Finding health insurance for Sole Proprietors in NY is difficult. NY has banned the formation of association health plans for small businesses, including sole proprietors. The good news is there are some options available if you happen to meet certain criteria.
NY requires a business set up as a Sole Proprietorship to get insurance in the INDIVIDUAL Marketplace. They do NOT qualify for the small group marketplace.
Unfortunately, some other businesses who traditionally were not considered sole proprietors are now getting caught up in its definition for the purposes of group health insurance eligibility. We call this the owner only problem. It happens when a small business owner or the owners spouse are the only one(s) enrolled on the health insurance. There could be other eligible employees who waive coverage but since only the owner is joining, most carriers consider this situation to be a Sole Proprietor. And by the definition described above, they are not eligible for group health insurance.
There are some caveats however where you can get health insurance for sole proprietors in NY. You can avoid the Sole Proprietor status and enroll in a small business health plan for the owner only if you:
- Have a corporation and have at least one other shareholder who is not your spouse. They can waive with other coverage.
- Have a corporation where only the owners wish to join, as long as one of the owners in not married to each other
- You are the sole shareholder of an S or C-Corp and you add a Medicare aged parent or in-law. Assign them 10% or more of the shares. They can waive coverage with Medicare and you can enroll as an owner only onto a group health plan.