On April 1, NY State of Health is planning to notify current Essential Plan 200-250 members about the plan discontinuance scheduled for June 30, 2026. The health plan is planning on sending follow-up letters and emails to these impacted members on April 3.
NY State of Health will send a second notice in mid-May explaining their new eligibility. Alternative coverage options for these members will depend on their personal situation.
Members who are pregnant now or were pregnant in the last 12 months: They may be able to either stay on the Essential Plan or move to our Univera Healthcare MyHealth℠ Medicaid plan, as determined by NY State of Health.
Members who are enrolled in Essential Plan 200–250 and are a U.S. citizen, national, or lawfully present: Their Essential Plan will end on June 30, 2026. They may be able to enroll in a Qualified Health Plan from Univera Healthcare through NY State of Health. Starting approximately May 16, you will be able to help them find a plan and see how much financial assistance they may qualify for.
Members who are not a U.S. citizen, national, or lawfully present and are enrolled in Essential Plan 1, 2, or 200–250: Their Essential Plan will end on June 30, 2026, and they will no longer qualify for coverage through NY State of Health. You may be able to enroll them in a Qualified Health Plan directly with Univera Healthcare.
Please encourage your members to keep their contact information up to date with NY State of Health. They will have 60 days after June 30 to choose their new coverage for the rest of 2026. If they miss this deadline, they will need to wait to enroll during the Open Enrollment Period starting November 1, 2026.
Commission for on and off exchange individual market medical products is $25 per contract per month (PCPM) and $2 PCPM for stand-alone dental plans. No commission will be paid for the Essential Plan or Safety Net plans. Your broker information must be included on the application to receive commissions.
Please contact your account consultant with questions.
Below are samples of the NY State of Health letter and samples of our planned follow-up letters and emails to impacted members.
NYSOH Notice T113 - Essential Plan Program Changes (PDF)
Univera - SAMPLE Follow-up Letter (PDF)
Univera - SAMPLE Follow-up Email (PDF)
