A health plan option for city employees
New York City Employees PPO Plan
National Coverage, Local Roots
New York City employees, non-Medicare retirees, and their dependents can enjoy the benefits of the New York City Employees PPO (NYCE PPO) health plan. The plan is delivered through a partnership between EmblemHealth and UnitedHealthcare.
Biggest Impact to Your Practice
When you see NYCE PPO members, you’ll have to use the new, single provider portal.
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 at nyceppo.com.
For this plan, there is a single provider portal for managing your NYCE PPO plan patients, whether you contract with EmblemHealth, UnitedHealthcare, or both.
Claim Submission FAQs
For all other questions, visit nyceppo.com/provider.
Submit claims using payer ID 26992.
For services before Jan. 1, 2026, claims should be submitted to EmblemHealth/Anthem using the existing process:
- EmblemHealth professional claims should be submitted electronically to EmblemHealth using payer ID 13551 or mailed to:
EmblemHealth
P.O. Box 2832
New York, NY 10116-2832 - EmblemHealth facility claims should be submitted electronically to EmblemHealth using payer ID 13551 or mailed to:
EmblemHealth
P.O. Box 2833
New York, NY 10116-2833 - For Anthem facility submissions, please follow the existing process to submit to Anthem.
For services on or after Jan. 1, 2026, claims are submitted to UMR using payer ID 26992 to the following:
- EDI number 26992
- NYCE PPO Plan, P.O. Box 21534, Eagan MN 55121
- Issuer (80840) 911-39026-02
For all services before Jan. 1, 2026, please contact EmblemHealth by either signing in to your provider portal and sending us a message or calling Provider Services at 866-447-9717. Our provider manual has more information on claims contacts.
For dates of service before Jan. 1, 2026, submit appeals or requests for reconsideration to the following:
- Professional claims handled by EmblemHealth, Provider Grievances, and Clinical Appeals can be filed as follows:
- EmblemHealth provider portal
- By mail: P.O. Box 2844, New York, NY 10116-2844
- By fax: 212-510-5320
- For facility submissions, please follow the current process to submit to Anthem.
For dates of service on or after Jan. 1, 2026, submit appeals or requests for reconsideration to UMR:
| General claims: NYCE PPO Plan P.O. Box 21534 Eagan, MN 55121 |
Appeals: CNY Post Service Appeals P.O. Box 211381 Eagan, MN 55121 |
MAPFRE: MAPFRE Life P.O. Box 70297 San Juan, P.R. 00936-8297 |
If you have questions not answered here, please contact your relationship manager or call us at 844-849-5750.