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Two-Tier Health Plan

Northwell Direct + Blue Cross Blue Shield® Health Plans

Better Access. Better Value. Smarter Healthcare. Northwell Direct paired with the nationwide BCBS network — lower deductibles and copays when members choose Northwell, plus coast-to-coast access.

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Northwell Direct by Memberly

Two-Tier Health Plan with Nationwide Blue Cross Blue Shield Access

Northwell Direct by Memberly is an exclusive multi-employer health plan that combines the Northwell Direct Network as Tier 1 with the Anthem Blue Cross Blue Shield National PPO Network as Tier 2.

Through a direct relationship with Northwell Health, New York's largest integrated healthcare system, the plan delivers significant savings when members use Tier 1 providers while maintaining nationwide access to hospitals and physicians through the Blue Cross Blue Shield PPO Network whenever care is needed outside the Northwell system.

No Annual Deductible Option

One of the plan's most popular choices is the Ultra Plan, which features no annual deductible when using Northwell Direct providers. This makes it easier for employers to transition from another health plan at any time during the year without employees having to satisfy a new deductible.

Fixed Rates Until January Renewal

Simply join the plan and your rates remain fixed through the current plan year, with all participating employers renewing together each January. This provides predictable healthcare costs and eliminates unexpected mid-year rate increases.

Small Group Friendly

Unlike many traditional health plans, underwriting is based primarily on the employees enrolling in coverage rather than overall workforce participation. This allows many employers with lower participation to qualify more easily.

The plan is available to:

EmployersSole ProprietorsProfessionals

The Best of Both Networks

Employers benefit from a unique two-tier design that encourages members to use Northwell's high-quality, cost-effective providers while preserving the flexibility of nationwide Blue Cross Blue Shield coverage for care outside the Northwell system. The result is a health plan that combines competitive pricing, broad provider access, and one of the strongest healthcare networks available in the New York market.

Two Networks. One Seamless Health Plan.

Tier 1 rewards. Tier 2 reach.

Tier 1 — Northwell Direct

When members choose Northwell Direct physicians, hospitals, and outpatient facilities, they receive enhanced Tier 1 benefits:

  • Lower deductibles
  • Lower copays
  • Reduced hospital cost-sharing
  • Coordinated care within the Northwell Health system
  • Access to one of New York's leading integrated healthcare networks

Tier 2 — Blue Cross Blue Shield

When care is needed outside the Northwell system, employees access one of the nation's largest provider networks:

  • More than 2 million physicians and providers
  • Over 95% of physicians nationwide
  • More than 96% of hospitals across the United States
  • Thousands of urgent care centers, imaging facilities, and laboratories

Confidence whether members are close to home or traveling.

Find a Northwell Direct Provider

Search the Northwell Direct network to confirm your doctors, hospitals, and facilities are in-network before you enroll.

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Choose the Plan That Fits Your Business

Every employer has different healthcare needs and budget goals. Pick from three distinct plan options — all with Northwell Tier 1 savings and nationwide BCBS access.

Ultra Plan™

Maximum Benefits. Lowest Out-of-Pocket Costs.

$0 Ind & Family Tier 1 Deductible
$500 Ind / $2,000 Fam Tier 2 Deductible

Includes

  • Low physician copays
  • Reduced specialist costs
  • Lower hospital expenses
  • Comprehensive medical coverage
  • Lower out-of-pocket costs

Best for

  • Executive benefit packages
  • Professional firms
  • Medical practices
  • Recruitment & retention focused employers
  • Organizations wanting the richest available coverage
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3K Plan™

The Perfect Balance of Cost and Coverage.

$2,000 Ind & $4,000 Fam Tier 1 Deductible
$3,000 Ind / $6,000 Fam Tier 2 Deductible

Includes

  • Reduced family deductible
  • Affordable physician copays
  • Comprehensive hospital coverage
  • Excellent value for everyday healthcare

Best for

  • Small and mid-sized businesses
  • Growing employers
  • Companies balancing benefits with cost
  • Employers seeking predictable spending
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6K Plan™

Affordable Premiums. Broad Healthcare Access.

$5,000 Ind and $10,000 Fam Tier 1 Deductible
$6,000 Ind / $12,000 Fam Tier 2 Deductible

Includes

  • Reduced Tier 1 deductible vs. Tier 2
  • Broad Northwell + BCBS access
  • Lower monthly premiums
  • Protection against significant medical expenses

Best for

  • Cost-conscious employers
  • Businesses transitioning from fully insured plans
  • Employers seeking lower premiums
  • Younger or healthier workforces
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Compare the Three Plans

