New York State of Health announces plans for 2016


Today the New York State of Health Marketplace announced which health insurance carriers will be offering plans on the Marketplace for 2016. This encompasses Qualified Health Plans for both individuals and small businesses, the new Essential Plan, and stand-alone dental plans.

The 200,000 individuals who hold policies with Health Republic will have to go shopping for new plans when Open Enrollment begins on November 1st. The CO-OP is winding down operations and no longer issuing renewals. The good news is that sixteen carriers will offer individual QHPs in 2016, and eight for the Small Business Marketplace (SHOP). The definition of a small business is new for 2016: firms with 100 or fewer full time equivalent employees can use SHOP – up from 50 employees in 2015.

While insurers and consumers alike are new to the Essential Plan, there is a strong show of support with 13 carriers offering plans for 2016. Consumers can use this interactive map to see which plans are offered in their county. Some counties, like the Bronx, have eight plans on offer, while New Yorkers in other counties, like Putnam and Schoharie, will only have one plan option if they qualify for the Essential Plan.

The stand-alone dental market is largely the same as 2015, with 11 carriers offering plans, 3 of which offer plans in every county in the state. The maps for dental, individual, and small business plans are available here.



Over 2.1 million New Yorkers have enrolled in quality coverage since the New York State of Health marketplace’s launch in 2013! Yesterday the New York State of Health released its report on the second open enrollment period, which ran November 15, 2014 through February 28, 2015. HCFANY is excited to dive into the numbers over the course of the coming weeks; we’ll share our analysis with you via this blog series, on twitter (@HCFANY), and Facebook.

The New York State of Health (NYSOH) goal was to enroll 1.1 million New Yorkers in health coverage in its first three years of operation. It’s an amazing accomplishment that almost double that number of people have been enrolled in only two years! On the individual market, enrollment has soared from less than 18,000 people before the marketplace opened (2012) to 450,000 in 2015.[i] And the marketplace continues to meet a critical need; over 89% of enrollees reported being uninsured when they applied.2015 Infographics - Qualified Health Plans

The marketplace is also succeeding in making coverage more affordable. Nearly three quarters of enrollees (74%) in the commercial plans – called Qualified Health Plans (QHPs) – received premium subsidies, which help bring down premium costs for middle-income people.

Of the 2,143,413 New Yorkers who have used the marketplace, 73% enrolled in Medicaid, and 95% of those consumers were uninsured at the time of application. We’re already gearing up for the third open enrollment period, which begins November 1, 2015!

This is the first in a series of blog posts about the NYSOH 2015 Open Enrollment Report.




NY State of Health

Yesterday, the New York State Department of health unveiled the new name of our Health Benefit Exchange – NY State of Health, The Official Health Plan Marketplace – in an information-packed webcast.

In addition to announcing the new name and logo, Donna Frescatore, Executive Director of the New York Health Benefit Exchange, announced the names of the health plans that will participate in the NY State of Health. An interactive map  posted on the new website (  lists the plans that will be offered in each county around the state.

In addition, NY State of Health debuted a new video to educate New Yorkers about the new marketplace.


read this!This week, the State-sponsored report on how to reduce health disparities through the New York Health Benefit was released, outlining a myriad of recommendations culled from a stakeholder meeting held back in September.

These recommendations track three core themes discussed at the stakeholder meeting: 1) consumer assistance, 2) network adequacy, and 3) data collection.  Recommendations are discussed in detail based on stakeholder comments, panel presentations and research models employed in other parts of the country.  These include:

1. Consumer assistance:

  • Language access and communication assistance
  • Language accessibility guidelines for insurers
  • Plain language
  • Availability of decision-making support tools
  • Sensetivity training for consumer assistors
  • Creating Exchange website and materials that have an inclusive look and feel
  • Diverse channels for consuemr outreach
  • Selection of trusted community entities to serve as Navigators

2.  Network adequacy:

  • Sufficient number of specialists
  • Sufficient providers for AI/AN communities
  • Sufficient providers with accessibility accomodations
  • Sufficient providers with linguistic ability

3. Data collection and dissemination

  • Collection of data
  • Dissemination of data

The report is available at the State Exchange website at: