Proposed 2015 Premium Rate Changes and HIOS Numbers for EmblemHealth Small Group Plans

New York City & Long Island Areas

EmblemHealth HMO
40/60 (Gold)

EmblemHealth HMO 35/55 (Silver)

EmblemHealth HMO HD6300 (Bronze)

EmblemHealth Healthy NY HMO (Gold)

  First Quarter 2015

9.5%

13.9%

9.5%

15.9%

  Second Quarter 2015

8.2%

12.6%

8.3%

14.5%

  Third Quarter 2015

7.0%

11.3%

7.0%

13.2%

  Fourth Quarter 2015

5.7%

10.0%

5.8%

11.9%

Mid-Hudson Area

EmblemHealth HMO
40/60 (Gold)

EmblemHealth HMO 35/55 (Silver)

EmblemHealth HMO HD6300 (Bronze)

EmblemHealth Healthy NY HMO (Gold)

  First Quarter 2015

31.3%

36.5%

31.3%

38.9%

  Second Quarter 2015

29.7%

35.0%

29.8%

37.3%

  Third Quarter 2015

28.2%

33.4%

28.3%

35.7%

  Fourth Quarter 2015

26.7%

31.8%

26.8%

34.1%

HIOS Plan Identification Numbers

Plan

Dependent coverage to
age 26 end-of-month

Dependent coverage to
age 30 end-of-month

EmblemHealth HMO 40/60 (Gold)

88582NY0840001

88582NY0850001

EmblemHealth HMO 35/55 (Silver)

88582NY0780001

88582NY0790001

EmblemHealth HMO HD6300 (Bronze)

88582NY0940001

88582NY0950001

EmblemHealth Healthy NY HMO (Gold)

88582NY0880001

88582NY0890001