Marsh Affinity Group Services
New York County Medical Society
Following are brief outlines of sponsored insurance program features. To receive information on any of these programs, please complete an Interest Form.

If you have any questions regarding the sponsored insurance programs please contact a Marsh Client Service Representative at 1-800-888-6926 or e-mail us at NYCMS.Insurance@marsh.com.

This web page is for illustrative purposes only, and is not a contract. It is intended to provide a general overview of the services described. Remember that only the policy can provide the actual description of services, terms, conditions and exclusions.

NYCMS Website
Information
Terms & Conditions
News & Information
• Medical Programs
• Term Life
• Long Term Disability
• Catastrophe Major Medical
• Nursing Home and Home Care Insurance
• Business Overhead Expense Program
• Accidental Death and Dismemberment Program
Open a Health Savings Account! Sign up online with HSABank.com
Medical
Medical
NEW! Members have an opportunity to lower premium costs, save on federal taxes, increase freedom of choice and utilize health care services more efficiently. Thanks to Health Savings Accounts (HSAs), members have a new way to help save for qualified medical and retiree health expenses on a tax-free basis. Among the HSA advantages are:
  • Contributions to the account are tax deductible up to the size of the HDHP deductible. In 2008, individuals may contribute up to $2,900; with family coverage you may contribute up to $5,800 (indexed for inflation).
  • Contributions may be made by an individual, an employer or both
  • Amounts in an HSA belong to the individual and are fully portable
  • Amounts in an HSA earn tax free interest
  • Unused amounts in the account at year end rollover for future years
  • Distributions are not taxed if used for qualifying medical expenses
  • Individuals between the ages of 55-64, can make additional “catch up” contributions. In 2008, an extra $900 can be contributed to the above amounts.

In order to qualify for a health savings account, an individual must be covered under a qualifying high deductible health plan (HDHP).

Oxford has arranged for members to open their Health Savings Accounts with Exante Bank. Click here to go to www.exantebankhsa.com and open your HSA today!

Or, consider the most popular plan among Society members — the Freedom Plan MetroSM, designed to reduce health insurance expenses for you, your dependents and your employees without having to sacrifice your choice of physicians. With the Freedom Plan Metro, you have access to Oxford’s extensive network of over 65,000 physicians. However, you pay for more of your care as you receive it, through higher co-payments rather than through higher premiums, regardless of whether or not you use medical services.

Oxford also offers their traditional Point-of-Service programs that differ by deductible. All three plans cover most in-network benefits either with no charge or with a small copayment. Out-of-network benefits are covered subject to deductibles and coinsurance. In addition, you pay the difference between the provider's charges and Oxford's usual, customary and reasonable allowances.

Premiums for all options are based on the New York borough or county your practice is located in.


Brief Highlights of the Point-of-Service plans:

In-network
Out-of-network
Options 1,2,3
and Metro
Option 1
Option 2
Option 3
Freedom Plan
Metro
Deductible
None
$250 (single)
$625 (family)
$500 (single)
$1,250 (family)
$1,000 (single)
$2,500 (family)
$1,000 (single)
$3,000 (family)
Coinsurance
None
20%
20%
30%
30%
Annual
out-of-pocket
maximum*
NA
$1,250 (single)
$3,125(family)
$1,500 (single)
$3,750 (family)
$2,500 (single)
$6,250 (family)
$4,000 (single)
$12,000 (family)
Lifetime
Maximum
Benefit
Unlimited
Unlimited
Unlimited
Unlimited
Unlimited
* Including deductible

Brief Highlights of the High Deductible Health plans:

Option A
Option B
In-Network
Individual Only
Family (2+)
Individual Only
Family (2+)
Deductible
$1,250
$2,500
$2,850
$5,700
Coinsurance
80%
80%
100%
100%
Maximum Out of Pocket
$3,250
$6,500
$2,850
$5,700
Out of Network
Deductible
$2,000
$4,000
$2,850
$5,700
Coinsurance
60%
60%
70%
70%
Maximum Out of Pocket
$6,000
$12,000
$5,850
$11,700
Underwritten by: Oxford Health Plans (rated "A-" by A.M. Best and Company)
Term Life
Term Life
Your family relies on you for financial protection. But what would happen to them if you were not there? Through the Society's Term Life program members and spouses may apply for up to $500,000 of coverage. An Accelerated Death Benefit up to $250,000 is also included.

Underwritten by The United States Life Insurance Company in the City of New York (rated "A++" by A.M. Best and Company)

LTD
Long Term Disability
Medical Specialty Definition of Disability

Long term disability coverage helps protect your income in the event you become totally disabled. You are protected in your medical specialty for the first 10 years of your total disability. Benefits are paid if you become totally disabled from your specialty, but are able to earn an income outside your specialty during this time. The maximum benefit period under the extended plan is age 65 for both injury and sickness related disabilities. The plan includes Waiver of Premium and a choice of elimination periods (either 90 or 180 days), Optional Benefits include Cost of Living Adjustment and more! Up to $10,000 per month is available after the selected waiting period for members under age 50. Members ages 50 - 54 may apply for up to $6,000 per month in benefits.

Underwritten by: The United States Life Insurance Company in the City of New York (rated "A++" by A.M. Best and Company)
Catastrophe
Catastrophe Major Medical
This high deductible ($25,000 per sickness or injury) program provides a supplement to your basic medical program. It is particularly attractive to members who are in HMO programs and would like the flexibility to receive out-of-network treatment for catastrophic illness. Also included is a convalescent home benefit of $300 per week for up to 3 years.

Underwritten by: The United States Life Insurance Company in the City of New York (rated "A+" by A.M. Best and Company).
LTC
Nursing Home and Home Care Insurance
Up to $10,000 per month available.

Members receive a 5% premium discount through MetLife and John Hancock.

Long Term Care benefits are payable upon the loss of two of the six Activities of Daily Living (ADLs) or cognitive impairment.

There is an additional premium discount if both you and your spouse purchase coverage at the same time. Applicants in good health may also receive further discounts.

Coverage is also available to employees of members, parents, parents-in-law and grandparents.

We can arrange to have a Long Term Care specialist meet with you to discuss your needs.

Underwritten by: Metropolitan Life Insurance Company (rated "A+" by A.M. Best and Company) and John Hancock Life Insurance Company (rated "A++" by A.M. Best and Company)

BOE
Business Overhead Expense
Pays the normal and fixed expenses of running your office while you are disabled so you don't have to use your personal disability income.

Examples of Covered Expenses Include:
• Rent
• Employee Salaries
• Utilities
• Association Dues
• Professional Liability

Apply for up to $10,000 per month in benefits. Medical specialty definition of disability is included. Benefits are payable as long as you remain disabled up to a maximum of 36 months. In a group practice, it pays your share of fixed expenses.

Underwritten by: The United States Life Insurance Company (rated "A++" by A.M. Best and Company)
AD&D
AD&D
This insurance program covers you 24-hours a day, 365 days a year. Your acceptance is guaranteed to age 70! Unlike some plans, this plan is not limited to just certain accidents (car, plane, etc.). This insurance plan pays regardless of any other insurance you may have.

Benefit Amounts:

  • Member $100,000 to $750,000 (increments of $10,000)
  • Spouse $100,000 to $750,000 (increments of $10,000) Coverage cannot exceed member's amount
  • Dependent Children $10,000

Underwritten by: First Unum Life Insurance Company (rated "A-" by A.M. Best and Company)

Questions?
Call Marsh Affinity Group Services at
1-800-888-6926 or e-mail us at NYCMS.Insurance@marsh.com


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Page Last Updated: 1/2/08

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