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How to Choose a Health Insurance Broker in New York: 9 Things to Check Before You Pick One

Written and reviewed by Dick Tracy, licensed health insurance broker (NPN 20414610) · Published September 4, 2026

📅 Book a free call ✅ Jump to the 9-point checklist 💬 Text me: 716-503-1113

Quick answer Nobody gets to call themselves the best health insurance broker in New York, so do not pick one on that claim. Pick one you can verify in about 60 seconds: confirm the license on the New York DFS Producer/Licensee Search, confirm NY State of Health certification on the state's Find Local Help tool if you might qualify for a credit, and ask for the National Producer Number (mine is NPN 20414610). Then ask two questions that separate a broker from a salesperson: how many carriers are you appointed with, and will you check my doctors by name before you quote? In New York the price of a plan is the same with or without a broker, because the carrier pays the broker and the rate is filed with the state. So the only thing you are actually choosing is the quality of the advice. Here are the nine things I would check, the questions to ask, and the red flags. I educate, you decide.

I'm Dick Tracy, an independent health insurance broker in Buffalo, licensed in New York (NPN 20414610) and 24 other states, working with 80+ carriers. I write business across the whole state, Western New York to Long Island, on the phone or on Zoom with the plan documents on the screen. You will notice this page never says I am the best broker in New York. I can't, nobody can, and any page that does is a page you should close. What I can do is hand you the checklist I would use on myself. I came out of the healthcare side of this business, so there is no gag clause on me. You get the tips, the tricks, and the traps, including the ones about brokers.

Sources: NY DFS Producer/Licensee Search; NY State of Health, Find Local Help; NY Insurance Law 4224. This site is not affiliated with or endorsed by NY State of Health or the New York State Department of Financial Services.

Start here: the two lookups that take 60 seconds

Before you read a single review, check the license. New York keeps a public record of every licensed insurance producer, and the state marketplace keeps its own list of certified brokers. Both are free, both are official, and a broker who is not in the first one is not a broker.

Then ask for the National Producer Number. The NPN is a unique number assigned to every licensed producer by the National Association of Insurance Commissioners, and it follows the person across every state they are licensed in. It is the cleanest way to confirm you are talking to the actual licensed human and not a lead-generation website wearing a borrowed name. A broker who publishes it on their website and in their signature is inviting you to check. Mine is 20414610, and it is in the footer of every page on this site.

The 9-point checklist for choosing a health insurance broker in New York

Run any broker in the state through this, me included. The order matters a little: the first two are pass or fail, the rest are where the good ones separate from the rest.

1. Licensed in New York by DFS, NPN published. Pass or fail. The license lookup above answers it, and a broker who will not give you their NPN has already answered it too. Ask: "What is your NPN?" A real broker says a number, not "why do you need that?"
2. Certified with NY State of Health, if that door might be yours. New York runs its own marketplace, not healthcare.gov. Certification is what lets a broker enroll you there, keep a premium tax credit attached, and help with the Essential Plan and Child Health Plus. If your income is anywhere near the credit range, this is not optional. Ask: "Are you certified with NY State of Health?" Then check the Find Local Help tool anyway.
3. Independent, not captive. A captive agent can only sell one company's plans and will always find that one company's plan is the right one for you. An independent broker is appointed with many carriers and shops all of them. The tell is whether they can say a number. Ask: "How many carriers are you appointed with?" I work with 80+. The exact number matters less than whether they have one.
4. Checks your doctors, hospital, and prescriptions by name, in your county, before quoting. New York sets marketplace plans and provider networks county by county. Erie County, Monroe County, Onondaga County, Albany County, and the five boroughs are five different plan lists with different hospital systems behind them. A plan chosen on premium alone is how people discover in February that their kid's pediatrician is out of network. Ask: "Before you quote, will you check my doctors and my hospital by name in my county?" If they quote first and ask later, that is your answer.
5. Knows the New York rules cold. This state is different, and a broker who learned the business in Florida or from a national call script will steer you wrong here. The rules that matter: New York is community rated, so there are no health questions and no age rating on individual plans, and a healthy 30-year-old pays the same premium as a 60-year-old for the same plan in the same county. There is no medically underwritten individual major-medical market. Short-term plans are not sold here. New York continuation coverage runs 36 months, not 18, and reaches small employers federal COBRA skips. The Essential Plan covers adults up to 200% of the federal poverty level. And for 2026 the federal subsidy cliff is back at 400% of poverty with no cap on repaying an overpaid credit. Ask: "Why does a 30-year-old and a 60-year-old pay the same premium in New York?" If they cannot answer, they do not know this state.
6. Prices the doors outside the marketplace, and still tells you when the marketplace is right. For a healthy self-employed New Yorker earning too much for a credit, the one door community rating does not govern is a pre-established ERISA group plan: federal law from 1974, group rates, a true PPO network, a policy you own. Most brokers never price it. The flip side is just as important: after a recent serious diagnosis, the guaranteed-issue marketplace plan is the right door, and a broker should say so even though it is the smaller commission. Ask: "If I am healthy and over the subsidy cliff, what do you price besides the marketplace? And when would you tell me to take the marketplace instead?"
7. Tells you plainly what they will not sell, and why. The honest ones have a short list. Mine: I write Medicare Supplements and I do not sell Medicare Advantage. I do not write health-sharing ministries, because they are not insurance and no claim is guaranteed. I do not sell short-term plans or fixed indemnity plans to New York residents, because they are not approved here as major medical. A broker who will sell you anything has no opinion, and you are paying for an opinion. Ask: "What will you not sell me?" Silence is an answer.
8. Stays on your side after you enroll. Enrollment is the beginning. The value shows up in April when a bill arrives that does not match the Explanation of Benefits, or in October when the renewal letter says the math doesn't math. Ask what happens then. A good broker decodes the EOB, catches the wrong billing code, calls the carrier with you, and reviews the whole plan every fall before open enrollment. Ask: "If a claim gets denied or a bill looks wrong next year, what do you do?" and "Do you review my plan every fall?"
9. Proof and reach. Reviews with real first names and specific stories, not star counts alone. A license in the states where you might move, retire, or spend the winter, so the same person can keep you covered. And the plain question of who answers the phone: one person who knows your file, or a call center that starts from zero. In New York the price is the same either way, so this is what you are actually paying for. Ask: "When I call next year, do I get you?"

