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
  • 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**
  • 2022
  • 2021
Tier
Platinum Pro
Platinum Pro Plus
Summary of Benefits and Coverage (PDF)
English
English
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 Plan table dropdown arrow
Tier
Gold Pro
Gold Pro Plus
Summary of Benefits and Coverage (PDF)
English
English
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 Plan table dropdown arrow
Tier
Gold 25/50/0 Pro
Gold 25/50/0 Pro Plus
Summary of Benefits and Coverage (PDF)
English
English
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 Plan table dropdown arrow
Tier
Silver Pro
Silver Pro Plus
Summary of Benefits and Coverage (PDF)
English
English
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 Plan table dropdown arrow
Tier
Silver 40/75/4700 Pro
Silver 40/75/4700 Pro Plus
Summary of Benefits and Coverage (PDF)
English
English
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 Plan table dropdown arrow
Tier
Bronze Pro
Bronze Pro Plus
Summary of Benefits and Coverage (PDF)
English
English
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 Plan table dropdown arrow
Tier
Bronze 6850 Pro
Bronze 6850 Pro Plus
Summary of Benefits and Coverage (PDF)
English
English
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 Plan table dropdown arrow
Tier
Bronze 8150 Pro
Summary of Benefits and Coverage (PDF)
English
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 Plan table dropdown arrow
Tier
Platinum Pro
Platinum Pro Plus
Summary of Benefits and Coverage (PDF)
English
English
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 Plan table dropdown arrow
Tier
Platinum Pro
Platinum Pro Plus
Summary of Benefits and Coverage (PDF)
English
English
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 Plan table dropdown arrow
Tier
Gold Pro
Gold Pro Plus
Summary of Benefits and Coverage (PDF)
English
English
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 Plan table dropdown arrow
Tier
Gold Pro
Gold Pro Plus
Summary of Benefits and Coverage (PDF)
English
English
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 Plan table dropdown arrow
Tier
Gold 25/50/0 Pro
Gold 25/50/0 Pro Plus
Summary of Benefits and Coverage (PDF)
English
English
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 Plan table dropdown arrow
Tier
Gold 25/50/0 Pro
Gold 25/50/0 Pro Plus
Summary of Benefits and Coverage (PDF)
English
English
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 Plan table dropdown arrow
Tier
Silver Pro
Silver Pro Plus
Summary of Benefits and Coverage (PDF)
English
English
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 Plan table dropdown arrow
Tier
Silver Pro
Silver Pro Plus
Summary of Benefits and Coverage (PDF)
English
English
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 Plan table dropdown arrow
Tier
Gold 1350 Pro
Gold 1350 Pro Plus
Summary of Benefits and Coverage (PDF)
English
English
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 Plan table dropdown arrow
Tier
Gold 1350 Pro
Gold 1350 Pro Plus
Summary of Benefits and Coverage (PDF)
English
English
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 Plan table dropdown arrow
Tier
Silver 40/75/4700 Pro
Silver 40/75/4700 Pro Plus
Summary of Benefits and Coverage (PDF)
English
English
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 Plan table dropdown arrow
Tier
Silver 40/75/4700 Pro
Silver 40/75/4700 Pro Plus
Summary of Benefits and Coverage (PDF)
English
English
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 Plan table dropdown arrow
Tier
Bronze Pro
Bronze Pro Plus
Summary of Benefits and Coverage (PDF)
English
English
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 Plan table dropdown arrow
Tier
Bronze Pro
Bronze Pro Plus
Summary of Benefits and Coverage (PDF)
English
English
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 Plan table dropdown arrow
Tier
Bronze 6850 Pro
Bronze 6850 Pro Plus
Summary of Benefits and Coverage (PDF)
English
English
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 Plan table dropdown arrow
Tier
Bronze 6850 Pro
Bronze 6850 Pro Plus
Summary of Benefits and Coverage (PDF)
English
English
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 Plan table dropdown arrow
Tier
Bronze 5250 Pro
Summary of Benefits and Coverage (PDF)
English
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
Vision Exams
Pediatric – $10 copay after deductible
Adult – not covered
Telemedicine (Teladoc)
$0 copay
More Plan Information Plan table dropdown arrow
Tier
Bronze 5250 Pro
Summary of Benefits and Coverage (PDF)
English
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
Vision Exams
Pediatric – $10 copay after deductible
Adult – not covered
Telemedicine (Teladoc)
$0 copay
More Plan Information Plan table dropdown arrow
Tier
Bronze 8225 Pro
Summary of Benefits and Coverage (PDF)
English
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 Plan table dropdown arrow
Tier
Bronze 8225 Pro
Summary of Benefits and Coverage (PDF)
English
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 Plan table dropdown arrow

*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<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.

  • 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. (Note: a three-month membership commitment is required up front.)

    Call Active&Fit Direct at 1-877-810-2746, Monday to Friday, 8am—9pm, to learn more and find out how you can join.

  • Rewards for Working Out

    Rewards for Working Out

    With the Active&Fit ExerciseRewards program,** you can earn $200 every six months if you visit a qualifying fitness center at least 50 days during the same six-month reward period. Your covered spouse or domestic partner can also get rewarded $100 every six months for going to the gym 50 days or more.  Visit ActiveandFit.com or talk to an Active&Fit ExerciseRewards representative at 1-877-810-2746, Monday to Friday, 8am—9pm.

Additional Benefits

  • 24/7 Access to Telemedicine with Teladoc*

    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.

You can also visit our Virtual Community Office to connect with a local Healthfirst representative or to find a community office near you.

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