EmblemHealth Announces Product Changes

 In Blog

Emblem health has announced that they will be discontinuing several of their comprehensive health plans in the NY small group market (2-50 employees) and will be replacing them with mostly High Deductible Plans.

EmblemHealth was formed in 2006 as the result of a company merger between GHI and HIP to become the largest insurer in the State of New York.

In the announcement Emblem said, “As we prepare for changes related to health care reform, we are modifying policies related to the New York small group marketplace.”

The plans being discontinued are the traditional EPO plans that offer co-pays for doctor and specialist visits. They are being replaced with high deductible plans that require people to pay more out of pocket for basic medical services. The change will take effect on May 1st, 2013.

The plans remaining in the EmblemHealth line up are:

  • The Consumer Direct EPO High Deductible Plan
  • EmblemHealth Health Essentials EPO Plan (A hospital only plan)
  • InBalance EPO Plan
  • Comprehealth HMO
  • PPO
  • InBalance PPO (large groups)
  • Consumer Direct PPO (large groups)
  • Consumer Direct EPO (large groups)

Along with the announcement of their product changes, Emblem has announced that they will be reducing broker commissions – an industry trend – but they will allow their clients to keep the discontinued EPO plans for an unspecified period of time.

It is unclear who will be providing service for their discontinued health plans because Emblem has reduced broker commissions to ZERO for the servicing and administration of their existing plans.

Emblem was the worst offender amongst insurance companies last year in the never ending rate increase game, and raised their health plan rates by a whopping 23.9%.

I’m curious to know, what other industry would be allowed to raise their rates by double digits each year while reducing their benefits without some kind of investigation or accountability.

The New York State Insurance Department is “asleep at the wheel” allowing insurance companies to do as they please, take advantage of their clients and screw their brokers.

Comment as you see fit.


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