Last-Minute Group Health Insurance Deal for Small NY Businesses

If you're running a small business in New York and have been putting off group health insurance because of cost or complexity, you've got just a few days left to take advantage of a little-known ACA provision that could change everything. There's a special enrollment period ending December 15 that lets businesses with as few as two employees get access to the same high-quality group health plans that big companies offer—and your business doesn't even have to contribute a dime.

What Changed

Under the Affordable Care Act, insurers are required to offer their best group health insurance plans to small businesses during a specific window each year. This year's special enrollment period ran from November 15 through December 15, with coverage starting January 1, 2026. The key difference? You only need one employee to actually participate in the plan—even if you have more on staff. And if you're the business owner with other coverage like Medicare, you don't have to participate at all.

Here's the game-changer: employees can pay their premiums on a pre-tax basis through payroll deduction, which saves them money even if the company isn't contributing to the premium. That pre-tax treatment can reduce an employee's taxable income significantly.

Who This Affects

This applies to New York businesses with 2-50 employees who want to offer group health insurance but haven't been able to make the economics work. It's particularly valuable for:

• Professional services firms with high-earning employees who would benefit most from pre-tax premium payments
• Retail or service businesses where you want to offer benefits to attract better talent but margins are tight
• Any business where the owner has coverage elsewhere (like through a spouse's plan or Medicare) but wants to offer something to their team

Whether you're in Manhattan, Albany, Buffalo, or anywhere else in New York, the rules are the same—though the specific plans and pricing will vary by region.

What You Need to Do

• Contact a licensed broker immediately—you have until December 15 to enroll for January 1 coverage
• Gather basic employee information (names, birthdates, ZIP codes) for anyone who might participate
• Review available plans in your area and decide on contribution strategy, even if it's zero employer contribution
• Set up payroll deduction process for pre-tax premium payments

Time is critically short here. Most carriers need at least a few business days to process applications, so waiting until December 15 might be too late.

The NY Angle

New York businesses have additional advantages other states don't offer. You can purchase group coverage through NY State of Health, which provides access to tax credits for eligible small businesses. The state's Essential Plan, which we've covered before, remains an option for lower-income employees, though federal funding concerns make employer-sponsored coverage more attractive for stability.

Additionally, recent changes to ACA reporting requirements mean less paperwork hassle for small employers—you no longer have to automatically send Forms 1095-B and 1095-C to employees, just provide them when requested. That removes one of the administrative barriers that used to make small group plans more burdensome.

For NYC businesses specifically, keep in mind that the city's own employee health plan changes are creating some disruption in the individual market, which makes employer-sponsored group coverage even more valuable for recruiting and retention.

Need help navigating this? Benton Oakfield's compliance team works with businesses like yours every day. We can review your current setup and make sure you're covered. Reach out - it's what we do.

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