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What is Empire's 360° Health® program?
A total health solution that helps members become more healthy, or live better with a condition, while lowering the cost of health care.
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Group Health Plans

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Small Group Health Plans
For businesses with 2-50* eligible employees
 
Small group plans offering 100% coverage for covered preventive services, integrated Rx, pediatric dental, and vision coverage, expanded gym reimbursement benefit, and have access to Empire’s Pathway Network and Blue Card for access to out of area providers. All small group products require PCP and specialist referrals for members living within our 28 county service area. Members residing outside of the area will not require PCPs or referrals.. All small group products require PCP and specialist referrals. 
Learn more today. Check out our Small Group Product Guide. Downstate / Upstate  
Empire Bronze Pathway EPO 4500/30%/6350 Plus with HSA and Empire Bronze Pathway EPO 3500/20%/6350 Plus with HSA (Health Savings Account)  
Bronze level plans for small groups looking for low cost comprehensive coverage. Core plans are higher deductible plans with copays after deductible is met on most services.  
Empire Silver Pathway EPO 2500/20%/4500 Plus with HSA (Health Savings Account)  
Silver level plans for small groups looking for moderate cost shares and comprehensive coverage. Essential HSA plans offer traditional HSA benefits subject to deductible and coinsurance.  
Empire Silver Pathway EPO 1500/30%/5500 Plus  
This Silver plan offers 3 diagnostic office visits at a low copay, in addition to covered preventive visits which are always covered at 100%, then benefits are subject to deductible and coinsurance.  
Empire Silver Pathway EPO 1500/30%/5500 Plus (with adult dental)  
This Silver plan offers 3 diagnostic office visits at a low copay, in addition to covered preventive visits which are always covered at 100%, with embedded adult dental. Benefits subject to deductible and coinsurance.  
Empire Gold Pathway HMO 1300/10%/6000 Plus with HSA (Health Savings Account)  
This Gold plan offers traditional HSA coverage including comprehensive benefits and preventive care covered at 100% for covered services. This option offers lower deductible and coinsurance than Silver and Bronze plans.  
 
*A minimum group size of business owner and one eligible non-spouse employee; a group of 50 consists of the business owner plus 49 eligible employees. 
 
 

Large Group Health Plans
For businesses with 51 or more eligible employees
 
Prism EPO  
Affordable in-network coverage with national access to the broadest network of providers. Optional Blue Priority network available for additional cost savings.  
Prism PPO  
Affordable and flexible benefits with In and Out of network coverage and national access to the broadest network of providers  
Empire PrismSM Deductible First EPO  
Comprehensive Prism benefits with lower premiums. A deductible is added before copays to help reduce premiums. Affordable in-network coverage with national access to the broadest network of providers. Optional Blue Priority network available for additional cost savings.  
Learn more today. Watch our Prism Deductible First product video: Downstate / Upstate  
Empire PrismSM Deductible First PPO  
Comprehensive Prism benefits with lower premiums. A deductible is added before copays to help reduce premiums. Affordable benefits with In and Out of network coverage and national access to the broadest network of providers.  
Learn more today. Watch our Prism Deductible First product video: Downstate / Upstate  
Empire Total BlueSM EPO with HSA (Health Savings Account)  
A consumer-directed option that combines a high-deductible health plan (HDHP) with an HSA that members and employers fund using pre- or post-tax contributions. The plan has the security of a traditional EPO offering with in-network access. Optional Blue Priority network available for additional cost savings.  
Learn more today. View our Product e-Tutorial: Downstate / Upstate  
Empire Total BlueSM EPO with HRA (Health Reimbursement Account)  
A consumer-directed flexible health care plan along with the security of a traditional EPO offering with in-network access. . Optional Blue Priority network available for additional cost savings.  
Learn more today. View our Product e-Tutorial: Downstate / Upstate  
Empire Total BlueSM PPO with HSA (Health Savings Account)  
A more active approach to healthcare with in and out of network access where consumers take the control.  
Empire Total BlueSM PPO with HRA (Health Reimbursement Account)  
A more active approach to healthcare with in and out of network access where consumers take the control.  
 

Superior Health Plans - Rich, Wide-Ranging Benefits
For businesses with 51 or more eligible employees
 
Direct POS  
Offers flexible benefits with in and out of network access as well as out of area coverage.  
PPO  
Comprehensive coverage with In and Out of network national access with premium benefits and low out-of-pocket expenses  
PPO with In-Network Cost-Sharing  
A more flexible plan with national in and out of network access and lower to moderate out-of-pocket expenses  
HMO  
Comprehensive coverage within Empire’s 28 county service area, at lower or no copays. Requires PCP selection and referrals.  
 
 
Empire’s 28-county service area: Albany, Bronx, Clinton, Columbia, Delaware, Dutchess, Essex, Fulton, Green, Kings, Montgomery, Nassau, New York, Orange, Putnam, Queens, Rensselaer, Richmond, Rockland, Saratoga, Schenectady, Schoharie, Suffolk, Sullivan, Ulster, Warren, Washington and Westchester. 
 
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