Now that you’ve enrolled in a health plan through NY State of Health, you may have some questions about how to use your health plan coverage. Here are some resources with answers to the questions you may have:
Welcome to the NY State of Health Producer Tool Kit.
The administrative guide below will provide information for agents, brokers, and other assistors as they help small groups enroll through the Marketplace. It provides general guidance and defines important policies. The guide may be downloaded and printed or used as a desktop resource.
Following the guide are specific tools and resources that are referenced in the guide, sorted by category. Many of these documents can also be downloaded and printed.
As a health care provider, you can confirm enrollment of your patients in a Marketplace health plan by contacting health insurance companies directly. Use the attached document to find health plan phone numbers and website links specifically for use by providers.
The Essential Plan is a new program for eligible New Yorkers enrolling in coverage through the NY State of Health. The Essential Plan covers all of the essential health benefits covered under the Qualified Health Plans offered on the Marketplace, including inpatient and outpatient care, physician services, diagnostic services and prescription drugs among others, with no annual deductible and low out-of-pocket costs. Preventive care such as routine office visits and recommended screenings are free. Eligible consumers will pay eit
The time of year when you can enroll in a health plan depends upon the type of health plan you are eligible for. Learn more about NY State of Health Enrollment Periods. Please print, copy, link to and share.