Oct 27, 2022
2023 Portfolio
EmblemHealth Insurance Plan (HIP), offering HMO plans, will remain available in 2023 but with a change to the available network offerings. All plans continuing into 2023 will only be offered on the Prime Network with tristate access - the Prime Network in New York, the ConnectiCare network in Connecticut, and the QualCare network in New Jersey.
The portfolio for 2023 will not have any plans on the Bridge Program with a national network. All plans, except Healthy NY, will continue to be non-gated with no referrals required.
In 2023, the following plans will be available to new and renewing groups:
- EmblemHealth Platinum Premier-P
- EmblemHealth Gold Premier-P
- EmblemHealth Silver Premier-P
- EmblemHealth Silver Plus HSA
- EmblemHealth Bronze Premier-P
- EmblemHealth Bronze Plus HSA
Plan Discontinuances
All HIP small group Value plans and Premier plans on Millennium and Select Care will no longer be offered, but will be mapped to the equivalent Premier metal level under the Prime Network (see above list of plans).
EmblemHealth Insurance Company (EHIC), offering EPO and PPO plans, will begin to exit the New York small group market during 2023. As a result, they will not market EHIC small group products in 2023 and thereafter. For the time being:
- Small groups with EHIC plans (except for Gold EPO-M) will renew into their respective EHIC plan in 2023, unless the group makes a different choice.
- Current Gold EPO-M groups will be enrolled in Gold EPO-N upon renewal in 2023 unless the group makes a different choice.
Please note that due to the expected start of the market exit, certain groups’ EHIC plan(s) will not renew in 2023. Such groups will receive advance notice of the discontinuance/non-renewal of their plan in advance of the end of their 2022 contract term.
Commission Update
EmblemHealth has announced changes to their commission schedule for group enrollments effective January 1, 2023. Please note these changes apply to new and renewing business:
- HMO (HIP) small group commissions will change from 4% to 3%.
- EPO/PPO (EHIC) small group commissions will change from 4% to $0.
Contact your Amwins Connect Sales Representative to learn more.
