Healthy NY
Healthy NY is a program designed to help promote comprehensive and quality health care for small business owners and their employee’s. The Healthy NY program also helps sole proprietors and those whose employers do not provide health insurance for them. The Healthy NY program was spawned after the passage of the Health Care Reform Act of 2000 which was created to insure a greater number of people could get access to health care insurance in the state of New York.
Healthy NY includes benefits that cover essential health needs including inpatient and outpatient hospital services, physician services, maternity care, preventative health services, diagnostic and x-ray services, and emergency services. Applicants may now choose a benefit package with a limited prescription drug benefit or a benefit package without a prescription drug benefit.
Vista Health Solutions and NYHealthInsurer.com strongly promote the Health NY program and offer several quality health plans to those who qualify. By filling out the form to the right and selecting the “under” option for income level you can see free quotes of the Healthy NY plans which NYHealthInsurer.com offers depending upon the other variables selected such as location and individuals to be covered under the policy. Vista Health Solutions deals mainly with the Empire Healthy NY and Oxford Healthy NY health care plan providers to bring you the most comprehensive coverage possible at the lowest prices.
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Download our Healthy New York Insurance Informational Guide.May require PDF Reader. |
Here is a breakdown of annual income requirements in order to qualify for the program:
| Individuals to be Insured |
Annual Income |
| Applicant |
below $27,084 |
| Applicant and Spouse |
below $36,432 |
| Applicant and Child |
below $36,432 |
| Applicant and 2 Children |
below $45,780 |
| Family (Applicant, Spouse and 1 Child) |
below $45,780 |
| Applicant and 3 Children |
below $55,128 |
| Family (Applicant, Spouse and 2 Children) |
below $55,128 |
| Family (Applicant, Spouse and 3 Children) |
below $64,476 |
| Applicant and 4 Children |
below $64,476 |
| Family (Applicant, Spouse and 4 Children) |
below $73,836 |
| *add $9,360 per year for each additional individual | |
More information concerning the Healthy New York Program.
| The following are some of the carriers offering Healthy New York (Healthy NY) Insurance plans through Vista Health Solutions: | |
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You are welcome to browse our Healthy NY health care options at no obligation by using the form to the right. If you do not qualify for the Healthy NY program NYHealthInsurer.com offers a wide variety of other comprehensive health care plans for the self employed of New York State.
Here are a few resources related to the Healthy NY Program:
![]() |
Download our Healthy New York Insurance Informational Guide. May require PDF Reader. |
Healthy NY For New York State
Health Care Reform Act of 2000
| NY | US | |
|---|---|---|
| Adults 19-64 Overall Employer-based Insurance Private Individual Insurance Medicaid/Other Public Uninsured |
58.0% 4.8% 17.6% 19.6% |
59.0% 5.7% 12.8% 22.5% |
| Adults 19-64 with Children Employer-based Insurance Private Individual Insurance Medicaid/Other Public Uninsured |
63.6% 3.4% 18.5% 14.0% |
64.0% 4.3% 13.0% 18.3% |
| Adults 19-64 without Children Employer-based Insurance Private Individual Insurance Medicaid/Other Public Uninsured |
55.2% 5.4% 17.0% 22.4% |
56.0% 6.5% 12.8% 24.8% |
The data above shows a comparison of the distribution of coverage in New York and nationally. Every year the Census Bureau conducts a survey regarding American families health insurance status and the kind of health plan they have.
The respondents of the survey were individuals aged between 19 and 64. This is the age group that Healthy NY enrolls. The survey indicates that the number of individuals enrolled through an employer sponsored health insurance plan in New York is the same with that in the national level.
The rate of uninsured in New York is a little lower than the rate across the nation. A lot of the insured in New York are enrolled in government-sponsored health insurance programs like Medicaid, Family Health Plus, Healthy NY. But the rate of uninsured has increased both in New York and the US. The uninsured rate in New York has increased by 1.5% while at the national level the increase is at 1.2% (for those with children) and 1.6% (for those without children).
| NY | US | |
|---|---|---|
| Adults 19-64 | 19.6% | 22.5% |
| By Employment Status At least 1 full-time worker Part time workers Non workers |
14.0% 26.4% 21.6% |
15.0% 33.4% 30.5% |
| By household income (percent of the federal poverty level) Under 139% FPL 139% – 250% FPL 251% – 399% FPL Over 400% FPL |
32.7% 26.8% 15.9% 14.1% |
46.0% 25.8% 13.0% 9.5% |
Overall New York has a lower number of uninsured when compared to that of the entire country. Improvement is seen among the working individuals in New York particularly among part-time employees. It has gone up from 24.7% to 26.4%.
Among low income individuals, New York has a much lower uninsured rate. But among higher income residents, New York’s uninsured is higher. Burns & Associates, Inc. (B&A) attributes this to the state’s generous Medicaid policies compared to other states
Source of table: http://www.statehealthfacts.org/comparecat.jsp?cat=3
The table below reflects members’ and employers’ feedback regarding Healthy NY. Burns & Associates, Inc. (B&A) conducted two surveys, one for business owners and one for individuals. The surveys were designed in such a way that respondents covered all the various health plans, regions, number of years enrolled in the Healthy NY program and product selection.
The survey for employers had 18 questions and the member survey had 16 questions. Most of the questions in both surveys were the same. Surveyees were asked to rate their satisfaction of the Healthy NY program in these aspects: cost, customer service and application process. They were asked to indicate their degree of satisfaction from very satisfied to somewhat satisfied. The table below reflects the survey result and you can compare them with last the previous year’s satisfaction rate.
Percentage of Respondents who are Very Satisfied or Somewhat Satisfied




