Documents Needed to Apply for Healthy NY
Before applying for the Healthy NY program, small business owners must gather specific documentation to verify eligibility. This guide outlines what’s required so you can prepare a complete and accurate application.
Required Business Information
- Employer Identification Number (EIN): Proof of business registration with the IRS
- Proof of NY State location: Utility bill, lease agreement, or other documents showing your primary business address
- Business structure: Whether you’re an LLC, S-corp, or sole proprietor employing W-2 staff
Proof of Employee Wages
You’ll need to verify that at least 30% of employees earn $53,650 or less annually. Acceptable documentation includes:
- Recent payroll reports or year-to-date wage statements
- W-2 forms from the previous tax year
- Employee census that includes job titles and income data
Employer Contribution Agreement
Healthy NY requires that your business contributes at least 50% of the premium for enrolled employees. You may be asked to provide a written statement or sign an agreement confirming this contribution level.
Healthy NY Documents Checklist
Here’s a visual summary of what you’ll need to complete the application process:
Common Mistakes to Avoid
- Submitting outdated payroll data (use current year figures)
- Forgetting to include part-time employee FTE calculations
- Applying without a signed contribution agreement
- Leaving out the required wage verification
Need Help with Your Application?
NY Health Insurer can help you review your paperwork, verify eligibility, and submit your Healthy NY application correctly. Call (888) 215-4045 or start your quote online.
Or return to our Healthy NY overview page to learn more.