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The Bridge Program

Fully insured large group and ASO clients have access to five of our largest networks.

group of healthcare providers looking at laptop in office

Driving More Members to Your Practice!

The Bridge Program gives members access to a combination of networks, ensuring they have a wide choice of providers and facilities in New York and across the country.

New for 2026: City of New York NYCE PPO members will have access to Bridge Program providers.

If a member has Bridge Program access but is not a NYCE PPO member, select the Large Group and ASO Plans button below.

Select plan ...
  1. NYCE PPO Plan
  2. Large Group and ASO Plans

The Bridge Program for NYCE PPO

The Bridge Program has been in place for several years but, for NYCE PPO, there is one important change:

The NYCE PPO Bridge Program offers in-network coverage focused on providers within the 13 lower New York State counties listed and mapped below. If a NYCE PPO member seeks care outside these 13 counties*, they will need to access providers contracted with United Healthcare’s Choice Plus Network. This gives NYCE PPO members more access to in-network coverage across the country.

*EmblemHealth providers outside this area may be in-network for other plans offering the Bridge Program, but they are not in-network for NYCE PPO unless they are contracted with the United Healthcare Choice Plus Network.

Bridge Networks

Within the 13 downstate New York counties, providers contracted with the following networks are considered in-network for NYCE PPO:

Prime Network or National Network (formerly GHI)*

* If you saw a City of NY member under the GHI Comprehensive Benefits Plan (CBP), you're in-network for NYCE PPO in the 13 downstate New York Counties listed below. Members in EmblemHealth GHI CBP/Anthem BlueCross and BlueShield are transitioning to this new NYCE PPO Plan Jan. 1, 2026.

Geography

If your practice is in one of the counties listed below and you participate in one of the networks named above,
you’re in-network for NYCE PPO: 

  • Bronx.
  • Dutchess.
  • Kings.
  • Nassau.
  • New York.
  • Orange.
  • Putnam.
  • Queens.
  • Richmond.
  • Rockland.
  • Suffolk.
  • Ulster.
  • Westchester.

NYCE PPO Member ID Card

Members will present this card when visiting your practice. Unlike the EmblemHealth GHI CBP/Anthem BlueCross and BlueShield plan NYCE PPO replaces, members will only have one card for all services. 

NYCE PPO Member ID Card

Bridge Program Resources

For more information about NYCE PPO, as well as a complete and updated list of Frequently Asked Questions with the answers you need to navigate this plan, visit our NYCE PPO page for providers. 

The Bridge Program for Large Group and ASO

The Bridge Program offers our fully insured large group and administrative services only (ASO) members access to care through different network combinations. The core networks for the Bridge Program consists of New York providers who are contracted with:

  • The Prime Network, or
  • The National Network.

This core is supplemented with one of the following options which will be shown on their EmblemHealth member ID cards: 

  • The Cigna Healthcare® PPO Network* (outside of New York State)
  • First Health Network (supplements in New York and across the country except for New Jersey) and QualCare (New Jersey only).

See all plans offering Bridge in this comprehensive Summary of Lines of Business, Networks, and Plans.

If you participate in any of the network listed above, you are an in-network provider for Bridge Program members. Note: If this is a NYCE PPO member, click the NYCE PPO Plan tab above for specific information. The Frequently Asked Questions section below details how to determine if you may see a member with Bridge access and how you will be paid.

Sample Member’s ID Card

See the Member ID Card chapter of the EmblemHealth Provider Manual for a description of the logos shown on samples of all member ID cards. If the card says “Bridge” as shown below, the member has access to care from all three networks shown above.

EmblemHealth Bridge sample ID card

Sample ID Card for EmblemHealth

How to Read the Member’s ID Card

Check the bottom right corner of the back of your member’s ID card to match the correct administrative processes to follow and discover which rules apply. The NYCE Plan page details the information you will need for NYC PPO members.

See links for Utilization Management and Claims Information below the chart for more guidance.

Member's ID Card

Utilization Management

Claims Information

Sample ID Card - Underwritten by EmblemHealth Plan Inc. (formerly GHI)

Preauthorization lists and UM programs follow non-City of New York EmblemHealth Plan, Inc. (Commercial)

Payor IDs, submission addresses, and processing rules follow non-City of New York EmblemHealth Plan, Inc. (Commercial)

Sample ID Card - Fully Insured Plans Underwritten by EmblemHealth Insurance Company (formerly HIPIC)

Preauthorization lists and UM programs follow EmblemHealth Insurance Company

Payor IDs, submission addresses, and processing rules follow EmblemHealth Insurance Company

Sample ID Card - ASO Self-Insured Plans Administered by EmblemHealth Insurance Company (formerly HIPIC)

Preauthorization lists and UM programs follow Administrative Services Only (ASO) client’s instructions.

