Guidance for Health Plans on the Essential Plan Expansion

The Essential Plan eligibility expansion will take effect April 1, 2024. In May of 2023, New York submitted a 1332 State Innovation Waiver application to expand the Essential Plan (EP) to New Yorkers with incomes up to 250% of the Federal Poverty Level to the U.S. Departments of Health and Human Services and Treasury. Through this expansion of Essential Plan coverage, the State seeks to increase access to high quality, affordable health insurance for low-and moderate-income individuals.

Guidance documents for health plans are posted below.

The 2024 Essential Plan Model Subscriber Contract and the 2024 Essential Plan Model Plan Contract are also available on the 2024 Invitation for Participation in NY State of Health.


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