2025 Invitation for Participation in NY State of Health


On May 3, 2024, NY State of Health issued its invitation to insurers to participate for the 2025 plan year.  

The invitation and related documents are listed below.

All questions about the application process should be directed to the Invitation Administrator at Nyhxpm@health.ny.gov.  

 

The 2025 Essential Plan Model Subscriber Contract is available here. 


 

Resource Type
Policies
Attachment Size
NY State of Health Plan Invitation 2025 Revised 12.03.24.pdf 667.23 KB
2025 QHP Rider Q&A Revised 07_12_24.pdf 163.55 KB
Attachment A - QHP Essential Health Benefits 2025.pdf 175 KB
Attachment B Standard Schedule of Benefits 2025 10-04-2024.pdf 571.16 KB
Attachment C - QHP and SADP Rating Regions by County 2025.pdf 110.42 KB
Attachment D - QHP and SADP Rating Regions Map 2025.pdf 211.25 KB
Attachment E - Letter of Interest 2025.docx 26.54 KB
Attachment F (1) - QHP and SADP Participation 2025.docx 51.75 KB
Attachment F (2) - QHP Products Offered by County and Market 2025.xls 59 KB
Attachment F (3) - SADP Products Offered by County and Market 2025.xls 83 KB
Attachment F (4) - QHP & SADP Product Offerings and Discontinuances 2025.xls 39 KB
Attachment G - EP Benefits and Cost-Sharing 2025.pdf 210.03 KB
Attachment H - EP Rating Regions 2025.pdf 238.44 KB
Attachment I - EP Rating Regions Map 2025.pdf 260.95 KB
Attachment J (1) - EP Participation Proposal 2025.docx 41.7 KB
Attachment J (2) - EP Products Offered by County 2025.xls 49.5 KB
Attachment K - EP Template Instructions 2025.pdf 214.95 KB
Attachment L - EP Admin Template 2025.xls 17 KB
Attachment M - EP Plans Template 2025.xls 17.5 KB
Attachment N - EP Rates Template 2025.xls 169 KB
Attachment O - EP Service Area 2025.xls 2.54 MB
Attachment P - Provider Network Submission Instructions 2025.pdf 140.5 KB
Attachment Q - URL Template Instructions 2025.pdf 87.41 KB
Attachment R - URL Template 2025.xls 25 KB
Attachment S - QDP and QHP with EmbedDntl Benes Cost-Sharing Filing Instructions 2025.pdf 225.44 KB
Attachment T - QDP and QHP with Embedded Dental Benefits Cost-Sharing Template 2025.xlsm 306.5 KB
Attachment U - 2025 Cost Sharing Reduction Initiatives Revised 9_5_24.pdf 259.07 KB
Attachment V - Essential Plan (EP) Guidance 2025.pdf 127.35 KB
Publication Date