| 2010 | 2009 | Percentage Point Difference | |
|---|---|---|---|
| Overall Impression Business Owners Sole Prop/individuals |
72% 73% |
61% 61% |
+11% +12% |
| Cost Business Owners Sole Prop/individuals |
53% 47% |
46% 39% |
+7% +8% |
| Customer Service Business Owners Sole Prop/individuals |
80% 80% |
60% 66% |
+20% +14% |
| Application Process Business Owners Sole Prop/individuals |
80% 80% |
64% 65% |
+16% +15% |
Every year Healthy NY conducts a survey to check how members feel about being part of this health insurance program. This information is included in their annual report. The survey was conducted by Burns & Associates, Inc. (B&A) during the summer of 2010.
The survey was given to 12% of sole proprietors and working individuals who enrolled as of March 2010. This totals to 8,685 members. The following variables were included:
- enrollment whether enrolled as a sole proprietor or a working individual, health plan carrier;
- county of home address;
- year of enrollment;
- age;
- gender;
- Healthy NY plan selected
Burns & Associates, Inc. (B&A) collected information from both the Insurance Department and insurance carriers from whom more than 1% of the Healthy NY members are enrolled.
The table below shows how the respondents applied for the program. Results are very similar to the previous year.

The plan’s premium rates played a major role in the respondent’s decision-making in terms of health plan choice.

Respondents were asked to rate their satisfaction with regards to their overall Healthy New York experience (taking into consideration the cots, customer service and the application process. They were asked to rank their level of satisfaction and the result is as follows:

Members are more satisfied now (2010, when the survey was conducted) than in the previous year.
In the comments section however, members indicated several aspects where members are not happy such as the prescription limit ($3000 per coverage year), no coverage for dental, mental, vision and chiropractic care, annual physical that’s limited to one in three years.
Enrollment in the Healthy NY program has increased as follows:
- 3.6% in 2008
- 3.5% in 2009
- 3.3% in 2010
Every month, there are about 3.9% and 8.6% new Healthy NY members. On the other hand discontinuation rate is between 3.5% and 7.3%. But rates for new members and discontinuing members are not that accurate. Some members discontinue their current plan and transfer to another plan from a different insurance company. This doesn’t mean however that they have already left the Healthy NY program.
Average Contract Size by Member Type, July 2010
| Small Buiness Employees | Sole Proprietors | Individuals | Total | |
|---|---|---|---|---|
| Subscribers | 35,592 | 13,886 | 68,547 | 118,025 |
| Dependents | 22,095 | 8,199 | 16,386 | 46,680 |
| Total enrollment | 57,687 | 22,085 | 84,933 | 164,705 |
| Dependents as Percent of Total | 38% | 37% | 19% | 28% |
| Average Contract Size | 1.62 | 1.59 | 1.24 | 1.40 |
The average contract size was 1.40 members. An average contract includes the policyholder and his/her dependents. Individuals have a lower contract size compared to sole proprietors or members of employer-sponsored plans.

Majority (51%) of the Healthy NY members are individuals; 13% are sole proprietors and 36% were enrolled in group plans of small businesses. The table above gives you a picture of the membership information of health plan providers. It is noticeable that the distribution of member types vary among providers. There are some providers like MVP and GHI where majority (50%) of their members are small businesses groups.
From 2006 to 2010, small business membership has grown from 27% to 35%. But the sole proprietors’ population decreased from 17% to 13%. The same is true for individuals. Membership has decreased from 56% to 52%.
In terms of product selection, HMO plans without prescription have been gaining popularity in the recent years. It has become a popular choice among sole proprietors and individuals. High deductible products on the other hand remain to be unpopular. See table.
Healthy NY Product Selection
| HMO w/ Prescription | HMO w/o Prescription | HDHP w/ Prescription | HDHP w/oPrescription | |
|---|---|---|---|---|
| Individuals | 68% | 22% | 4% | 6% |
| Sole Proprietors | 63% | 30% | 3% | 4% |
| Small Business | 84% | 14% | 1% | 1% |
| Small Business Groups | 82% | 16% | 1% | 1% |
The table below shows you the membership distribution for every region in contrast with the regions’ population. Capital District Region, Hudson Valley and Long Island have a higher percentage of membership compared to the region’s population percentage.
Comparison of Regional Population to Healthy NY Membership
| Region | State Population (July 2009) Percent of Population |
Healthy NY Membership (July 2010) Percent of Members |
|---|---|---|
| Capital District | 7% | 9% |
| Central NY | 6% | 6% |
| Hudson Valley | 11% | 14% |
| Long Island | 15% | 23% |
| New York City | 43% | 28% |
| North Country | 2% | 2% |
| Southern Tier | 4% | 3% |
| Western NY | 12% | 13% |
| Out of State | 1% |
