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New York City Employees PPO Plan
National Coverage, Local Roots
Effective Jan. 1, 2026, New York City employees, non-Medicare retirees, and their dependents are now offered the New York City Employees PPO (NYCE PPO) plan, a health plan delivered through a partnership between EmblemHealth and UnitedHealthcare.
Biggest Impact to Your Practice
If your practice is in the 13 downstate New York counties highlighted in yellow below and you currently serve City of New York members, you’re already part of this plan’s network. Claims for covered services submitted through the provider portal are processed using your contracted EmblemHealth reimbursement rates.
If your practice’s location is outside of those 13 counties, your contracted UnitedHealthcare reimbursement rates apply. For providers with office locations that span both geographies, the location where the service is provided determines which rates apply. Additional details can be found in our FAQs.
For this plan, there is a new, single provider portal for managing your NYCE PPO plan business, whether you contract with EmblemHealth, UnitedHealthcare, or both. The portal is be powered by UMR, the third-party administrator that’s part of the same family of companies as UnitedHealthcare.
Frequently Asked Questions
We have collected the most common questions and their associated answers to help our providers better understand this new plan and how to work with us.
Important note on payer ID 26992