What Health Insurance Pool In New York Can I Swim In?

An insurance pool is a term that is used by the insurance industry to describe risk classification for a certain group that meets certain criteria. To an insurance company we are all classified based on certain factors as to what pool we belong in. For Health insurance it’s much easier to just describe the pool in terms of a marketplace, so for the sake of understanding the term marketplace will be adopted. Being that NY is a Community rated state (please see the article Factors that Effect Health Insurance Rate Increase), the amount of health insurance markets is limited to 4. Each marketplace only uses a factor of working status as to describe which market you belong in. The 4 insurance markets are the individual market, the self employed market, the small group of 2-50 employees and the large group market of 51+ employees.

For the self employed in New York, the two health insurance markets that you can join are the individual and the sole proprietor market. Insurance companies by law in New York must offer health insurance to any consumer that requests it, however based on price it’s just too costly for most to afford. If you’re interested in receiving rates for the individual market just follow the link www.ins.state.ny.us/acrobat/newyork.pdf or contact any New York insurance company direct. Single Rates currently vary from $650 to $1,000 per month (yes for single coverage). Based on rates alone, the individual market is a last resort.

With The Exception of Healthy NY health insurance (a state mandated program that all insurance companies must participate in) Self Employed health insurance plans are not sold directly by insurance companies. Rather, Insurance companies contract with business associations or insurance trusts to offer certain health insurance plans to members of the trust or association if they meet eligibility criteria. In most cases the business association member must be self employed, working full time and be able to verify self employment income through tax documentation. If they qualify then that member becomes part of the self employed health insurance pool managed & governed by that particular association. A member must pay association dues, usually ranging from $30 to 60 per year for a member.

Though there are several business associations that offer self employed plans, only a few insurance companies participate. Unlike the individual market, Insurance companies aren’t required by law to offer health plans to the self employed. Currently, the insurance companies that make plans available to New York Business Associations are Easy Choice health plans, GHI, HIP, MDNY, VYTRA, and PerfectHealth & Oxford. Rates for single coverage currently vary from $200 per month to over $595 for single coverage. For complete rate information please follow the link www.nyhealthinsurer.com