Empire Blue Cross Blue Shield Review

 In Insurance Company Reviews

Empire Blue Cross Blue Shield review NYIf you’re looking for a comprehensive group health plan for your small business our Empire Blue Cross Blue Shield review explains why this company is one of the best. This insurer is probably one of the most admired insurance providers in the state of New York.  And for many reasons; Empire has one of the strongest provider networks of coverage across the entire state – only second to behemoth, Oxford.

The Empire BCBS network includes more than 90,000 participating doctors and over 160 hospitals making them one of the best health insurance companies in New York. And even though, the company only provides health insurance coverage to the New York City metropolitan area and selected counties in upstate New York, they are a solid choice for small business health insurance.

If your employees live or work out of New York State, they are given access to doctors and hospitals almost anywhere in the United States and 170 countries through Empire’s BlueCard Network.

Empire BCBS Small Business Group Health Plans

Empire offers a wide variety of health plan options for both small and large companies. In addition to health insurance, the company also offers group dental, vision, life and disability insurance. Their small business health plans are comprised of 3 different programs. Each program offers business owners different plan designs and options for providing health care to their employees.

Empire Blue Card Program

BlueCard, formerly known as the Prism plan is Empire’s premier health plan. It offers national access to EPO and PPO health insurance plans for small groups in New York. BlueCard has over 150 in-network hospitals and over 85,000 in-network physicians.

The BlueCard network is the largest provider network in the United States. More than 96% of hospitals and 93% of doctors across the country give your employees access to health care services with BlueCard,

Blue Priority Program

Blue Priority is an in-network only EPO plan. This is a smaller network than Blue Card however this program still boasts more than 85,000 physicians and more than 160 hospitals in the New York metro area.  Referrals are not required to see a specialist provided they are in network only. For small business owners, Empire requires 60% of full-time employees to enroll excluding valid waivers. Valid waivers include: Medicare, Medicaid, Spousal, Veterans, and Parental.

Pathway Program

After leaving the New York small group marketplace (1-50 employees) in 2012, Empire re-emerged in 2016 with their Pathway Program. Pathway is an HMO only plan and has the most limited network of doctors and hospitals of all the Empire programs. Empire’s Pathway Network has nearly 49,000 physicians and 83 hospitals that are considered in-network only providers. Referrals are required to see a specialist and 60% of full-time employees are required to enroll in a small group plan.

Product Types Offered Through Empire Blue Cross

Preferred Provider Organization (PPO)

PPO plans allow employees to receive care in-network and out-of-network. Members pay the negotiated rate for medical care at substantially less rates when they use a provider in the PPO network. But they also have the choice to go outside of the network for medical care and still receive reimbursement for services. There are no referrals needed to see a specialist.

Exclusive Provider Organization (EPO)

Empire EPO plans cover in network medical services only but do not require a referral from their Primary Care Physician (PCP).

Health Maintenance Organization (HMO)

HMO plans only cover services from providers in the HMO plan network. Employees are required to choose a PCP in the HMO network. If a specialist is needed, the PCP must provide a referral.

Consumer Driven Health Plans (CDHP’s)

CDHP’ are high deductibles plans and can be integrated with Health Savings Accounts (HSA’s) and Health Reimbursement Arrangements (HRA’s).  Empire CDHPs are available as an HMO, EPO and PPO plans.

Health Savings Accounts (HSA’s)

Health Savings Accounts allow employees pay for their health care expenses on a tax-free basis. Accounts are funded with pre-tax dollars usually through payroll deductions. Funds can be used for qualified medical expenses and prescriptions.

Empire Blue Cross For Your Business

If you are looking for a group health plan with flexibility, numerous plan options and a robust provider network, Empire should definitely be considered. Employers in New York can offer their employees a choice of 2 or 3 Empire plans to help keep health insurance costs under control.

For instance: employers can offer a platinum EPO plan for employees who are looking for the highest amount of coverage with the least out of pocket expenses. Other employees who want to maximize premium savings can opt for a high deductible plan or HSA plan to control their health care costs.

At Healthplansny, we are independent insurance advisers and we work with the top insurance carriers in the industry. We are not beholden to any insurance company and will never try to push you to one particular carrier. We work for you! For more information or if you would like a free group health consultation, give our office a call at: 800-514-3513

Recent Posts
Contact Us

We're not around right now. But you can send us an email and we'll get back to you, asap.

Start typing and press Enter to search