Prior Approval Rate Changes and/or Product Discontinuances


NY Small Group 2022 Proposed Premium Rate Change / Notice of Filing

We have submitted a premium rate change request to the New York Department of Financial Services (NYDFS) to modify premium rates for our small group plans effective 1/1/2022 upon renewal.

The requested amount of the increases range from 6% to 27.9%, depending on the plan and rating area, which is based on the county the group is situs in. If approved, the rate increase will be effective January 1, 2022 upon renewal. The final, approved rates may differ from what we have requested.

2022 SMALL GROUP PRODUCTS
Member Letter  
 
Narrative Summary 
 


NY Small Group 2021 Proposed Rate Change / Prior Approval Initial Notice

We have submitted a rate change request to the New York Department of Financial Services (NYDFS) to modify rates for our Small Group plans effective 1/1/2021 upon renewal.

New York State law requires that health insurance carriers provide an initial notice to you when we submit requests for rate changes to the NYDFS. The law also requires that we explain any proposed rate change. Therefore, the below grid outlines the requested rate changes for specific small group products. The submitted rate change requests are pending NYDFS approval. A narrative, which explains the proposed rate change requests, can be found in the below grid.

Since the NYDFS must approve all community rates, the actual rate increase will not be available until approval is received. At that time, we will send you another notice. The second notice, which we will send to you at least 60 days prior to the effective date of the rate change, will include the approved rate changes. You have 30 days from the date of our June 2021 filing to contact Empire or the DFS to ask for more information about the rate-change filing, or to submit written comments to the DFS. If you have any other questions, you can contact us by sending an email to Empire at premiumratechange@empireblue.com. If you are an employee, call the customer service number on the back of your member ID card. Written comments submitted to the DFS will be posted on the website of the DFS with all personal identifying information removed. Comments may be submitted to the DFS online at http://www.dfs.ny.gov/healthinsurancepremiums or by contacting:

NYS Department of Financial Services

Health Bureau - Premium Rate Adjustments

One Commerce Plaza

Albany, NY 12257

You may also reach the DFS at premiumrateincreases@dfs.ny.gov

SMALL GROUP PRODUCTS Employer Letter/Member Letter
Narrative Summary 
 
Healthy NY 
 
January - May Renewed Small Group Products 
 
All Other non-Healthy NY Small Group Products 


NY Small Group 2019 Proposed Rate Change / Prior Approval Initial Notice

We have submitted a rate change request to the New York Department of Financial Services (NYDFS) to modify rates for our Small Group plans effective 1/1/2019 upon renewal.

New York State law requires that health insurance carriers provide an initial notice to you when we submit requests for rate changes to the NYDFS. The law also requires that we explain any proposed rate change. Therefore, the below grid outlines the requested rate changes for specific small group products. The submitted rate change requests are pending NYDFS approval. A narrative, which explains the proposed rate change requests, can be found in the below grid.

Since the NYDFS must approve all community rates, the actual rate increase will not be available until approval is received. At that time, we will send you another notice. The second notice, which we will send to you at least 60 days prior to the effective date of the rate change, will include the approved rate changes. You have 30 days from the date of our June 2018 filing to contact Empire or the DFS to ask for more information about the rate-change filing, or to submit written comments to the DFS. If you have any other questions, you can contact us by sending an email to Empire at premiumratechange@empireblue.com. If you are an employee, call the customer service number on the back of your member ID card. Written comments submitted to the DFS will be posted on the website of the DFS with all personal identifying information removed. Comments may be submitted to the DFS online at http://www.dfs.ny.gov/healthinsurancepremiums or by contacting:

NYS Department of Financial Services

Health Bureau - Premium Rate Adjustments

One Commerce Plaza

Albany, NY 12257

You may also reach the DFS at premiumrateincreases@dfs.ny.gov


Small Group Products Rate Grids 1st quarter 2019 rates
2nd quarter 2019 rates

3rd quarter 2019 rates

4th quarter 2019 rates
Narrative Summary   Empire HealthChoice Assurance Inc. Empire HealthChoice HMO Inc. 
Small Group Products 
Employer and Member Letter  
January - Mar Renewed Small Groups  
 
Empire Gold Healthy New York Pathway Plus HMO 600/0%/4000
Upstate and Downstate 
All other non-Healthy New York products
Upstate and Downstate 
Apr - June Renewed Small Groups 
 
Apr - June groups
Upstate and Downstate 
July - September Renewing Small Groups  
 
July - September groups
Upstate and Downstate 
October - December Renewing Small Groups  
 
October - December groups
Upstate and Downstate 


2018 Notification of Rate Change Request for Large Groups

July 2018

We have submitted a rate change request to the New York Department of Financial Services (NYDFS) to modify premium rates for our Large Group HMO plans. New York State law requires that health insurance carriers provide an initial notice to you when we submit requests for premium rate changes to the NYDFS. The law also requires that we explain any proposed rate change. Therefore, the below grid provides a link to employer and subscriber letters that outline the requested rate changes for specific large group products. The submitted rate change requests are pending NYDFS approval. A link to the narrative, which explains the proposed rate change requests, can be found in the below grid.

