September 27, 2012

Streamlining HIP and HIPIC Small Group Plans

Alternative Coverage Offered

In our ongoing effort to streamline and simplify our product portfolio, EmblemHealth will be discontinuing certain HIP/HIPIC Small Group products effective January 1, 2013. We will replace them with plans that provide more contemporary benefit designs and cost-sharing arrangements. Existing HIP Prime® HMO, HIP Classic, and HIP Select® PPO plans will not be affected.

Transition to Replacement Coverage

Your clients currently covered by one of the discontinued plan options will be automatically enrolled in an alternative plan, unless they inform us otherwise. These groups will have the option to purchase any EmblemHealth plan offered to the small group market. Please refer to this chart to view the key plan differences and replacement options.

Notifying Groups and Members

We are mailing letters announcing the discontinuance to affected groups, about 90 days before the effective date. This will provide ample time for your clients to evaluate replacement plans and consider their options. For your reference we've attached samples of the small group and member communications. Please note that 2013 rates shown are subject to NYSDFS approval.

At EmblemHealth, we're committed to serving the small group market in New York, offering plans that have attractive benefits at competitive prices. If you have questions about the plan discontinuance, please contact your EmblemHealth representative.