The LIA Health Alliance is a Health Purchasing Cooperative (HPC) that is designed to increase insurer competition and significantly expand choices for small businesses and their employees. It gives small businesses the same marketplace advantages enjoyed by large corporations. It is the first Alliance authorized by New York State.

[Return to top]  [Home]

What is the advantage of getting health insurance through the LIA Health Alliance?

The Alliance offers health insurance at low rates. It provides more choices to small businesses and gives their employees the ability to make selections that meet their personal needs. The Alliance offers:

	six insurer selections.
	multiple benefit plan options.
	two, three and four tier rates.
	the most extensive choices of doctors and hospitals in New York City and Long Island.
	a single enrollment form.
	a single bill.

Giving employees choice is particularly important, if they are contributing towards their health insurance.

[Return to top]  [Home]

What is an HMO?

A Health Maintenance Organization (HMO) is a benefit plan that has one benefit level: in-network; it allows enrolled members, who live in a defined service area, to use participating HMO providers in order to receive benefits. HMO members must have all care authorized by their Primary Care Physician (PCP). There are minimal copayments, but no deductibles and virtually no claim forms. There aren't any out-of-network benefits.

[Return to top]  [Home]

What is a POS?

A Point-of-Service (POS) is a benefit plan that has two benefit levels: in-network and out-of-network. In-network benefits provide the maximum benefit to members and provide the same cost and quality controls of the HMO product with minimal co-payments. To maximize in-network benefits, members are required to select a PCP from the insurer's directory of participating providers; the member's PCP will coordinate all of the members' health care needs. Members can choose, at the time services are needed, to seek care from an in-network provider and receive the highest benefit level possible or go out-of-network and receive benefits that are subject to deductibles and coinsurance.

[Return to top]  [Home]

What is an EPO?

An Exclusive Provider Organization (EPO) is a benefit plan that has one benefit level: in-network. In-network benefits provide maximum benefit to members with minimal co-payments. Referrals are not required to access in-network benefits. Members must select in-network providers to seek care for needed services. There aren't any out-of-network benefits.

[Return to top]  [Home]

A Preferred Provider Organization (PPO) is a benefit plan that has two benefit levels: in-network and out-of-network. In-network benefits provide the maximum benefit to members with minimal copayments. Referrals are not required to access in-network benefits. To maximize in-network benefits, members must select in-network providers to seek care for needed services. Members can choose, at the time services are needed, to seek care from an out-of-network provider and receive benefits that are subject to deductibles and co-insurance.

[Return to top]  [Home]

The Alliance standardizes most of the HMO, EPO, POS and PPO benefit plans to facilitate competition...though there are minor benefit variations. Each insurer prices (or rates) these same benefit plans. This gives you and your employees the ability to make meaningful rate comparisons in a quick and easy fashion. The Alliance also allows each insurer to offer a benefit plan that is unique to that insurer. These plans are called Specialty Benefit Plans.

[Return to top]  [Home]

They can select a primary care physician in any of the New York Counties listed in the provider directories of the participating insurers.

[Return to top]  [Home]

An employer contribution program allows you to fix your company's insurance costs. You can select a fixed dollar amount, a percentage of premium or whatever financial formula is best for your company.

When you decide what the employer contribution will be, you should inform your employees of that amount. This financial information is an important decision factor in the employee selection process.

[Return to top]  [Home]

It is important that you inform each eligible employee that they can make insurer selections and benefit plan selections that meet their personal needs. Distribute the Employee Selection Guide, the rate comparison sheet and a Healthcare Enrollment/Change Form to each one of your employees. You should also tell each employee to list the dependents that they want covered on their enrollment form.

[Return to top]  [Home]

Electronic debiting brings electronic funds transfer technology to the health insurance bill payment process. Electronic debiting is the simplest and most worry-free way to pay your monthly health insurance bills. On or about the 15th day of each month, you will receive an itemized bill from the Alliance's Enrollment Processing Center. The bill details the premium dollars that are due the first day of the following month. On the last business day of the month, a debit request will be sent to the bank you have designated and the payment due will be electronically transferred to the Alliance. You won't have to worry about making late payments.

[Return to top]  [Home]

Questions about the Alliance, the enrollment process or billing can be answered by contacting the Alliance Enrollment Processing Center at 1-800-LIA-5513. This line is available between 9:00 a.m. and 5:00 p.m. for employers and brokers.

Employees with questions on benefit plans or PCP selections should contact their selected insurer. Toll-free numbers are detailed on the employee ID card and in the Employee Selection Guide.

[Return to top]  [Home]