Understanding Child Health Plus in New York: A Guide for Working Families
When it comes to employer-sponsored benefits, most conversations focus on the employee — but what about their children?
In New York State, Child Health Plus (CHPlus) offers affordable, comprehensive coverage to children under 19, regardless of whether the parent receives health insurance through work. If you're an employee, HR manager, or small business owner, understanding how Child Health Plus fits into the larger benefits picture can help support your team and their families.
What Is Child Health Plus?
Child Health Plus is a state-sponsored health insurance program for children in New York. It’s administered by private insurance carriers but overseen and partially funded by the New York State Department of Health and the federal Children’s Health Insurance Program (CHIP).
There are no deductibles, no copays, and no coverage limits for eligible services.
There are two versions:
- CHPlus A: For families who qualify for Medicaid (lowest income).
- CHPlus B: For families who don’t qualify for Medicaid but still need help affording care.
Who Qualifies?
Eligibility is based on:
- Age: The child must be under 19.
- Residency: Must live in New York State.
- Citizenship: U.S. citizens and certain legal immigrants.
- Income: Household income must fall below certain thresholds.
2025 Income Guidelines for CHPlus B:
| Household Size | Annual Income Limit (for subsidized premium) |
|---|---|
| 2 | $52,000 |
| 3 | $65,500 |
| 4 | $79,000 |
| 5 | $92,500 |
If a child does not qualify for free coverage, families pay a monthly premium based on income — ranging from $9 to $60/month per child, with a maximum of $180/month per family.
What’s Covered?
Child Health Plus includes comprehensive medical, dental, and vision benefits, often with better coverage than typical high-deductible employer plans.
Covered services include:
- Routine doctor visits and checkups
- Vaccinations and preventive care
- Hospital care and emergency services
- Prescription medications
- Dental cleanings, fillings, orthodontics
- Vision exams and glasses
- Mental health and substance abuse treatment
No copays. No deductibles. No surprise bills for covered services.
Can an Employee Still Enroll Their Kids If They Have Job-Based Insurance?
Yes — and this is key.
Child Health Plus is available even if the parent receives insurance through work, as long as:
- The child is not eligible for Medicaid.
- The household meets the income guidelines.
Many families find it more cost-effective to:
- Cover the employee on the group plan
- Enroll children in Child Health Plus
This can be a better option when the employer doesn’t contribute to dependent premiums.
Why Should Employers & HR Teams Care?
Even if you're not directly offering CHPlus, understanding it allows you to:
- Support employees with budget-friendly options
- Reduce financial strain when your plan doesn’t cover dependents well
- Improve morale and retention
Consider including a link to NY State of Health in your onboarding materials or open enrollment packets.
How to Apply
Not sure if your family qualifies? Benton Oakfield can help.
We work with families across New York to determine eligibility, compare options, and complete enrollment in programs like Child Health Plus.
To get started:
- Visit our website at bentonoakfield.com
- Call us at (631) 555‑1212
- Email us at benefits@bentonoakfield.com
We’ll walk you through the steps, gather the right documents, and help you understand how CHPlus fits into your overall benefits strategy — whether you're an employee, employer, or broker.
Our goal is to make healthcare access simpler for working families.
Final Thoughts
Child Health Plus is one of the most generous children’s health programs in the country — and many working families don’t realize they qualify. Whether you're an employee, employer, or broker, it's worth understanding how CHPlus fits into your benefits strategy.
At Benton Oakfield, we believe employee benefits should support the whole family.
Let’s build a smarter, more inclusive plan — together.
Posted by Benton Oakfield Benefits — helping New York businesses build better benefit plans since 2017.