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Commercial Networks and Benefit Plans
EmblemHealth offers individuals, fully insured large and small groups, and organizations seeking administrative services the Bridge Program. Bridge is an innovative concept that gives our members access to a combination of our existing networks through our affiliated companies and partners. See Extended Networks’ Geographic Coverage Area below. Learn more about the Bridge Program.
EmblemHealth and its affiliate ConnectiCare Insurance Company, Inc. partner with QualCare and First Health to provide coverage for certain of our benefit plans beyond our own contracted networks’ geographic coverage. These extended networks are considered in-network for our members, based on their geography, as follows:
Bridge Program (EmblemHealth and ConnectiCare)
QualCare = New Jersey Only
First Health Network (for EmblemHealth’s companies) = All States except:
- Connecticut
- Massachusetts’s 4 Counties (Berkshire, Hampden, Hampshire, and Franklin)
- New Jersey
- New York’s 28 Counties (Albany, Bronx, Broome, Columbia, Delaware, Dutchess, Fulton, Greene, Kings, Montgomery, Nassau, New York, Orange, Otsego, Putnam, Queens, Rensselaer, Richmond, Rockland, Saratoga, Schenectady, Schoharie, Suffolk, Sullivan, Ulster, Warren, Washington, and Westchester)
ConnectiCare Insurance Company, Inc.’s Flex Network
First Health Network = All States except:
- Connecticut
- Massachusetts’s 4 Counties (Berkshire, Hampden, Hampshire, and Franklin)
- New York’s 28 Counties (Albany, Bronx, Broome, Columbia, Delaware, Dutchess, Fulton, Greene, Kings, Montgomery, Nassau, New York, Orange, Otsego, Putnam, Queens, Rensselaer, Richmond, Rockland, Saratoga, Schenectady, Schoharie, Suffolk, Sullivan, Ulster, Warren, Washington, and Westchester)
Starting in January 2023, the following Qualified Health Plans will no longer be offered by EmblemHealth licensed under Health Insurance Plan of Greater New York (HIP). Small group plans will maintain membership until the renewal date has passed for all groups with that plan. In 2023, there will be no members with the individual and family plans listed below.
| Small Group: | Individual/Family: |
|---|---|
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For plan details and complete lists of the commercial plans offered, see:
- 2023 Summary of Companies, Lines of Business, Networks, and Benefit Plans
- 2022 Summary of Companies, Lines of Business, Networks, and Benefit Plans
To easily determine if you or a provider you manage is in-network for an EmblemHealth or ConnectiCare member, use the Check Provider Network Status tool in the Member Management section of the provider portal.
Member ID cards for 2022 have been redesigned. Plans that need a referral have a primary care doctor (PCP) shown on the front of the card. Plans without referrals no longer have a PCP name on the ID cards. Providers and members can confirm PCP names through our Provider and Member portals, respectively. Members can select a PCP whether their plan requires it or not, and this ID card design change does not affect the member’s PCP selection. There will be no changes made to a member’s assigned PCP.
Please refer to the Sample ID Cards section of the EmblemHealth Provider Manual to see representative ID cards for all our members.
JP59586 11/22