Payor IDs, submission addresses, and processing rules follow EmblemHealth Insurance Company

EmblemHealth

*Cigna Healthcare® is an independent company and not affiliated with EmblemHealth. Access to the Cigna Healthcare PPO Network is available through the contractual relationship between EmblemHealth and Cigna Healthcare. All Cigna Healthcare products are provided exclusively by or through operating subsidiaries of The Cigna Group, including Cigna Health and Life Insurance Company. The Cigna Healthcare name, logo, and other marks are owned by Cigna Intellectual Property, Inc. The Cigna Healthcare® PPO Network refers to the health care providers (doctors, hospitals, specialists) contracted as part of the Cigna Healthcare PPO for Shared Administration.

Frequently Asked Questions

Bridge Provider:

What does being part of the Bridge Program mean to my practice/organization?

It means:

  • Increasing the number of our members who may come to you for care.
  • Ensuring your staff knows how to identify these new members who can see you.
  • Following the underwriting company’s administrative guidelines.
  • Sending members to their designated utilization management programs.

How do I know if I can see members with Bridge access?

The simplest way to see if you are considered in-network for a member is to use the Check Network Status feature on the provider portal.

Here’s how:

  • From the provider portal home page, select the Member Management tab.
  • From the drop-down list, select Provider Network Status.
  • In the Search By field drop-down, select either Member ID or Member Name. Member name search requires entering the First Name, Last Name, and Date of Birth.
  • Click Search.
  • Click Check Provider Network Status button in the main section at the top of the page.
  • The member’s information will carry forward to a new screen where you can search for the provider in your practice.*
  • The results will display the provider’s network status for that member in the right-most column in the table.

You are considered in-network for a member seeking care if you are part of any of the networks listed below and the word “Bridge” appears on the member’s ID card.

  • EmblemHealth Insurance Company’s Prime Network.
  • EmblemHealth Plan Inc.’s National Network.
  • Cigna Healthcare Network.**
  • First Health Network and QualCare Network.**

Look to the branding and instructions on the member’s ID card. The card will have “Bridge” in the network field and Cigna’s logo or First Health’s and QualCare’s logos.

* Portal user must be authorized to conduct business for the provider they are looking up.

** EmblemHealth works with the Cigna Healthcare Network, First Health Network, and QualCare network to provide coverage for care beyond our own contracted networks’ geographic coverage. Depending on the group or plan, members may have different networks through which they receive care.

In the following counties, the EmblemHealth network is the primary network for the member:

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.

These extended networks are considered in-network for non-city large group and ASO members, based on their geography, for our members with the Bridge Program as follows:

  • Cigna Healthcare Network = All states except for New York. In New York, care is covered solely through the EmblemHealth networks.
  • First Health Network = All states except for New Jersey. Also provides coverage in New York outside of the counties listed above.
  • QualCare = New Jersey only.

Payment:

What rate will I be paid?


Members whose coverage is part of our Bridge Program have access to providers in many of our networks. Providers are paid according to their contracts with our company.  The chart below sets the guidelines for determining how Bridge Program claims are reimbursed:

How we pay Bridge Program claims

If you have a contract with the following plans (first applicable contracted plan applies to all Bridge Program claims)

You will be paid these rates

Health Insurance Plan of Greater New York (HIP)*

Health Insurance Plan of Greater New York –  HMO

EmblemHealth Insurance Company

EmblemHealth Insurance Company

EmblemHealth Plan, Inc.

EmblemHealth Plan, Inc.

ConnectiCare only

  

Cigna only

Cigna

First Health only

First Health

QualCare only

QualCare

If you still have questions or concerns about which contract rate applies, contact us at 866-447-9717, Monday through Friday, from 8 a.m. to 6 p.m., and a Customer Service agent will assist you.

*To the extent that you contract with HIP, the HIP rates will always apply to Bridge Program claims, regardless of whether you are contracted with any other EmblemHealth entity.

Where do I submit my claims?

You follow the same billing protocols as you would for any other member falling under a given underwriting company and their applicable vendor partnerships.

See EmblemHealth Claims Contacts.

Utilization Management:

What Utilization Management rules apply?

Referrals are not required. Follow the Utilization Management rules for the underwriting company found on the back of the Member’s ID Card.

See Who To Contact for EmblemHealth Preauthorization.

Does it matter if a member is ASO vs. Fully Insured?

Fully insured members follow all the standard administrative guidelines as every other member with the same benefit plan underwritten by the same company. This includes using the same preauthorization lists, preauthorization contacts, and special vendor managed utilization management programs.

The Bridge ASO program was initially launched with the goal of having all Bridge ASO members follow EmblemHealth Insurance Company’s standard utilization management rules. However, based on client request, we have given ASO clients the option to customize their utilization management rules. They may adopt an existing standard set of rules, or they may choose to develop their own.

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