Guide to Enrolling with NY State of Health(The Marketplace)



Individuals and families with incomes at or below certain levels ($47,080 for individuals and $97,000 for a family of four) may be eligible for financial assistance in the form of federal tax credits to help them pay for the monthly cost of coverage. In 2014, nearly three-quarters of individuals and families qualified for this financial assistance.

New Yorkers may use the calculator on the New York State of Health website (nystateofhealth.ny.gov) to estimate their eligibility for tax credits:

NY State of Health Calculator

Once you have determined your eligibility for premium tax credits, please follow the steps below to create your profile. If you do not qualify for a tax credit, please contact our office for other Individual plan options.

  1. Have your 2016 Federal income taxes available as you will need to enter information from these documents. Also have your 2017 income to date available
  2. Have additional information available (1)
  3. Go to: NYSOH%20Logo
  4. Select Individuals & Families
  5. Select Get Started, Click Here to Register and create your government ID
  6. Once you have a government ID, log onto the site and begin entering information to create your account
  7. On the left side of the page under "Options" you will see a link for "Manage Broker/Navigator"
  8. Click on this link and under Agency, please select the following agency:
    Century Enrollment & Benefit Services LLC
  9. Once completed, please contact us via phone or email to review the available plans and help you select the coverage that meets your needs
  10. For a list of Frequently Asked Questions(FAQ), go to: NY State of Health FAQ
 

Here are four things to remember about how your income affects your premium tax credit:

  • The amount of the premium tax credit is based on a sliding scale, with greater credit amounts available to those with lower incomes.
  • If the advance credit payments made on your behalf are more than the allowed premium tax credit, you will have to repay some or all the excess.If your household income is 400 percent or more of the federal poverty line for your family size, you will have to repay all of your excess advance credit payments.
  • If your projected household income is close to the 400 percent upper limit, be sure to carefully consider the amount of advance credit payments you choose to have paid on your behalf.
  • If your household income on your tax return is more than 400 percent of the federal poverty line for your family size, you are not allowed a premium tax credit and will have to repay all of the advance credit payments made on behalf of you and your tax family members.
 

For purposes of claiming the premium tax credit for 2016, the following table outlines household income that is at least 100 percent but no more than 400 percent of the federal poverty line.

 

This table applies only to residents of the 48 contiguous states and Washington, D.C.:

Federal Poverty Line For 2016 Returns
100% of EPL 400% of EPL
One Individual $11,770 up to $47,080
Family of Two $15,930 up to $63,720
Family of Four $24,250 up to $97,000
 

The federal poverty guidelines are sometimes referred to as the “federal poverty line” or FPL. The Department of Health & Human Services determines the federal poverty guideline amounts annually. You can find all of this information on the HHS website.




(1)What do I need to apply for coverage through the Marketplace?


We ask about income & other information about you to tell you what coverage you qualify for and if you can get help paying for it. We keep all of the information you provide private, as required by law. For everyone applying for help paying for your insurance through the Marketplace, you may need:

  • Social Security numbers (or document numbers for legal immigrants who need health insurance)
  • Birth dates
  • Employer and income information for everyone in your family
  • Policy numbers for any current health insurance
  • Information about any job related health insurance available to your family