If you’re like most New York small business owners, you’ve probably heard of EmblemHealth. Now, it is worth mentioning that although Emblem is one of the numerous insurance companies we represent, we have not been paid to give them a review.
As independent insurance agents, our reviews are unbiased and are only meant to help you make the best decision regarding a group health insurance program for your business.
About EmblemHealth Insurance Company
Emblem is one of the Nation’s largest not-for-profit health plan providers and has more than 3.1 million customers as of 2016. The company is headquartered in downtown New York City and was formed through a merger of GHI (Group Health Incorporated) and HIP (Health Insurance Plan of New York) in 2006. GHI and HIP were serving the New York City as health insurance providers for more than 75 years.
Benefits Of EmblemHealth
Emblem primarily offers medical coverage to the New York Tri-State area. They offer a range of health care coverage to small and large businesses as well as government and union organizations. If your business is located in New York, you and your employees will have access to an extensive network of doctors and hospitals throughout the New York, New Jersey and Connecticut.
Emblem Small Business Health Plans
Emblem separates their health plan programs between small business groups (less than 100 employees) and large groups (over 100 employees). For small groups, employees would utilize the Select Care regional HMO network. This network has more than 34,000 primary care doctors and specialists, plus the tri-state area’s leading hospitals.
Select Care offers your small business a choice of 4 HMO (Health Maintenance Organization) plans. HMO plans require referrals from a PCP (Primary Care Physician) and do not cover out of network medical services.
1. Bronze Value S (with adult dental & vision)
The Bronze Value is a low-cost HMO Plan and has the highest deductibles of any plan that Emblem offers. The deductibles or out of pocket costs to members are $7,150 for singles and $14,000 for Families. This plan is a good choice for employees who want the lowest premiums, are in relatively good health and don’t go to the doctor very often. The plan offers free generic drugs, 2 free primary care visits, free preventive care and free lab services before the deductible must be met. The Bronze plan also provides dental and vision coverage for adults and children.
2. Silver Value S (with adult dental & vision)
This HMO plan is a good choice for employees who regularly go to doctor or a specialist but want lower out of pocket costs. The Silver Value plan has deductibles of $5,800 for singles and $11,600 for families. Once the deductible is met, the plan offers unlimited specialist visits and urgent care visits. In addition, it covers 3 free primary care visits, free generic drugs, free telehealth, free preventive care and free lab services. This plan also provides dental and vision coverage for adults and children.
3. Emblem HMO 40/60 (Gold)
This nonstandard Gold HMO plan offers low deductibles of $250/single and $500/family. It’s a good choice for people who go to the doctor frequently, but want lower out of pocket expenses for medical care. Doctor visits are $40 and $60 for specialists. Before the deductible, this plan includes free telehealth and free preventive care.
4. Emblem HMO 15/35 (Platinum)
This is no-deductible HMO plan which has the lowest out-of-pocket costs but also has the highest monthly premiums. It’s a good choice for people who need a lot of medical care and want to pay the least amount of money for medical expenses. Plus, it offers free telehealth and free preventive care.
Emblem Large Business Health Plans
For large companies with more than 100 employees, Emblem offers a variety of PPO and EPO plans as well as an HMO plan which is still branded under the old HIP company of New York.
Emblem’s PPO plans offer coverage for in network and out-of-network medical services. National coverage is provided through the MultiPlan network. No referrals are needed to see a specialist or go out of network. These plans provide the highest amount of medical coverage, including prescription benefits.
There are 3 PPO plans to choose from:
- Emblemhealth PPO
- InBalance PPO
- Consumerdirect PPO
Large Group EPO Plans
EPO plans offer in-network coverage only but no referrals are needed to a specialist. EPO plans also provide National coverage through the Emblem network.
There are 5 EPO plans available for your business:
- Emblemhealth EPO
- CompreHealth EPO
- InBalance EPO
- ConsumerDirect EPO
- HealthEssentials Plus
EmblemHealth Insurance For Your Business
If you are looking for a group health plan, Emblem is definitely a company you should consider. If you have 2 employees or 200, we can design a plan that meets the needs of your small business.
As independent agents, we offer unbiased advice and will not try to push you to one particular insurance company.
We work the best health insurance companies in New York, New Jersey and Connecticut. And we work for you, our client! If you would like a free group health consultation, give our office a call at: 800-234-3702