2025 Summary of Lines of Business, Networks, and Benefit Plans

Please use this chart to let your appointment schedulers know how you participate with EmblemHealth. Circle the networks below covered by your contract(s). Use the Check Provider Network Status look-up tool in the Member Management section of the provider portal to easily determine if a provider is in-network for a member. See sample member ID Cards in the EmblemHealth Provider Manual and our Bridge Program page.

Network	Line(s) of Business	Plan Names	Out of Network (OON) Coverage, Referral Required
National Network (GHI PPO National/CBP)	New York City Plan	GHI CBP DC37-Med-Team	OON Coverage: Yes Referral Required: No
Enhanced Care Prime	Commercial – Essential Plan	Essential Plan 200-250 Essential Plan 1 Essential Plan 2 Essential Plan 3 Essential Plan 4	OON Coverage: No Referral Required: No
Enhanced Care Prime	State Sponsored Programs – Medicaid, Health and Recovery Plans (HARP)	EmblemHealth Enhanced Care EmblemHealth Enhanced Care Plus	OON Coverage: No Referral Required: No, PCP needed unless homeless
Select Care	Commercial – Individual and Family Plans (On- and Off-Exchange)	EmblemHealth Select Care Platinum/Platinum D EmblemHealth Select Care Gold/Gold D EmblemHealth Select Care Silver/Silver D EmblemHealth Select Care Silver CSR 1 EmblemHealth Select Care Silver CSR 2 EmblemHealth Select Care Silver CSR 3 EmblemHealth Select Care Catastrophic/Catastrophic D	OON Coverage: No Referral Required: No
Select Care	Commercial – Small Group	EmblemHealth Platinum Premier EmblemHealth Gold Premier EmblemHealth Silver Premier EmblemHealth Silver Plus H.S.A. EmblemHealth Bronze Premier EmblemHealth Bronze Plus H.S.A. EmblemHealth Healthy Gold NY	OON Coverage: No Referral Required: No
Select Care	Commercial – Large Group	HIP Prime HMO EmblemHealth HMO Plus	OON Coverage: No Referral Required: Yes
Millennium	Commercial – Individual and Family Plans (On and Off Exchange)	EmblemHealth Millennium Platinum/Platinum D EmblemHealth Millennium Gold/Gold D EmblemHealth Millennium Silver/Silver D EmblemHealth Millennium Silver CSR 1 EmblemHealth Millennium Silver CSR 2 EmblemHealth Millennium Silver CSR 3 EmblemHealth Millennium Catastrophic/Catastrophic D	OON Coverage: No Referral Required: No
Millennium	Commercial – Large Group	HIP Prime HMO EmblemHealth HMO Plus	OON Coverage: No Referral Required: Yes
Prime	State-Sponsored Programs	Child Health Plus	OON Coverage: No Referral Required: No
	Commercial – Large Group	HIP Prime HMO EmblemHealth HMO Plus EmblemHealth HMO Preferred Plus HIP Access I HIP Access II	OON Coverage: No Referral Required: Yes
	Commercial – Large Group	HIP Prime POS	OON Coverage: Yes Referral Required: No
Bridge*	Commercial – Large Group	EmblemHealth EPO EmblemHealth PPO EmblemHealth Consumer Direct EPO EmblemHealth Consumer Direct PPO EmblemHealth InBalance EPO EmblemHealth InBalance PPO Administrative Services Only (ASO)	OON Coverage: Yes Referral Required: No
VIP Prime	Medicare	EmblemHealth VIP Dual EmblemHealth VIP Dual Enhanced EmblemHealth VIP Gold	OON Coverage: No Referral Required: No, PCP needed
VIP Bold	Medicare	EmblemHealth VIP Gold Plus (HMO) EmblemHealth VIP Rx Saver (HMO)	OON Coverage: No Referral Required: No, PCP needed
VIP Reserve	Medicare	EmblemHealth VIP Dual Reserve (HMO D-SNP)	OON Coverage: No Referral Required: Yes

*The Bridge Program offers access to care through the Prime, ConnectiCare Choice, Qualcare, National, and First Health networks.

JP 69764 09/2025

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2025 Summary of Lines of Business, Networks, and Benefit Plans