Requested medical premium rate changes are as follows across the following service areas (Downstate1, Downstate2, Mid-Hudson, Capital, Upstate 1 and Upstate 2):

Renewal QTR     Requested Annual Increase
     
1Q19     9.1%
2Q19     12.4%
3Q19     20.8%
4Q19     20.8%


2018 Notification of Rate Change Request for Individual Grandfathered Plans

Individual Grandfathered Products - Sample Member Letter

NY Small Group 2018 Proposed Rate Change / Prior Approval Initial Notice

05/2017

We have submitted a rate change request to the New York Department of Financial Services (NYDFS) to modify rates for our Small Group plans effective 1/1/2018 upon renewal.

New York State law requires that health insurance carriers provide an initial notice to you when we submit requests for rate changes to the NYDFS. The law also requires that we explain any proposed rate change. Therefore, the below grid outlines the requested rate changes for specific small group products. The submitted rate change requests are pending NYDFS approval. A narrative, which explains the proposed rate change requests, can be found in the below grid.

Since the NYDFS must approve all community rates, the actual rate increase will not be available until approval is received. At that time, we will send you another notice. The second notice, which we will send to you at least 60 days prior to the effective date of the rate change, will include the approved rate changes. You have 30 days from the date of our May 2017 filing to contact Empire or the DFS to ask for more information about the rate-change filing, or to submit written comments to the DFS. If you have any other questions, you can contact us by sending an email to Empire at premiumratechange@empireblue.com. If you are an employee, call the customer service number on the back of your member ID card. Written comments submitted to the DFS will be posted on the website of the DFS with all personal identifying information removed. Comments may be submitted to the DFS online at http://www.dfs.ny.gov/healthinsurancepremiums or by contacting:

NYS Department of Financial Services
Health Bureau - Premium Rate Adjustments
One Commerce Plaza
Albany, NY 12257

You may also reach the DFS at premiumrateincreases@dfs.ny.gov.

To view and compare other Empire plans, use our Plan Comparison Tool at the below links and follow the steps to get a side-by-side comparison. You can compare copays, deductible or out-of-pocket maximums.

For EBC: http://ebcplancomparison.com/
For EBCBS: http://ebcbsplancomparison.com/


Small Group Products Rate Grids  
Narrative Summary  
2017 Small Group Products 
Employer and Member Letter  
January - May 2017 Renewed Small Groups  
Empire Gold Healthy New York Pathway Plus HMO 600/0%/4000
All other non-Healthy New York products
June - December 2017 Renewing Small Groups  
June 2017 groups
July - September groups
October - December groups


Large Group Prior Approval Decision Notice - Effective June 2017 upon Renewal

In October 2016, we communicated our rate changes planned for 2017. Since then, Empire has received approval from the New York Department of Financial Services (NYDFS) to modify premium rates for our Large Group HMO plans for new and renewing groups starting on June 1, 2017. The second round of required notifications to impacted Large Groups will be sent as part of their renewal package. Notifications will be mailed at least 60 days prior to the group�s renewal date, starting with June 2017 renewals.

Final medical premium rate changes are as follows:

 

Downstate 1

Downstate 2

Mid-Hudson

Capital

Upstate 1

Upstate 2

June 2017 renewing groups

6%

6%

11%

-4%

-4%

-4%

3Q 2017 renewing groups

7%

7%

12%

-3%

-3%

-3%

4Q 2017 renewing groups

8%

8%

13%

-2%

-2%

-2%

1Q 2018 renewing groups

8%

8%

13%

-1%

-1%

-1%


Final pharmacy (Rx) rider premium rate changes are as follows:  

 

Rx rider

June 2017 renewing groups

5%

3Q 2017 renewing groups

6%

4Q 2017 renewing groups

7%

1Q 2018 renewing groups

8%



2017 Notification of Rate Change Request for Individual Grandfathered Plans

Individual Grandfathered Products - Sample Member Letter

2016 Notification of Rate Change Request for Large Groups

October 27, 2016 

We have submitted a rate change request to the New York Department of Financial Services (NYDFS) to modify premium rates for our Large Group HMO plans. New York State law requires that health insurance carriers provide an initial notice to you when we submit requests for premium rate changes to the NYDFS. The law also requires that we explain any proposed rate change. Therefore, the below grid provides a link to employer and subscriber letters that outline the requested rate changes for specific large group products. The submitted rate change requests are pending NYDFS approval. A link to the narrative, which explains the proposed rate change requests, can be found in the below grid.

