How many employees do I need for group health insurance in New York?

Usually 2, including at least one employee who isn't an owner or an owner's spouse. Prescience works with New York groups of 2 or more employees.

Can Prescience cover employees outside New York?

Yes. Prescience covers teams across all 50 states, and the carrier network is national.

Can small businesses in New York self-fund health insurance?

Traditional self-funding is effectively closed to small groups because New York Insurance Law § 3231(h) bans stop-loss coverage for them.

What is New York's continuation coverage law?

Employers with fewer than 20 employees must offer continuation coverage for up to 36 months, at up to 102% of the plan's cost.

Why don't New York premiums vary by age?

New York requires community rating in the small group market, so premiums can't vary by age or health status within a region.

Small business health insurance in New York

New York runs one of the most regulated small group markets in the country. Plans are community-rated, small group runs up to 100 employees, and state law bans stop-loss insurance for small groups, which rules out the level-funded plans many brokers sell elsewhere. Here's what that means for a New York startup.

By Aditya Jain, MD, Cofounder and COO, PresciencePublished October 3, 2026

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Small group size: 1–100 employees
State continuation: 36 months, under 20 employees
Small-group stop-loss: Prohibited
Rating: Community-rated

Small business health insurance in New York (Prescience guide by Aditya Jain, MD)

The rules that matter in New York

New York rules for employer health coverage
Rule	What it means
Small group definition	1–100 employees since January 1, 2016.
Community rating	Small group premiums can't vary by age or health; everyone in a region pays the same rate for the same plan.
State continuation	Employers with fewer than 20 employees must offer continuation coverage for up to 36 months at up to 102% of cost.
Stop-loss ban	Insurance Law § 3231(h) prohibits stop-loss, catastrophic or reinsurance coverage for small groups, so small employers can't self-fund in the usual way.
NY State of Health	The state's marketplace, including small business coverage.

What it means for your company

Community rating protects older and sicker employees, which I think is the right instinct. But it also means a young New York startup pays the same premium as everyone else in the pool, and the stop-loss ban closes the usual escape hatch of level-funding. Most small New York companies end up on a fully insured plan or a PEO.

That's why it pays to compare carefully here. We'll walk you through exactly what your New York plan covers and what it costs before you sign.

How a Prescience plan works in New York

At Prescience, we design and run your company's health plan, from setup and enrollment to claims, compliance and COBRA. What your team gets:

An effective $0 deductible, so the plan helps from the first visit.
Simple copays shown before a visit, capped by a low out-of-pocket maximum.
A broad national PPO network, plus providers we contract with directly.
24/7 physician-led care navigation: a care team that finds the right provider, books appointments and explains costs up front.

What your company gets: one monthly cost set in your quote, usually 10–20% below comparable fully insured coverage and fixed before the plan starts, with no admin fees. You keep your payroll provider, and the plan can start mid-year.

We work with New York employers of 2 or more employees, and with distributed teams that have employees in New York and other states.

See what your team would pay with Prescience

Answer a few questions about your team and get a quote in about 60 seconds, or talk it through with one of our benefits experts.