Plans through NY State of Health, employer group coverage from level-funded to ICHRA, plus Medicaid and Essential Plan context — all under one DFS-regulated platform with broker support from NYC to Buffalo to Rochester.
Benefitra is the parent platform for benefits brokerage, HR SaaS, marketing, and decision-support tools. New York employers can adopt one pillar or stack them.
Seven funding paths: fully-insured, level-funded, self-funded, ICHRA, PEO-integrated, captive, Taft-Hartley.
Compare paths →Lead-engine and rankings for growing employers. Page-2-to-page-1 in months.
See trajectories →New York health plans give consumers and employers more options for dependable health insurance coverage. These options match different budgets and needs.
Individual and family plans. New York operates its own state-based exchange — NY State of Health — one of the original 2014 SBEs. Plans are ACA-compliant qualified health plans regulated by the New York Department of Financial Services (DFS), which uniquely combines insurance and banking regulation. New York's uninsured rate is 4.8% (2023 ACS), among the lowest in the nation, supported by the Essential Plan and broad Medicaid coverage.
Qualified health plans, Essential Plan, and subsidies. NY State of Health offers QHPs with federal premium tax credits and also operates the Essential Plan, a Basic Health Program (BHP) under ACA Section 1331 for households earning 138-250% FPL. Essential Plan members pay $0 or $20 per month with full essential benefits and no deductible — a benefit unavailable in most other states. Open enrollment runs Nov 16 – Jan 31, and special enrollment applies to qualifying life events.
New York Medicaid. New York Medicaid is administered by the New York State Department of Health Office of Health Insurance Programs and covers eligible low-income adults, children, pregnant individuals, seniors, and people with disabilities. New York expanded Medicaid under the ACA effective January 1, 2014, raising the income limit for adults to 138% FPL. The state also stacks the Essential Plan on top of Medicaid expansion to extend low-cost coverage further up the income scale.
Employer group plans in New York. New York employers with 1 or more employees can offer group health insurance year-round (New York guarantees small-group access at 1+ employees). New York's community-rated small-group market means premiums don't vary by health status or claims experience, which makes level-funded and self-funded arrangements particularly attractive for healthy mid-market employers across NYC, Buffalo, and Rochester. Benefitra's Funding-Fit Discovery models the math across all seven arrangements.
Sam helped our New York team navigate community-rated small group and find a level-funded path that worked for our healthy roster.
ICHRA opened a real option for our Brooklyn team — fixed contribution, individual plan choice through NY State of Health, no underwriting surprises.
Switching to the Essential Plan through NY State of Health cut our family premium dramatically. Benefitra walked us through eligibility.
Marketplace, Medicaid, group plans, and ICHRA. Common New York-specific questions for families and employers.
Answer twelve short questions. We grade your fit across the seven funding arrangements — fully-insured, level-funded, self-funded, captive, ICHRA, PEO-integrated, and Taft-Hartley.
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