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Group Health Plans

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Small Group Health Plans
The below Small Group products will be discontinued from our product portfolio starting 1/1/14 upon a group’s renewal and not available for new sale.*  
Empire EPO Essential*  
A lower premium, wellness-focused plan for individuals or families— with comprehensive preventive benefits covered 100%, gym reimbursement and vision benefits.
(For businesses with 2-50 eligible employees)
 
Empire PPO*  
This plan offers new deductible options and coinsurance as a way to provide the advantages of a broad PPO national network, as well as out of network coverage.
(For businesses with 2-50 eligible employees)
 
HMO*  
Comprehensive coverage within Empire’s 28 county service area, at lower or no copays. Requires PCP selection and referrals.
(For businesses with 2 or more eligible employees)
 
 
Introducing new Accountable Care Act (ACA) compliant Small Group portfolio starting 1/1/14 
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 Core Guided Access Plus EPO 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.
(For businesses with 2-50 eligible employees)  
Empire Essential Guided Access Plus EPO with HSA (Health Savings Account)  
Silver level plans for small groups looking for moderate cost shares and comprehensive coverage.  
Essential H.S.A plans offer traditional H.S.A. Benefits subject to deductible and coinsurance.
(For businesses with 2-50 eligible employees)
 
Empire Essential Guided Access Plus EPO 
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.
(For businesses with 2-50 eligible employees)
 
Empire Essential Guided Access Plus EPO 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.
(For businesses with 2-50 eligible employees)
 
Empire Preferred Guided Access Plus HMO with HSA (Health Savings Account)  
This Gold plan offers traditional H.S.A. 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.
(For businesses with 2-50 eligible employees)
 
 
Large Group Health Plans
Prism EPO  
Affordable in-network coverage with national access to the broadest network of providers. Optional Blue Priority network available for additional cost savings.
(For businesses with 51 or more eligible employees)
 
Prism PPO  
Affordable and flexible benefits with In and Out of network coverage and national access to the broadest network of providers
(For business with 51 or more eligible employees)
 
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.
(For businesses with 51 or more eligible employees)
 
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.
(For businesses with 51 or more eligible employees)
 
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.
(For businesses with 51 or more eligible employees)
 
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.
(For businesses with 51 or more eligible employees)
 
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.
(For businesses with 51 or more eligible employees)
 
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.
(For businesses with 51 or more eligible employees)
 
Superior Health Plans - Rich, Wide-Ranging Benefits
Direct POS  
Offers flexible benefits with in and out of network access as well as out of area coverage.
(For businesses with 51 or more eligible employees)
 
PPO  
Comprehensive coverage with In and Out of network national access with premium benefits and low out-of-pocket expenses
(For businesses with 51 or more eligible employees)
 
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
(For businesses with 51 or more eligible employees)
 
HMO  
Comprehensive coverage within Empire’s 28 county service area, at lower or no copays. Requires PCP selection and referrals.
(For businesses with 51 or more eligible employees)
 
 
 
 
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