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Empire BCBS 2014 Individual Products

Discover the key facts about Empire BCBS's 2014 Individual Products, including the size of the Pathway Network, number of hospitals, service areas, and more. Find complete coverage details and enrollment information.

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Empire BCBS 2014 Individual Products

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  1. Empire BCBS 2014 Individual Products

  2. Pathway Network Key Facts: • 75% the size of the larger HMO Provider network • 75+ hospitals in the Pathway Network • The network can be accessed through Provider Finder at www.empireblue.com • 28 county New York Service Area for HMO products • 28 county New York Service Area for EPO products • Under the EPO, members who reside outside of the 28 county NY service area can use Blue Card.

  3. Consolidation of rating regions • Empire’s operating area is dividing into five rating regions for all medical products • Rates are based on the following locations: • Albany (region 1):Albany, Columbia, Fulton, Green, Montgomery, Rensselaer, Saratoga, Schenectady, Schoharie, Warren and Washington • Long Island (region 8): Nassau and Suffolk • Mid-Hudson (region 3):Delaware, Dutchess, Orange, Putnam, Sullivan and Ulster • New York City (region 4):Bronx, Kings, New York, Queens, Richmond, Rockland and Westchester • Upstate (region 7):Clinton and Essex

  4. Empire’s Individual OFF Marketplace portfolio(non-child only plans) The above is a summary. See the Certificate of Coverage with the Schedule of Benefits and any riders associated with the plan for complete coverage details and related terms and conditions.

  5. Individual Enrollment • To be eligible, an individual must live in one of the 28 counties where Empire is licensed to sell • Open Enrollment: • Plans can be purchased once a year through an open enrollment period • 1/1/14 effective date – open enrollment from 10/1 to 12/15 • Post 1/1/14 effective date – open enrollment from 12/16/13 to 3/31/14 • Effective date assignment rules will be the same for ON and OFF theIndividual Marketplace • If application received 1st – 15th, effective 1st of next month • If application received 16th – EOM, effective 1st of following month • Exception: Newborns and adopted children can be added or enrolled in a plan as of the date of birth or placement as long as we are advised within 60 days.

  6. Empire BCBS 2014 Individual Rates

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