Launching January 1, 2026
The City of New York
PPO Strong Plan
National Coverage, Local Roots
Effective January 1, 2026, New York City employees, non-Medicare retirees, and their dependents will be offered the New York City Employees PPO (NYCE PPO) plan, a health insurance plan delivered through a partnership between EmblemHealth and UnitedHealthcare.
Biggest Impact to Your Practice
If your practice is in the 13 downstate New York countiesinfo highlighted in yellow 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 will be processed using your contracted EmblemHealth reimbursement rates.
If your practice’s location is outside of those 13 counties, your contracted UnitedHealthcare reimbursement rates will apply. For providers with office locations that span both geographies, the location where the service is provided will determine which rates are applied. Additional details can be found in our FAQs.
For this plan, there will be a new, single provider portal for managing your NYCE PPO plan business, whether you contract with EmblemHealth, UnitedHealthcare, or both. The portal will be powered by UMR, the third-party administrator that’s part of the same family of companies as UnitedHealthcare.
What to Expect Next
This web page will be your source for education materials and training opportunities specific to the NYCE PPO plan in the months leading up to the January 1, 2026 launch.
We look forward to working closely with you and your practice.
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.