INFO REGARDING NEW CIVIL SERVICE HEALTH PLAN - EFFECTIVE 1/1/2026 - (1/1/2026)

Effective January 1, 2026, the City of New York will be offering a new health plan, replacing the current GHI-CBP/Anthem BlueCross and BlueShield plan for active employees and pre-Medicare retirees, and their eligible dependents under age 65. This new plan, NYC Employees PPO plan (NYCE PPO), will be offered by EmblemHealth (Emblem) and United Healthcare (UHC).

NYCE PPO Plan Information

The NYCE PPO will offer an expanded network of healthcare providers in the Downstate 13 counties (New York City, Long Island, and Westchester, Dutchess, Rockland, Putnam, and Ulster counties) through Emblem’s network. The NYCE PPO is also a national plan, providing access outside of those counties for all active employees/pre-Medicare retirees through the UHC national Choice Plus Network. Cost sharing for members remains generally the same as in the GHI-CBP plan.

Effective January 1, 2026, all active employees/pre-Medicare retirees, and their dependents under age 65, who are enrolled in GHI-CBP/Anthem BlueCross and BlueShield will be transferred to the new health plan (unless they choose a different plan during the Annual Fall Transfer Period in November) with no gap in coverage. Therefore, they do not need to take any action in order to continue their City health benefits.

If the employee/pre-Medicare retiree enrolled in GHI-CBP/Anthem BlueCross and BlueShield has a Medicare-eligible dependent, the Medicare-eligible dependent will remain in GHI/Anthem Senior Care plan.

As for prescription drug coverage, if the employee/pre-Medicare retiree is enrolled in the GHI optional rider, then they will continue prescription coverage through the new NYCE PPO plan and they will use their NYCE PPO member ID card for prescriptions. If they have prescription drug coverage through their union/welfare fund, that coverage will continue and they will continue using that union-provided ID card for their drug coverage.

NYCE PPO Communications

Information regarding the new plan will be mailed to all employees and pre-Medicare retirees in mid-October, prior to the November Transfer Period.

All employees/pre-Medicare retirees enrolled in NYCE PPO will receive a new ID card and welcome kit in late December 2025 from Emblem/UHC. Please note that they will only receive one ID card as this is a single plan, unlike the GHI-CBP plan which had separate coverage for Medical and Hospital services.

Annual Fall Transfer Period and Rate Information

Employees and pre-Medicare retirees who are currently enrolled in GHI-CBP/Anthem BlueCross and Blue Shield and want to be in the NYCE PPO do not have to do anything, as they will be transferred automatically to the NYCE PPO in January 2026.

If an employee/pre-Medicare retiree is currently enrolled in the GHI-CBP/Anthem BlueCross and BlueShield plan and does not wish to be transferred to the NYCE PPO, then they will have the opportunity to select a new health plan during the Annual Fall Transfer Period from November 1, 2025 through November 30, 2025, for an effective date of January 1, 2026.

If an employee/pre-Medicare retiree is not currently enrolled in the GHI-CBP/Anthem BlueCross and BlueShield plan and wishes to enroll in NYCE PPO, then they will be able to do so during the Annual Fall Transfer Period in November 2025, for an effective date of January 1, 2026.

Please note that Employee Self-Service (for NYCAPS agencies) will be updated with the new health plan option for the Annual Fall Transfer Period.

NYCE PPO Resources

Visit the NYCE PPO website (www.nyceppo.com) for more information, including:

FAQs

In-Network Provider search

Registration details to attend in-person and virtual Information sessions

Information about the new NYCE PPO may also be obtained by calling Emblem/UHC at (212) 501-4444 from 8 a.m. to 6 p.m., Monday through Friday.

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