The waiting is over…

After a five year hiatus, Empire BlueCross BlueShield will once again be offering BlueCard (formerly known as “Prism”) national access EPO and PPO health insurance plans to small groups in New York starting in 2017. I’m sure many business owners in the mid-Hudson Valley, Westchester County, New York City, and on Long Island recall their Empire Prism plans, which were all discontinued in 2012. Well, these plan options are finally back! Call us today to learn more about Empire’s re-engagement in the NY small group market, and how we can help provide you and your employees with robust and affordable coverage options.

Why BlueCard?

The BlueCard network is the largest provider network in the United States. Specifically, 96% of hospitals and 93% of doctors across the country are in-network with BlueCard, along with additional in-network BlueCard access outside of the United States (spanning 170 countries and territories). In New York alone, BlueCard has over 150 in-network hospitals/facilities, and over 85,000 in-network physicians. Even Empire “Blue Priority” EPO plans will have over 65,000 in-network physicians in the metro NY area (which rivals the Oxford Freedom network), while still providing national (and worldwide) BlueCard network access outside of the metro NY area.

You can learn more about Empire’s three different small group provider networks (BlueCard, Blue Priority, and Pathway) here: Empire – Network Overview Flyer – 2017

Numerous Plan Options To Choose From

Effective January 1st 2017, small business owners in downstate New York will have the luxury of selecting from 18 different Empire health plan options (across all medal levels) which utilize the BlueCard national network. Of those 18 plans (all of which do not require specialist referrals), 9 will be structured as PPO’s (plans offering both national in and out of network access), with the other 9 being structured as EPO’s (national in-network only plans). Bear in mind that all of these health plans will utilize the BlueCard national drug formulary, which provides the same level of prescription drug benefits currently only available to large Empire groups in New York.

Additionally, Empire will offer other small group plans with scaled down networks to help small employers manage their health insurance costs. For example, “Blue Priority” EPO plans will offer a reduced BlueCard physician network in the metro NY area, while maintaining national BlueCard access should one require medical services outside of the NY metro area. “Pathway” HMO plans will also be available, which provide referral-based (gated) coverage in the NY metro area only.

*Note* “Blue Priority” and “Pathway” plans will utilize Empire’s “Select” drug formulary, which will contain a smaller selection of prescription drugs as compared to their EPO/PPO plans’ drug formulary.

You can view Empire’s entire NY small group product portfolio here: Empire – NY Small Group Product Guide – 2017

Competitive Pricing

Unlike in years past, Empire is re-engaging the NY small group market not only with a plethora of national coverage options, but at reasonable prices as well. For example, small employers in NY will be able to obtain single-rate Empire BlueCard EPO platinum coverage as low as $949 per month, as compared to Oxford Freedom’s $943 per month price tag (Aetna is not even offering platinum coverage in NY for 2017). For those small employers who previously had Empire Prism plans back in 2011, paying the additional $6 per month in premium for BlueCard access over Freedom/UHC Choice Plus access is a no brainer of a decision.

You can view Empire’s Q1/2017 downstate NY small group product offerings and prices here: Empire – Downstate NY – Q1/2017 – Small Group Rate Sheet

Implementing Empire Coverage For Your Business

Small employers in New York will be able to offer their employees with single, double, or triple-option Empire coverage. This will give small business owners more health plan flexibility for their employees, and a means to keep their premium costs under control. For example, employees can be given a choice of enrolling in platinum EPO coverage for maximum benefits, a “middle” option consisting of a reasonable deductible to lower premiums without compromising too much coverage, and a “low” HSA-compatible option for maximum premium savings. So long as at least one employee is enrolled in each plan, Empire will allow small groups to offer up to three concurrent health plans (spanning their entire small group product portfolio) for their employees.

Eligibility Requirements

Empire’s small group eligibility requirements in New York will mirror the eligibility requirements of Oxford and Aetna. They are as follows:

-60% of all eligible employees must enroll in coverage, excluding valid waivers
-Empire’s valid waivers include Spousal, Medicare, Medicaid, Veterans, and Parental

You can read all of Empire’s small group eligibility guidelines here: Empire – Small Group Eligibility Guide – 2017

For more information, or to setup group Empire BlueCard coverage for your small business in New York, contact us today!