NY State of Health Announces "SHOP"-ping Just Got Easier in New York State

Expansion of State's Small Business Marketplace Results in 4 New Insurers

Over 300 Percent Increase in Total Plan Options Offered

ALBANY, N.Y. (April 5, 2018) - NY State of Health, the state's official health plan Marketplace, today announced significant changes to the Small Business Marketplace (SHOP) to make it easier for New York's small businesses to access federal small business tax credits. Four new health insurers will now be included in the SHOP 2018 health plan line-up: CDPHP, Emblem, Healthfirst, and Oscar. In addition, three insurers already participating in SHOP, Excellus, MVP Health Care, and Univera, will offer additional plan options starting today.

"Our goal has always been to make it easy for New York's small businesses to access the federal tax credits they are entitled to," said Donna Frescatore, Executive Director. "When federal rules changed, we saw the opportunity to make it easier for small businesses to access these credits and expand the number of products for which tax credits could be claimed, so we moved forward quickly."

Through the NY State of Health SHOP expansion, 1,600 new Qualified Health Plan options will be available through the SHOP. Small businesses will have a choice of at least two insurers in every county of the state and up to five insurer choices in certain counties. With these changes, small businesses on Long Island will now have SHOP options – three insurers in Nassau County and two insurers in Suffolk County.

Starting today, New York State small businesses newly applying for SHOP coverage will complete only a short application through NY State of Health and enroll in SHOP-certified plans directly with insurers. NY State of Health certified brokers and navigators will continue to be available for assistance. If determined SHOP-eligible, the employer will receive a certification from NY State of Health documenting its eligibility for federal tax credits when enrolled in any one of the Qualified Health Plans shown on the NY State of Health Marketplace. Prior to this change, small businesses were only able to access federal tax credits if they enrolled through the NY State of Health web portal and selected from a limited number of plans.

NY State of Health's SHOP is open to businesses with 100 or fewer full-time-equivalent employees. Under federal law, federal small business tax credits are available to businesses with fewer than 25 full time equivalent employees with an average annual employee salary (not including the owners) of $53,000 or less in 2018, and that contribute at least 50 percent toward the cost of employee coverage, and offer coverage to all full-time employees. Tax credits are available to eligible NYS employers only when determined eligible by SHOP and when selecting a QHP certified by NY State of Health. The maximum tax credit is 50 percent of the employer contribution for employee coverage (35 percent for non-profit employers). For example, an eligible employer with 10 full time equivalent employees with an annual average salary of $50,000 would receive a tax credit equal to one-half of the amount the employer paid for premiums.

Coverage for the nearly 2,000 small businesses currently enrolled through SHOP will continue without any change throughout the remainder of their plan year. Upon renewal, these businesses will also be able to apply through the new simplified process.

The insurers participating in SHOP are:

  • CDPHP
  • EmblemHealth
  • Excellus (Excellus Blue Cross Blue Shield, Central NY; Univera, Western NY)
  • Healthfirst
  • HealthNow (BlueShield of Northeastern NY; BlueCross BlueShield of Western NY)
  • Independent Health
  • MetroPlus
  • MVP Health Care
  • Oscar