Essential Plan Broker Resources

The Essential Plan is a plan offered by MetroPlusHealth through the New York State of Health that provides health insurance coverage with $0 premiums, copays, and deductibles for qualified New Yorkers.

New York State residents who are lawfully present in the U.S., 19–64 years old, not eligible for Medicaid or Child Health Plus, and not eligible for employer or other coverage, may qualify for the Essential Plan if they meet the income requirements.

• Starting April 1, 2024, the Essential Plan income requirement will expand to cover higher income New Yorkers. More people currently uninsured or insured through Qualified Health Plans will now qualify for
  the Essential Plan.

The Essential Plan offers all of the benefits your clients need:

• Preventative care
• Emergency care
• Prescription drugs
• Mental health
• Dental
• Vision
• And more
• New for 2026, members get $112 per quarter on their wellness card, that’s $448 per year.

And MetroPlusHealth members get access to more benefits such as member rewards, $0 24/7 telehealth access through MetroPlusHealth Virtual Visit, reimbursements for gym memberships, and more.

To become a MetroPlusHealth Broker, please reach out to the Field Marketing Organizations (FMO)

In order to continue selling MetroPlus Essential Plans, please ensure completion of NYSOH Spring Training requirements to maintain your Certified Assistance Counselor certification. ​

Training can be accessed at: https://info.nystateofhealth.ny.gov/SpringTraining2024.

To request Marketing materials and questions regarding your order you can:​

• Email [email protected] ​
• Call our Broker Support Line at 833-917-3525

A. Brokers should contact the Field Marketing Organizations (FMO) for answers about their proprietary information. (see below)​

• Ritter Insurance Marketing at 800-769-1847, Opt.3. | Email: [email protected]​
• Benefits Concierge Group at Tel: 855-275-2243 | Email: [email protected]​
• Gamma Care at Tel: 1-888-737-7673 | Email: [email protected]​
• Genesis Business Capital Inc at Tel: 1-833-422-2436 | [email protected]​

B. Broker should contact their General Agency (GA) for answer about their proprietary information.​

C. Independent Brokers should contact Broker Support at [email protected] for any inquiries regarding Proprietary Information. ​

A. To become a Broker with MetroPlusHealth, you must have an active Certified Application Counselor (CAC) Certificate, complete all required MetroPlusHealth and compliance training modules.​

B. Brokers must have a valid NYS Department of Financial Services License (DFS). ​

For more information click this link: https://nystateofhealth.ny.gov/agent/

MetroPlusHealth will offer the product trainings – listed on our website at www.metroplus.org/broker.

​

Please reach out to the Field Marketing Organizations (FMO) for all commission related questions.​

To access the Broker Portal, follow the steps below.

1. Check your email: You will receive a welcome email from the Broker Portal.​
2. Set up your account: In the welcome email, click the provided link to enter the portal.​
3. Click “Forgot My Password”: On the login page, select “Forgot My Password.”​
4. Reset your password: You will receive an email with a link to reset your password.​
5. Update your password: Follow the link to set a new password.​
6. Log in: Use your updated password to log in and start enrolling prospects.​
7. You are set to start enrolling.

​You can also watch a video to guide you to setup your account and how to navigate salesforce follow the link below:

No. All EP applications must be completed through NY State of Health Marketplace website:
https://nystateofhealth.ny.gov/index

How to enroll/refer a prospect into EP?​
A. Zoom (Telephonic Enrollment)​

• Zoom guide​

B. Conflict of Interest Statement and Disclosure Form​

C. End of Sale Brochure​

D. https://metroplus.org/brokers/

If a member informs you that they have not received or have misplaced their Member ID Card please direct them to the MetroPlus Customer Service at 1-800-303-9626. ​

Customer Services will respond and can offer this link​

Please refer to the MetroPlus website at https://www.metroplus.org/Member​.

Plan ID card needed https://www.metroplus.org/member/FAQs.

Members can also email us at [email protected]. If a member emails to receive their member ID, we will need to schedule a call back to verify their identity for security purposes.​

If a member needs assistance locating a participating provider or pharmacy they can use the links below.​

Provider lookup https://www.metroplus.org/find-doctor​

Specialist lookup https://www.metroplus.org/member/provider-directory​

Pharmacies in Network https://www.metroplus.org/Find-Pharmacy​

To determine whether a medication is covered under a member’s plan, they can use the link below to find our formulary.​

Formulary lookup https://www.metroplus.org/Plans/Medicare/prescription-drug-information​

Brokers have training available through the MetroPlus University.​

​Contact MHP Broker Services at 833-917-3525 to find out more on enrollment sites/venues, leads, special marketing equipment and other resources and promotional enhancement opportunities.

Broker Support at 833-917-3525 ​
Email: [email protected]

What are some member resources Brokers can share / view?
Rewards Program Link https://metroplus.org/member-rewards/
Member Portal Link https://www.metroplus.org/Member​
MetroPlus Mobile available for App Store iOS