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Your ARPA Questions Answered About The Individual Market

We have received many questions from brokers regarding the American Rescue Plan Act of 2021 (ARPA) and how it impacts members who may have transitioned from group coverage to the individual market.

Several new changes have been implemented for NY State Residents:

  • New and expanded financial assistance is available through the Advance Premium Tax Credit (APTC) to New Yorkers in Qualified Health Plans (QHPs) on the NY State of Heath Exchange.
  • Enhanced assistance is available to current enrollees and new enrollees, including higher-income individuals (over 400% of the federal poverty level) for the first time.
  • If a client received Unemployment Insurance for at least one (1) week in 2021, ARPA allows them to sign up for a nearly free health plan through NY State of Health for coverage that lasts all of 2021.

Questions around these changes and more are addressed in this Frequently Asked Questions document .

In addition, NY State of Health has announced recent changes to the Essential Plan (EP) effective June 1, 2021. The Essential Plan 1 premium of $20 per person per month will be eliminated. All plans will include Vision and Dental coverage at no cost to the consumer.

Members will receive notifications from NY State of Heath about the change in premium. No action is required.



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