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Individuals and Sole Proprietors

New York’s Special Options for Working Individuals and Sole Proprietors
Depending on your location, income level, and your health care needs, the following programs may offer affordable options to you. This list offers various options for New Yorkers, but it is not all-inclusive.

Healthy New York
Designed for small businesses that have not provided health insurance during the last 12months, and sole proprietors and uninsured workers whose employers don't provide coverage.

Brooklyn Health Works
A low-cost designed for Brooklyn's employees of small businesses, small business owners and uninsured workers whose employers do not provide coverage.

Working Today
Offers a group insurance option and other benefits to independent workers (freelancers, temps, consultants, contingent workers and contract workers) in and around NYC.

LIA Health Alliance
Gives NYC's small businesses and sole proprietors the opportunity to choose from five insurers and 39 benefit plan options, with one simple bill for employers.

Do any of These Options Meet My Needs?
A Guide to Health Insurance Options for New York City's Small Businesses, and Working Individuals (in PDF) helps you examine how these options may meet the needs of your business. This Guide also offers tips on how to select a health insurance plan.

You can also use the pre-screening tool for small businesses and working individuals. The tool allows you to pre-screen for potential eligibility for the special options noted above. 

Purchasing Coverage through an Association
If you are a sole proprietor and purchase your insurance coverage through an association, you may be able to purchase the same coverage that would be available to a group that purchased coverage through the association. In order to be eligible to purchase the same insurance products that are offered to groups, an insurer may require a sole proprietor to present documentation verifying that all employees electing health insurance are legitimate employees of the employer.

The documentation requirements are set forth in sections 3231 and 4317 of Insurance Law as amended by Chapter 557 of the Laws of 2002. Insurers must accept the required documentation you submit. Beyond that, insurers cannot require other forms of documentation without the prior approval of the State Insurance Department. However, if you are unable to submit one of the forms of required documentation, insurers may, at their discretion, accept other forms of documentation. In addition to the documentation requirements, an insurer may also require a sole proprietor to work at least twenty hours per week to be considered for the group coverage.

Finally, insurers are allowed to require that you be a member of the association group or a Chamber of Commerce for at least sixty days prior to the date that their coverage would become effective. Insurers may, at their discretion, impose a lesser timeframe or waive the sixty-day membership requirement in its entirety, so long as such action is uniformly applied to all sole proprietors applying for coverage through an association group. The rates for this coverage may not exceed 120% of the corresponding group rate for the same coverage. If you have questions about purchasing plans through an association, contact the New York State Insurance Department

Public Health Insurance Options for Individuals and Families
New York State offers free and low-cost public health insurance programs that can help pay health care cost for you and your family.
  • Children under age 19 may be eligible for either Child Health Plus A (children's Medicaid) or Child Health Plus B. Almost all children can qualify, regardless of their immigration status.

  • Adults aged 19 to 64 who have limited incomes may be eligible for Medicaid or Family Health Plus.
You can find out if you are eligible for Medicaid, Family Health Plus or Child Health Plus by using HealthStat's on-line pre-screening tool. This tool allows you to find out if you or your family qualifies financially for public health insurance programs. Additionally, you can request a public health insurance application kit, which include a list of places where you can go to enroll.

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Welcome to the HealthStat pre-screening system for health insurance. The pre-screening system serves both individuals and families living in New York City. This system can help you find out if you and your family qualify financially for public and private health insurance options.

Begin Pre-Screening
Access NYC
Visit www.nyc.gov/
accessnyc
, a free Web site where New Yorkers can screen for eligibility and get information for City, State, and Federal benefits and programs. Learn how to apply, what documents to bring, where offices are and how to get there, and even print partially completed applications. Visit ACCESS NYC online anytime, from any computer with an internet connection. Benefit Information. One Place.


Access NYC
 
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