2026 Invitation for Participation in NY State of Health


On May 5, 2025, NY State of Health issued its invitation to insurers to participate for the 2026 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 2026.pdf 662.15 KB
Attachment A - QHP Essential Health Benefits 2026.pdf 175 KB
Attachment B - Standard Schedule of Benefits 2026.pdf 533.78 KB
Attachment C - QHP and SADP Rating Regions by County 2026.pdf 110.42 KB
Attachment D - QHP and SADP Rating Regions Map 2026.pdf 211.25 KB
Attachment E - Letter of Interest 2026.docx 29.03 KB
Attachment F (1) - QHP and SADP Participation 2026.docx 52.47 KB
Attachment F (2) - QHP Products Offered by County and Market 2026.xls 53 KB
Attachment F (3) - SADP Products Offered by County and Market 2026.xls 89 KB
Attachment F (4) - QHP & SADP Product Offerings and Discontinuances 2026.xls 39 KB
Attachment G - EP Benefits and Cost-Sharing 2026.pdf 348.68 KB
Attachment H - EP Rating Regions 2026.pdf 238.44 KB
Attachment I - EP Rating Regions Map 2026.pdf 260.95 KB
Attachment J (1) - EP Participation Proposal 2026.docx 41.63 KB
Attachment J (2) - EP Products Offered by County 2026.xls 43.5 KB
Attachment K - EP Template Instructions 2026.pdf 213.89 KB
Attachment L - EP Admin Template 2026.xls 17 KB
Attachment M - EP Plans Template 2026.xls 17.5 KB
Attachment N - EP Rates Template 2026.xls 163 KB
Attachment O - EP Service Area 2026.xls 249.5 KB
Attachment P - Provider Network Submission Instructions 2026.pdf 201.45 KB
Attachment Q - URL Template Instructions 2026.pdf 176.71 KB
Attachment R - URL Template 2026.xlsm 10.56 KB
Attachment S - SBC Templates All EP Tiers 2026.docx 263.84 KB
Attachment T - Call Performance Reporting Template 2026.xlsm 10.03 KB
Attachment U - Cost Sharing Reduction Initiatives 2026.pdf 232.16 KB
Attachment V Essential Plan (EP) Guidance 3.1 2026.pdf 127 KB
Publication Date