How Much Is Small Business Health Insurance in NY? Updated 2024
According to the 2024 Data from the NY Health Exchange, the average Bronze-level monthly premium is $849 for a single employee and $2420 per family. The average deductible is $7350 for a single employee and $14,700 per family.
What is NY SHOP? Who is qualified and who is not?
The Small Business Marketplace, also known as SHOP, is a platform designed to aid employers in providing high-quality, affordable health insurance coverage to their employees. This insurance coverage is offered directly from New York State of Health certified insurers.
To qualify for SHOP, certain criteria need to be met:
- Eligible businesses or non-profit organizations must have a physical business location within New York State
- Employ between 1 and 100 Full-Time Equivalent (FTE) employees.
- Should offer, or plan to offer, coverage to all their full-time employees.
To qualify for the Small Business Health Care Tax Credit (up to 50% of premiums) is particularly beneficial for employers who:
- Have less than 25 full-time equivalent employees and
- Pay average wages of less than $58,000 a year for the 2022 tax year per FTE employee.
- Eligibility also requires these employers pay at least 50% towards the available lowest-cost individual medical coverage.
- Offer SHOP coverage to all full-time employees who work at least 30 hours per week.
Small Business Health Insurance Premiums Average for 2024
There are four tiers of small group premiums available in the SHOP marketplace - Bronze, Silver, Gold, and Platinum. These tiers offer different coverage levels and costs. For example, the monthly premium for a single Bronze plan is $849, while a Platinum plan for a couple with a child is $4,014. These rates allow small businesses to select a plan that best fits their budget and coverage needs.
Monthly premium per employee
| Tier | Single | Single + Child | Couple | Couple + Child |
|---|---|---|---|---|
| Bronze | $849 | $1,698 | $1,443 | $2,420 |
| Silver | $976 | $1,952 | $1,659 | $2,782 |
| Gold | $1,186 | $2,373 | $2,017 | $3,382 |
| Platinum | $1,408 | $2,816 | $2,394 | $4,014 |
For example, if you are planning to cover 10 employees, half have families and half don't, and plan to contribute 60% toward their premiums.
Am I Required to Offer Health Insurance?
Under the Affordable Care Act (ACA), small businesses are not legally required to provide health insurance to their employees. The Employer Mandate of the ACA applies only to large businesses with 50 or more full-time equivalent employees. These employers must provide health insurance to at least 95% of their full-time employees and dependents up to age 26, or pay a fee. However, many small businesses choose to offer health insurance to attract and retain employees, and to take advantage of tax credits.
Can I Offer Health Insurance Via SHOP But Contribute Less than 50%?
No, one of the eligibility criteria for the Small Business Marketplace (SHOP) and the Small Business Health Care Tax Credit is that an employer must pay at least 50% towards an employee's available lowest-cost individual medical coverage. This requirement is in place to ensure that employers make a significant contribution towards their employees' health insurance costs. Failure to meet this requirement may result in ineligibility for the SHOP program and the associated tax credit.
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The Mira Research team conducts original data and medical research on the most applicable topics of today and translates them into easy-to-understand articles to educate the public. Each of our articles is carefully reviewed and curated with interviews and opinions from medical experts, public health officials, and experienced administrators. The team has educational backgrounds from New York University, the University of Virginia, more.