxford plus dental and EverGuard through Guardian. HealthPass provides employers and employees CHOICE, just like a Fortune 500 company.  Rates vary based on the plan design and coverage level chosen with plans available from under $220 for single coverage to under $630 for family coverage. 

Which carriers and plans?

With HealthPass small businesses are able to choose from EmblemHealth, GHI, HIP, Oxford and Guardian for Dental and EverGuard.

In-Network Only plans offer comprehensive benefits from participating doctors, hospitals, labs and x-ray facilities. Services rendered by in-network providers are usually covered at no additional cost or a copay.  Most HealthPass plans do not require a referral to see an in-network specialist.

In & Out-of-Network plans provide the flexibility for employees to seek care from any provider. In-Network providers are usually covered at no additional cost or at a co-pay. Out-of-Network providers can be visited for covered services subject to a deductible and coinsurance.

In-Network Cost-Sharing plans are designed to lower premiums by sharing more of the cost of services with members.  Most plans cover preventive care at 100%.  Doctor office visits are usually covered at a copay.  Services rendered outside of the doctor's office are usually covered at a deductible and coinsurance.

Health Savings Accounts (HSA’s) combine a High Deductible Health Plan (HDHP) with a tax-favored savings account that gives employers and employees more control over healthcare dollars. Most services are subject to a deductible and/or coinsurance. These plans offer lower premiums which offset higher out of pocket costs. Money saved from reduced premiums can be used to fund the corresponding savings account pre-tax and pay for eligible medical expenses on a tax-free basis.

How will HealthPass help me save money?

There are several ways HealthPass saves small employers money.  By setting a Defined Contribution amount for each employee, employers can fix a benefits budget.  Also with HealthPass employees can choose a plan which meets their needs without overspending for unused benefits.  And with access to over 200,000 providers, employees are more likely to find their doctors in one of our networks, thus reducing potential out of pocket costs.

Do the plans cover prescription drugs?

  • Yes, Select from 3 Rx options that include a variety of copays for generic and brand-name drugs or choose no coverage at all.  You determine the right option to offer your employees:
  • $10/$20/$40 option with no annual maximum
  • $10/$20/$40 option with a $50 deductible and a $2000 annual maximum per person
  • No coverage or plans with embedded Rx cards may be offered
  • SUNRx card is a free discount program, for those with limited or no prescription coverage.  The card can be used nationwide and allows members a savings of 15-70% on prescription drugs.  This is not a form of insurance therefore no claim forms need to be filed.  Just show the card to your pharmacist and the applicable discount will be applied.

Who can enroll?

Small businesses and non-profits with a business address in New York City (5 boroughs), Long Island, Westchester, Rockland, Orange, Putnam, Dutchess, Sullivan or Ulster counties can enroll.  Employees of those companies who live in New York State, New Jersey, Connecticut and Bucks County, Pennsylvania are eligible to enroll. In addition, up to 20% of the eligible employees who live outside these areas can be enrolled in HealthPass.
Sole Proprietors with a business address in the New York (five boroughs), and Long Island. Oxford medical plans and a Guardian dental plan options are available.

Can husband and wife only businesses be considered eligible?

Businesses where a husband and wife are the only 2 employees may enroll with HealthPass if:
  • The business can provide the appropriate tax documents
  • The employees in question meet the member eligibility requirements, and
  • The employees enroll for coverage separately

How many employees must participate in the medical plan?

75% of eligible employees must be covered through HealthPass or have other coverage such as another employer-sponsored plan, COBRA coverage or any individual or government sponsored insurance plan. To offer HealthPass, a minimum of 2 full time employees must be eligible though only one must participate, if the other is waiving out due to other coverage.

Who is eligible?

A Partner, Owner, or Officer receiving a salary or a W2 employee who works from 20-40 hours per week as set by the employer, who satisfies the company set waiting period, if any.

How many plans can I offer my employees?

All of them! Through HealthPass, each employee can choose a different plan using 1 universal enrollment form, while you get 1 bill and write only 1 check a month, regardless of the number of plans your employees choose.

Will my employees and I be able to keep our current doctors?

Yes! HealthPass gives employees the power to access one of 5 carriers that combined cover over 200,000+ providers. In addition, each employee will be able to select a plan with an out-of-network benefit if their physician does not participate in their chosen network. To find your physician, hospital or dentist, click here.   Each of our partner carriers (GHI, HIP, EmblemHealth, and Oxford) offer added value benefits and discounts. Your clients can take advantage of these in addition to the comprehensive benefits included in their respective plan designs. Some of these added value benefits include, but are not limited to: discounts at participating vision centers, fitness clubs, weight loss centers, apparel and footwear retailers, massage therapy, child safety products, vitamin/ herbal supplements and much more! Please click here for additional information.

When can I start coverage for my business?

HealthPass has 2 effective dates each month, on the 1st and 15th. For 1st of the month effective dates enrollment materials must be received by the 21st day of the preceding month. Applications for 15th of the month coverage must be received by the 5th. If your group elects to enroll on the 15th of the month, the enrollment materials must be accompanied by a business check for 1 1/2 times the cost of monthly coverage. If you have current employer coverage with one of the HealthPass participating providers (EmblemHealth, GHI, Health Net Take out!, HIP and Oxford), you can only enroll for a 1st of the month effective date.

What is HealthPass Dental?

HealthPass offers 2 outstanding dental insurance plans through Guardian:
The Managed DentalGuard (DMO) plan is a voluntary In-Network benefit which covers preventive care services at a $5 copay. In addition, the DMO provides generous discounts for diagnostic and restorative treatments.

The DentalGuard Preferred (Dual Option DMO/PPO) plan offers a choice of DMO or PPO coverage. With access to over 65,000 dentists without a referral, the PPO offers coverage for any dentist you choose to visit.

What is EverGuard?

HealthPass offers two EverGuard options through Guardian:
 
 EverGuard:
  • $1,000 per month of Disability Income
  • $25,000 of Term Life Insurance
  • $75,000 of Accidental Death & Dismemberment Insurance

EverGuard Plus:

  • $1,500 per month Disability Income
  • $50,000 of Term Life Insurance
  • $100,000 of Accidental Death & Dismemberment Insurance take out!

EverGuard & EverGuard Plus make it easy to offer your employees the personal protection they need at an affordable rate.  No medical evaluation is required! No industry excluded!

What is Health Advocate?

All small group medical members have access to Health Advocate.  Health Advocate helps members solve problems and find solutions related to their healthcare and health insurance needs, such as finding the best doctors and hospitals, resolving insurance claims, and obtaining approval for needed services.
What is TaxSaver?

A Premium Only Plan is one of the simplest benefits an employer can offer, but it delivers real savings to employees and their company.  By allowing employees to pay their portion of premium costs BEFORE taxes, employees typically save 25% or more and the employer benefits from nearly 8% in FICA savings.  Click here to start saving!

How do I get a quote?

It’s easy. Contact:

***BE SURE TO INDICATE THAT YOU ARE A CULINTRO MEMBER COMPANY***