The questions to ask on the first call, in one place

Copy these into your notes. A good broker enjoys them. A bad one changes the subject.

Red flags, New York edition

• A gift for getting a quote. New York insurance law caps what a producer may give a prospect at $25 per person per year, and NY State of Health bars incentives of any kind for marketplace enrollments. A gift card for a quote is not generosity, it is a violation.
• A fee to enroll you. The carrier pays the broker, and a certified broker may not charge you for help with a NY State of Health application. If someone asks you to pay to be enrolled in a health plan, close the tab.
• Looks official, isn't. A private company using a seal, "official," "marketplace-approved," or state branding it has no right to. The real marketplace is NY State of Health. This site is not it, and neither is anyone's brokerage.
• A product that is not sold to New Yorkers. Short-term medical and fixed indemnity plans pitched as major medical. New York does not approve them as such, and a plan that cannot be sold to you legally is a plan you should not be hearing about.
• Medicare Advantage or a health-share presented as "the same thing." Both have their pitches. Neither is a Medicare Supplement, and a health-share is not insurance at all.
• A quote before a question. If the first email has a premium in it and nobody asked about your doctors, your county, or your income, the plan was picked for the broker, not for you.
• Cannot explain community rating. The single rule that makes New York different from 40 other states. If the broker cannot tell you why the healthy 30-year-old and the 60-year-old pay the same premium here, they learned the business somewhere else.

Broker vs. NY State of Health assistor: which one do you need?

Both are free to you. A navigator or assistor is certified to help with the NY State of Health application, Medicaid, the Essential Plan, and Child Health Plus, and stops at the edge of the marketplace. A licensed broker can enroll you in those same marketplace plans at the same price, and can also show you what is outside: the identical plan bought off-exchange with less paperwork when no credit applies, a pre-established ERISA group plan for a healthy self-employed person, supplemental layers for the deductible, and a Medicare Supplement when the time comes. A broker also stays with you after enrollment. If your income lands in the Medicaid or Essential Plan band, an assistor is a perfectly good choice. If you are self-employed, near or over the cliff, running a small business, or you simply want the whole map, you want a broker. Here is the full side-by-side of the exchange website versus a broker.

Upstate or downstate: does it matter where the broker sits?

Less than people think, and more than brokers admit. A New York license is statewide, and the work happens by phone or Zoom, so a broker in Buffalo can enroll someone in Brooklyn and a broker on Long Island can enroll someone in Syracuse. What is not statewide is the plan list. New York sets marketplace plans and provider networks county by county, and the hospital systems behind them are regional: Western New York is built around a couple of large systems, Rochester is a two-system town, Syracuse and the Capital Region each have their own, and the Hudson Valley, Long Island, and New York City have more carriers, narrower networks, and higher prices. So the question is never "where is your office," it is "do you check my county's list and my doctors by name." Here is how that conversation goes in each market I write in:

• Buffalo and Erie County, plus what a Buffalo broker actually does and the Niagara County line
• Rochester and Monroe County
• Syracuse and Onondaga County
• Albany and the Capital Region
• The statewide New York guide, including New York City, the Hudson Valley, and Long Island

The New York programs your broker should be able to explain without looking them up

A broker's knowledge of this state shows in whether they can walk you through these in plain English. Each one has its own page here, because each one is a door somebody in your family might belong behind.

• NY State of Health income limits for 2026: Medicaid, the Essential Plan, Child Health Plus, and the premium tax credit lines by family size
• What happened to the Essential Plan in 2026: who lost the 200 to 250% tier and what replaced it
• Child Health Plus: $0 to $60 per child per month, and the split-the-family move
• How much health insurance costs per month in New York: the KFF 2026 averages, $610 Bronze, $817 benchmark Silver, $1,057 Gold, before any credit, identical at every age
• COBRA and New York's 36-month continuation: when to take it and what is cheaper
• The pre-established ERISA group plan: the one door New York community rating does not govern
• The 2026 ACA subsidy calculator, preset for New York and the subsidy cliff checker
• Dental plans New Yorkers can buy on their own

How I stack up against my own checklist

Fair is fair. Here is the same nine points, answered for me, with the links so you can verify instead of trust.

That is my answer to the checklist, not a claim to a title. Run the same nine on anyone else you are considering, and go with whoever answers best for your situation. I educate, you decide.

Common questions about choosing a health insurance broker in New York