Emblem Healthcare Plan Design and Rates

Beginning January 1, 2014, all current Emblem plans (including the GHI Healthy NY EPO and HIP Healthy NY HMO) will end. At this time, new plans will be offered. For Clients that have Emblem through HealthPass or the LIA, existing plans will be mapped to a different plan being offered. All new Emblem plans will meet the 10 essentials benefits that are now required by the Affordable Care Act.

The benefits and rates for all the new Emblem HMO plans (including Healthy NY) are attached to this distribution. The Affordable Care Act, requires benefits such as physical therapy, mental health/substance abuse treatment, chiropractic, and durable medical equipment to be included in the Healthy NY Plan.

The network of doctors and hospitals on these plans have also changed. If continuing your current physician relationship is important to you, we suggest contacting your physician’s office to see if they participate in the new network. The name of the new network is Select Care.  If  your physician already participates in the Select Care Network or you are willing to change physicians, this plan is a viable cost effective option. It should be noted that this plan has a significantly smaller physician network.

If you wish to choose any of the new Emblem plans for January 1, 2014, you are required to fill out new applications to reapply.

The Emblem Healthy NY Plan, while competitively priced, has a smaller network than previous. We are here to help you, with this transition of benefits. Mainline Insurance will review all of the options available to you and synthesize the optimal individual solution. We are very sensitive to our client’s benefit needs and budgets.  If obtaining benefits on the New York State Health Benefit Exchange is the most viable option, Mainline Insurance is certified and authorized to help you with this at no additional cost.

For clients that have Emblem and are billed directly from Emblem, additional steps must be completed or no coverage will be effective for January 1, 2014.

It has been difficult due to technical malfunctions and insurance network changes to identify participating physicians. We hope to see these issues remediated over the next few months. However, for the present time please check directly with those providers that are vital to your well being about which networks they participate in.  This is very important as we previously mentioned, networks have changed significantly.



Click To Download 2014 Emblem HMO Plan Design And Rates

Click To Download 2014 Emblem Healthy NY Rates

Click To Download 2014 Emblem Healthy NY Plan Design

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