HIP (Health Insurance Plan of Greater New York)

HIP bills EFA members directly for their premiums on a monthly basis. Plan enrollment is administered by RBA Insurance Strategies, LLC. HIP plans are available to members of EFA who are self-employed.

RBA's plans are for downstate New York and northern New Jersey residents only.

Members must submit two of the following documents along with the enrollment materials as proof of self-employment:

• Form 1040 (both pages) plus one of the following
  • Current Schedule C (both pages)
  • Schedule K-1
  • Schedule 1120-S
  • Quarterly Wage and Withholding Form NYS-45

Forms must be submitted to:

RBA Insurance Strategies
319 Clematis Street, Suite 408
West Palm Beach, FL 33401
888-722-8121
roy@RBAstrategies.com

Group Benefits and Premiums

Insurance Coverage (Standard Plan—HMO)

HIP offers one of their most comprehensive plans to members of the EFA. This plan covers a broad range of health care and services. These include medical services, hospital care, emergency care, skilled nursing facilities, home care, and chiropractic health care. All services require a copay. The plan also includes prescription drug coverage with a copay of $20 for generic and $30 for most brand-name drugs. Please note that there is a $300 deductible per calendar year for prescription drugs. For more details and a list of benefits and costs, please contact RBA.

Monthly rates are effective 6/15/2011.

• Individual: $617.29
• Individual & Child(ren): $1,185.34
• Individual & Spouse: $1,455.69
• Family: $1,922.22

Insurance Coverage (High Deductible)

RBA offers two plans that will save you on premiums. However, your medical costs are not met until you have used up the deductible. After that EMBLEM pays 100 percednt of your costs and Oxford charges you a small co-pay per medical visit.

• Deductible = $5,800 individual, $11,600 family [annual]
• Premium = $286.62 individual, $831.20 family [monthly]

• Deductible = $2,850 individual, $5,700 family
• Premium = $475.35 individual, $881.21 parent & child, $1045.77 husband & wife, $1,504.51 family

If you are interested, review the list of benefits and costs. For additional information, contact RBA. This is a group plan, available only to self-employed members of the EFA. Continuous membership is required.

RBA Insurance Strategies
319 Clematis Street, Suite 408
West Palm Beach, FL 33401
888-722-8121
roy@RBAstrategies.com

Please do not call the EFA office.

TEIGIT (The Entertainment Industry Group Insurance Trust)

Since 1965, The Entertainment Industry Group Insurance Trust has administered health insurance plans for members of participating associations. On July 28, 2006, TEIGIT announced the expansion of its plans to include Long-Term Care, Life, Disability, and International Travel Health Insurance. The TEIGIT website has more information on most of these new offerings; if you do not find what you're seeking there, contact TEIGIT directly.

TEIGIT offers health insurance to EFA members in New York State through Oxford Health Plans, Emblem (formerly GHI) and, in Connecticut, Florida, California, and the Greater Chicago area through CIGNA. TEIGIT also offers individual insurance to members in Texas, Arizona, and Virginia.

CIGNA HMO Dental is available in most parts of the country.

TEIGIT also offers long-term care insurance, international health and travel insurance, and life insurance and disabiity.

Oxford

• Prescription coverage: Liberty Metro—no Rx coverage. All other plans are now on a $10/$30/$60 plan; 2.5 times that for mail order, $100 Rx tier 2/tier 3 deductible (deductible not applicable in HSA/HD plan.)
• Liberty Metro: Out-of-network deductible increased to $3,000 ($9,000 for family). Office Visit copays are now $50/$75 for primary care/specialist. Hospital copay is $750/day for a maximum of 5 days/year. Outpatient surgery is $500. Radiology is 50 percent to a max of $100 per procedure.
• Freedom Exclusive EPO: Copays are $25/$50 for primary care/specialist. Hospital copay is now $300/day for a maximum of 5 days/year. Radiology is 50 percent to a max of $100 per procedure. Outpatient surgery: $300.
• HSA-HD Plan: In-network coverage at 90% for first $10,000 after separate deductible of $2,850 for in-network and $2,850 for out-of-network (additional out-of-pocket max of $1,000, after which the members incur no further expenses).
• Freedom POS: Out-of-network deductible $2,000 ($5,000 for family) with the out-of-pocket (OOP) maximum capped at $3,500 ($8,750 for famiily). Copays are $25/$25 for primary care/specialist. Hospital copay is $500/admission. Out-patient surgery and Radiology in-network: No Charge. Unlimited biology-based Mental Health coverage; Preventive Dental through age 11.
• Freedom Plan: Out-of-network deductible $300 ($750 for family), with re-imbursement 80 percent and OOP maximum capped at $1,300 ($3,250 for family). Office visit copays are $20/$20 for primary care/specialist. Hospital copay: $100/admission. $100 deductible for tier 2 and/or tier 3 prescriptions. Alternative medicine (such as acupuncture). Unlimited Skilled Nursing Facility days.

For more information about the TEIGIT plans, please contact TEIGIT directly:

TEIGIT
Alice and David Rubin
632 Plank Road, Suite 203
Clifton Park, NY 12065
800-886-7504
teigit@teigit.com
www.teigit.com

Please do not call the EFA office.

Northeast Dental Plan

Somewhat analogous to HMO plans. Clients choose from a list of affiliated dentists; the area covered is limited. There is an annual fee that covers some services and offers discounts on more complicated procedures. To learn more, contact the EFA office administrator at office@the-efa.org for an information packet.