Requested medical premium rate changes are as follows:

 

Downstate 1

Downstate 2

Mid-Hudson

Capital

Upstate 1

Upstate 2

April 2017 renewing groups

20%

20%

26%

9%

9%

9%

May & June 2017 renewing groups

12%

12%

18%

2%

2%

2%

3Q 2017 renewing groups

13%

13%

19%

3%

3%

3%

4Q 2017 renewing groups

14%

14%

20%

4%

4%

4%

1Q 2018 renewing groups

14%

14%

20%

4%

4%

4%

Requested pharmacy rider premium rate changes are as follows:

 

Rx rider

April 2017 renewing groups

20%

May & June 2017 renewing groups

12%

3Q 2017 renewing groups

13%

4Q 2017 renewing groups

14%

1Q 2018 renewing groups

14%

Since the NYDFS must approve all community rates, the actual rate increase will not be available until approval is received. At that time, we will send you another notice. The second notice, which we will send to you at least 60 days prior to the effective date of the rate change, will include the approved rate changes. You have 30 days from the date of our October 27, 2016, filing to contact Empire or the DFS to ask for more information about the rate-change filing, or to submit written comments to the DFS. If you have any other questions, you can contact us by sending an email to Empire at premiumratechange@empireblue.com. If you are an employee, call the customer service number on the back of your member ID card. Written comments submitted to the NYDFS will be posted on the website of the NYDFS with all personal identifying information removed. Comments may be submitted to the NYDFS online at http://www.dfs.ny.gov/healthinsurancepremiums or by contacting:

NYS Department of Financial Services
Health Bureau - Premium Rate Adjustments
One Commerce Plaza
Albany, NY 12257
Email: premiumrateincreases@dfs.ny.gov
DFS website: www.dfs.ny.gov/healthinsurancepremiums

You may also reach the DFS at premiumrateincreases@dfs.ny.gov or by calling 1-800-342-3736.


Large Group HMO Products:
Empire Direct Connection HMO
Empire HMO  
Employer
Letter
 
Subscriber
Letter
 
Narrative
Summary
 
 
Upstate  
Upstate  
Upstate  


Small Group Prior Approval Decision Notice - Effective January 2017 upon Renewal

10/2016

In May 2016, we communicated our rate changes planned for 2017. Since then, Empire has received approval from the DFS to modify medical premium rates for new and renewing groups starting on January 1, 2017 for Small Group and Healthy New York. The second round of required notifications to impacted Small Groups will be sent as part of their renewal package. Notifications will be mailed 60 days prior to the group's renewal date, starting with January 2017 renewals.

To view and compare Empire�s small group plans, use our Plan Comparison Tool at the below links and follow the steps to get a side-by-side comparison.

For Upstate: http://ebcplancomparison.com/
For Downstate: http://ebcbsplancomparison.com/


2016 Small Group Products 
Approved
Medical Rates
 
Employer and
Member Letter
 
Empire Gold Pathway HMO 1250/10%/6000 Plus
Empire Gold Healthy New York Pathway HMO 600/0%/4000
Empire Silver Pathway EPO 1500/30%/5500 Plus
Empire Silver Pathway EPO 1500/30%/5500 Plus
with adult dental
Empire Silver Pathway EPO 2600/20%/4500 Plus
with H.S.A.
Empire Bronze Pathway EPO 3500/50%/6550 Plus with H.S.A.
Empire Bronze Pathway EPO 4500/30%/6550 Plus with H.S.A.
Letter  
Renewal insert :
Upstate

Downstate
 


NY Individual 2017 Discontinuance Notification

Some Empire individual plans are being discontinued effective January 1, 2017. Impacted subscribers will not be able to continue with these plans in 2017. These subscribers will have the opportunity to move to a different plan. Empire will continue to offer a range of comprehensive products in the market in 2017.

The discontinuance impacts approximately 9,000 members. Impacted plans are both on and off the New York State of Health Marketplace.

