New York State Department of Financial Services
About Healthy NY
The Health Care Reform Act of 2000 introduced the Healthy NY program to provide more affordable health insurance to New Yorkers who need it most. Healthy NY, in partnership with HMOs and other insurance companies in New York State, offers comprehensive health insurance to small businesses. DFS oversees the program.
Small Business Owners
Healthy NY includes comprehensive coverage for essential health benefits including inpatient and outpatient hospital services, physician services, maternity care, preventive health services, diagnostic services, mental health services, chiropractic care, prescription drugs, ambulance and emergency services.
Small Business Owners (50 or fewer employees) can buy coverage directly from their insurer or from New York State of Health Marketplace through the Small Business Health Options Program (SHOP). The Marketplace will help you shop for and enroll in health insurance.
Individuals and Sole Proprietors
As of January 1, 2014, Healthy NY no longer provides coverage for individuals or sole proprietors. Instead, the New York State of Health Marketplace can help individuals and sole proprieters shop for and enroll in health insurance. You may also qualify to receive assistance to help pay for insurance offered through the Marketplace.
Guidance for Insurers Participating in Healthy NY
The DFS issues guidance to insurance companies participating in Healthy NY to assist in program implementation. Below are a selection of Healthy NY guidance memoranda. This is not an exhaustive list of all guidance memos.
- July 28, 2015 - Employer Eligibility for Healthy NY coverage issued or renewed on or after January 1, 2016, New Healthy NY Recertification Form, Loss of Eligibility for Healthy NY Coverage.
- June 20, 2013 - Small Employer Groups.
- February 7, 2013 - Federal Health Care Reform Benefit and Annual Limit Updates, Spouse as Primary Policyholder, High Deductible Health Plan (HDHP) Deductible Amounts, Current Wage Level for Small Employers, 2013 Individual Income Eligibility Levels.