FeatureUltra Plan™3K Plan™6K Plan™
Tier 1 Deductible$0 Ind / Fam$2,000 Ind / $4,000 Fam$5,000 Ind / $10,000 Fam
Tier 2 Deductible$500 Ind / $2,000 Fam$3,000 Ind / $6,000 Fam$6,000 Ind / $12,000 Fam
Out-of-Network Deductible$1,000 Ind / $2,000 Fam$6,000 Ind / $12,000 Fam$9,200 Ind / $18,200 Fam
Max Out-of-Pocket Costs$6,000 Ind / $18,200 Fam$7,500 Ind / $18,200 Fam$9,200 Ind / $18,200 Fam
Tier 1 Primary Care Visit - Injury/Illness$25 copay/visit$35 copay/visit$40 copay/visit
Tier 2 Primary Care Visit - Injury/Illness$35 copay/visit$45 copay/visit$45 copay/visit
Premium Level$$$$$$
Best ForRich BenefitsBalanced ValueLowest Premium
Northwell SavingsExcellentExcellentExcellent
Nationwide BCBS Access✓✓✓

Why Employers Love This Plan

Lower Healthcare Costs

Direct contracting with Northwell helps reduce overall healthcare spending and monthly premiums.

Better Employee Experience

Enhanced benefits when choosing Northwell, plus nationwide provider access through Blue Cross Blue Shield.

Flexible Plan Choices

Three plan options let employers balance premiums, deductibles, and employee cost-sharing.

Broad Provider Access

Access to Northwell's integrated health system plus one of the largest provider networks in the country.

For Businesses of All Sizes

Small business, growing company, or larger employer — flexible solutions tailored to your organization.

Coordinated, Quality Care

Directly contracted Northwell providers help improve healthcare value and member outcomes.

Frequently Asked Questions

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Application Form

Complete the application below for Northwell Direct by Memberly. All information is used for eligibility and underwriting review only.

Applicant & Group Information
Health Questionnaire

1. Significant Medical Conditions

Has anyone applying for coverage ever been diagnosed with, treated for, or currently have any significant medical condition? Examples include cancer, diabetes, kidney disease, liver disease, autoimmune disorders, neurological disorders, any chronic medical condition, or any planned or imminent surgery.

2. Prescription Medications

Is anyone applying for coverage currently taking, receiving, or scheduled to begin any specialty medication, biologic therapy, injectable medication, infusion therapy, GLP-1 medication, or other high-cost prescription medication?

3. Recent Medical Care

Has anyone applying for coverage been hospitalized, had surgery, or received ongoing medical treatment within the past three years?

4. Pregnancy

Is anyone applying for coverage currently pregnant or expecting to become covered during an active pregnancy?

5. Other Medical Information

Is there any other medical condition, disability, or health information that could affect eligibility, treatment, or continuity of care that has not already been disclosed?

Medical Disclosure

Please disclose all current medical conditions and prescription medications for every applicant. Complete disclosure helps ensure an accurate underwriting review, verifies compatibility with the selected health plan, and helps avoid interruptions in care. Failure to disclose material medical information or prescription medications may result in delayed underwriting, denial of coverage, rescission of coverage, or non-payment of claims.

Applicant Certification

I certify that the information provided in this application is true, complete, and accurate to the best of my knowledge. I understand that any omission, misrepresentation, or failure to disclose material medical information or prescription medications may affect eligibility for coverage and may result in the denial, rescission, or termination of coverage, or the non-payment of claims, as permitted by applicable law.

Authorization to Obtain and Use Health Information

I authorize Northwell Direct by Memberly, its authorized underwriting partners, third-party administrators, stop-loss carriers, reinsurers, network partners, claims administrators, and other entities involved in the administration of my health plan to obtain, use, and disclose my protected health information as necessary to: determine eligibility for coverage; evaluate underwriting risk; verify medical information and prescription medications; obtain reinsurance or stop-loss coverage; administer health plan benefits and claims; and perform other activities necessary for the administration of the health plan. I understand that I may revoke this authorization in writing at any time; however, any action taken before such revocation shall remain valid.

HIPAA Authorization

I authorize my physicians, hospitals, pharmacies, laboratories, health plans, pharmacy benefit managers, and other healthcare providers to release my medical records, prescription history, and other protected health information to Northwell Direct by Memberly and its authorized underwriting and administrative partners for the purpose of determining eligibility for coverage, underwriting, obtaining reinsurance or stop-loss coverage, administering benefits, processing claims, and managing my health plan. I understand that this authorization may be revoked in writing, except to the extent that action has already been taken in reliance upon it. I also understand that information disclosed under this authorization may no longer be protected by federal privacy regulations once received by authorized recipients.

Electronic Signature

Answer all questionnaire questions, accept the three authorizations, and sign to submit.

Plan Disclosure: Northwell Direct is not an insurance product underwritten or insured by Northwell Health, Anthem Blue Cross Blue Shield, Health Plan Apply, or Memberly, Inc. Northwell Health and Anthem Blue Cross Blue Shield provide network access and/or related services as applicable to the plan. Network participation, benefits, eligibility, rates, underwriting requirements, and plan terms are subject to change and the applicable plan documents. In the event of any discrepancy, the official plan documents shall govern.