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Small Group Healthy New York Application And Forms Updated For 2025

The Healthy New York (HNY) maximum wage has been increased to $53,650 and the HNY New Business form and HNY Recertification form have been updated. Please use the new forms (linked below) moving forward to reflect the new wages.

If you have any questions on the Healthy New York – New Group Application or Recertification Form, please contact your broker or account manager or dedicated underwriter.

HNY Updated New Group Application (PDF)

HNY Updated Recertification Form (PDF)

For future reference, the forms can also be found online at:

 
 
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Tax Form 1095-B

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