- Offer a wide selection of flexible benefit designs and cost-sharing options to help you get the most for your institution's precious health care dollars.
- Deliver real value by providing your members with access to our extensive provider network of top doctors, specialists and top medical professionals throughout the tristate area.
- Offer your faculty and staff entry to hospital networks that includes nearly every acute-care hospital in the region, including Memorial Sloan-Kettering Cancer Center, Northern Westchester Hospital Center, St. Frances Heart Center and many others.
- Incorporate online tools and digital resources that let our members take a more active role in maintaining their own health and get the information needed to do so in an instant.
- Can include an impressive array of industry-recognized, preventive care and wellness programs. We take health and wellness seriously: in 2011, the National Committee for Quality Assurance awarded accreditation to our wellness programs.
Get your faculty and staff the care they deserve with EmblemHealth.
Quality Networks Mean Quality Care for Your Faculty and Staff
Our robust medical network provides access to a wide range of medical practitioners, including:
- Primary care physicians and specialists, including pediatricians, cardiologists, oncologists and more.
- Behavioral and mental health services provided through an alliance with ValueOptions®
- Other essential providers, including skilled nursing facilities, medical equipment and vision care.
- Clinical labs, such as Quest Diagnostics.
Our hospital networks include every acute-care hospital, including Memorial Sloan-Kettering Cancer Center, Northern Westchester Hospital Center, St. Frances Heart Center and many others.
Administrative Services Only (ASO) Arrangements
ASO Doctor and PatientOur ASO arrangements offer higher education institutions claims processing and customer service for a low per-member administrative fee, plus the quality care and competitive fee schedules available through the EmblemHealth National Network.
EmblemHealth case management services enable your institution to take advantage of our medical management and member assistance capabilities through all aspects of cases — even the most complex.
Flexible Benefits Designs
EmblemHealth gives your institution choice and flexibility. Our broad selection of plans gives you the flexibility to offer multiple options to your faculty and staff.
Our PPO and InBalance PPO (Preferred Provider Organization) plans feature the EmblemHealth National Network and combine family-friendly benefit designs with freedom of provider choice. No referrals are required. They also offer members out-of-network coverage for additional out-of-pocket costs. The InBalance option lowers group premiums by applying member cost-sharing for certain services received in-network.
Our EPO and InBalance EPO (Exclusive Provider Organization) plans provide access to the EmblemHealth National Network and offer family-friendly, in-network-only benefits that make these plans attractive and affordable. No referrals are required. The InBalance option lowers group premiums by increasing member cost-sharing for certain services.
Ou Consumer Direct PPO and Consumer Direct EPO plans provide access to the EmblemHealth National Network and offer low group premiums based on higher-than-customary member deductibles. These high-deductible health plans help groups offset member costs with tax-saving Health Savings Accounts (HSAs).1
Our CompreHealth EPO provides in-network-only benefits with no referrals required, and offers access to the EmblemHealth NY Metro Network, with leading physicians and other medical practitioners across New York City and Nassau, Suffolk and southern Westchester counties. In addition to physicians in private practice, it features multispecialty physician group practices that offer a broad range of medical services, often under one roof, as well as access to the metro area’s leading hospitals.
Our Dental Plans provide a choice of three programs featuring different benefit designs, network size and cost-sharing responsibilities, ranging from paid-in-full network coverage to in-network discounts on more costly services.
Our Pharmacy Benefit Services, available by separate rider, provides a wide range of retail and mail-order prescription drug benefits, as well as an extensive formulary of drugs covered by the prescription plan.
Your EmblemHealth sales representative will work closely with you to help put together a benefit plan design that best serves the needs of your institution.
1 HSAs are options the group may add to its HDHP plan. Groups must make arrangements for the HSA before offering it to their members.