The latest Annual Provider Notice is now available. As 2025 comes to an end, now is the time to prepare your practice for the year ahead. Make sure you haven’t overlooked key policy updates, regulatory requirements, or trainings from 2025 that are essential for your participation in 2026.
Also, learn more about our key vendor changes including our switch to DentaQuest Sept. 1, 2025, as our new dental provider replacing HealthPlex, and other important health plan and service updates effective Jan. 1, 2026:
- New York City employees, non-Medicare retirees, and their dependents are being offered the New York City Employees PPO (NYCE PPO) plan, a health insurance plan delivered through a partnership between EmblemHealth and UnitedHealthcare. This plan replaces the GHI Comprehensive Benefits Plan (CBP).
- Prime Therapeutics will replace ExpressScripts, Inc. as our Pharmacy Benefit Manager (PBM) and Utilization Review agent for our pharmacy medical benefits.
- Cigna and First Health/QualCare will be the two wrap network options for plans with out-of-area coverage.
- ConnectiCare commercial plan members with renewal dates in 2026 will continue to keep their coverage through Molina, ConnectiCare’s parent company. EmblemHealth and ConnectiCare will no longer offer provider network reciprocity for any of their members. This means EmblemHealth providers will no longer see ConnectiCare members seeking in-network care from them.
Read about our 2026 suite of networks and benefit plans, working with us through our user-friendly provider portal, and our EmblemHealth programs to help your patients find cost-effective and convenient care options.
Here are links to this year’s Annual Provider Notice and other helpful resources: