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Information for Brokers

Healthy NY is a unique program that provides more affordable coverage to eligible individuals, sole proprietors and small businesses.  Every HMO in the state offers the comprehensive, streamlined coverage.  Premiums are more affordable than traditional individual and small group coverage thanks to state sponsorship.  Healthy NY is a great way to introduce small businesses that thought they could not afford insurance to the values of providing coverage.

Broker Compensation

Some insurance companies pay commissions on sales to small businesses and sole proprietors.  For a list of companies and more information on broker compensation, please visit the Broker Commission page.

Benefit Package

Healthy NY’s comprehensive benefit package is standardized and covers essential health needs including inpatient and outpatient hospitalization, physician services, maternity care, preventive health services, diagnostic services and emergency services.  Applicants may choose a benefit package with or without a limited prescription drug benefit.  Healthy NY also offers a high deductible health plan (HDHP) option that enrollees may use with a health savings account (HSA).

Eligibility Criteria

Individuals, sole proprietor and small businesses must meet different eligibility criteria in order to participate.  The insurance companies offering Healthy NY make eligibility determinations and process applications.  For more information on eligibility, please reference the links below.

Eligibility Criteria for Small Businesses

Eligibility Criteria for Sole Proprietors

Eligibility Criteria for Individuals

Premium Rates

To obtain premium rates, visit the Insurers and Rates page.  Please contact the insurance companies for the most up-to-date premium rates.

Provider Directories

Although coverage is standardized, insurance companies use their own provider networks.  All coverage except for emergency services must be in-network; there is no out-of-network benefit.  Please visit the Provider Directories page to access the insurance companies’ provider directories.

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