Broker News Series

OCTOBER 2013 — ISSUE 2

The New EmblemHealth Healthy NY Plan

As we informed you earlier this year, New York State is replacing the current Healthy NY benefit packages available to small employer groups with a single new, more comprehensive plan design that includes a core set of benefits called "Essential Health Benefits" as required by the ACA.

We are pleased to be able to offer the new EmblemHealth Healthy NY plan for sale to eligible downstate small groups starting in October 2013 for coverage effective January 1, 2014. For your reference, here are the new plan's Summary of Benefits and Rate Sheet.

The EmblemHealth Healthy NY plan will be sold outside the SHOP Exchange, and it can be purchased by brokers for their clients through our secure broker portal at www.emblemhealth.com/producers or directly by small group employers. Groups who wish to have coverage under this new plan must re-apply.

EmblemHealth Healthy NY Connects Members to Select Care

The provider network for this plan differs from the previous GHI and HIP network. The new EmblemHealth Healthy NY plan will use the Select Care network — a new provider network that connects members to high-quality primary care and specialty care doctors. We work closely with all of our Select Care network providers to help members get the most out of their health plan.

The service area for the Select Care network includes all five counties of New York City, Nassau, Suffolk, Rockland, Westchester and Orange counties. Groups outside of the service area are not eligible for the new EmblemHealth Healthy NY plan.

Notifying Healthy NY Members and Employers

This week, we are informing groups and group subscribers who currently have GHI or HIP Healthy NY coverage of their coverage options for 2014. Below is a summary of the mailer components.

  • Groups within the new service area receive: a downstate group Letter, the Summary of Benefits and the Rate Sheet.
  • Group subscribers within the new service area receive: a downstate subscriber Letter and the Summary of Benefits.
  • Groups outside the new service area receive: an upstate group Letter only.
  • Group subscribers outside the new service area receive: an upstate subscriber Letter only.

If you have any questions about the new EmblemHealth Healthy NY plan for small groups, please contact your EmblemHealth representative. This plan is underwritten by HIP Health Plan of New York. Note that GHI will not offer a Healthy NY replacement plan in 2014.

Please DO NOT respond to this message. If you have any questions about this communication, please speak with your Account Representative.

 

 

 

©2013 EmblemHealth. All Rights Reserved. Privacy Policy.

EmblemHealth Healthy NY Plan is underwritten by HIP Health Plan of New York. Refer to HIP policy form number 155-23-SGOFFHIXHNYCERT (04/13), et al.

Group Health Incorporated (GHI), HIP Health Plan of New York (HIP), HIP Insurance Company of New York and EmblemHealth Services Company, LLC are EmblemHealth companies. EmblemHealth Services Company, LLC provides administrative services to the EmblemHealth companies.