The New York State Department of Financial Services (DFS) has approved the discontinuance, and we have mailed discontinuance notices to impacted subscribers. Subscribers will receive them by August 1, 2016. Here are sample notices:

On-Marketplace: upstate and downstate
Off-Marketplace: upstate and downstate

Impacted subscribers will also receive a discontinuance reminder notice in October.

Individual plans being discontinued as of January 1, 2017:

(Note: this lists all plan variations and metal levels being discontinued.)

On-Marketplace:

Empire HMO 5850 X, Bronze, NS, INN, Pediatric Dental, Dep 25
Empire HMO 5850 X, Bronze, NS, INN, Pediatric Dental, Dep 29
Empire HMO 2750 X, for HSA, Silver, NS, INN, Pediatric Dental, Dep 25
Empire HMO 2750 X, for HSA, Silver, NS, INN, Pediatric Dental, Dep 29
Empire HMO 2750 X, Silver CSR 2, NS, INN, Pediatric Dental, Dep 25
Empire HMO 2750 X, Silver CSR 2, NS, INN, Pediatric Dental, Dep 29
Empire HMO 2750 X, Silver CSR 3, NS, INN, Pediatric Dental, Dep 25
Empire HMO 2750 X, Silver CSR 3, NS, INN, Pediatric Dental, Dep 29
Empire HMO 5850 X, Bronze AI, NS, INN, Pediatric Dental, Dep 29
Empire HMO 2750 X, Silver AI, NS, INN, Pediatric Dental, Dep 25
Empire HMO 2750 X, Silver AI, NS, INN, Pediatric Dental, Dep 29
Empire HMO 5850 X, Bronze AI, NS, INN, Pediatric Dental, Dep 25
Empire HMO 5850 X, Bronze, NS, INN, Pediatric Dental, Dep 25, $0 PCP Office Visit
Empire HMO 5850 X, Bronze, NS, INN, Pediatric Dental, Dep 29, $0 PCP Office Visit
Empire HMO 5850 X, Bronze AI, NS, INN, Pediatric Dental, Dep 25, $0 PCP Office Visit
Empire HMO 5850 X, Bronze AI, NS, INN, Pediatric Dental, Dep 29, $0 PCP Office Visit
Empire HMO 2750 X, Silver CSR 1, NS, INN, Pediatric Dental, Dep 25
Empire HMO 2750 X, Silver CSR 1, NS, INN, Pediatric Dental, Dep 29

Off-Marketplace:

Empire HMO 5850, Bronze, NS, INN, Pediatric Dental, Dep 25
Empire HMO 5850, Bronze, NS, INN, Pediatric Dental, Dep 29
Empire HMO 0, Platinum, ST, OON, Pediatric Dental, Dep 25
Empire HMO 0, Platinum, ST, OON, Pediatric Dental, Dep 29
Empire HMO 0, Platinum, Child Only, ST, OON, Pediatric Dental
Empire HMO 0, Platinum, ST, OON, Pediatric Dental, Dep 25, SNF
Empire HMO 0, Platinum, Child Only, ST, OON, Pediatric Dental, SNF
Empire HMO 0, Platinum, ST, OON, Pediatric Dental, Dep 29, SNF
Empire HMO 6000, Bronze, NS, INN, Pediatric Dental, Dep 25, FM
Empire HMO 6000, Bronze, NS, INN, Pediatric Dental, Dep 29, FM
Empire HMO 5850, Bronze, NS, INN, Pediatric Dental, Dep 25, FM
Empire HMO 5850, Bronze, NS, INN, Pediatric Dental, Dep 29, FM
Empire HMO 2750, Silver, NS, INN, Pediatric Dental, Dep 25, FM
Empire HMO 2750, Silver, NS, INN, Pediatric Dental, Dep 29, FM
Empire HMO 2250, Silver, NS, INN, Pediatric Dental, Dep 25, FM
Empire HMO 2250, Silver, NS, INN, Pediatric Dental, Dep 29, FM
Empire HMO 1000, Gold, NS, INN, Pediatric Dental, Dep 25, FM
Empire HMO 1000, Gold, NS, INN, Pediatric Dental, Dep 29, FM
Empire HMO 250, Platinum, NS, INN, Pediatric Dental, Dep 25, FM
Empire HMO 250, Platinum, NS, INN, Pediatric Dental, Dep 29, FM
Empire HMO 5850, Bronze, NS, INN, Pediatric Dental, Dep 25, $0 PCP Office Visit
Empire HMO 5850, Bronze, NS, INN, Pediatric Dental, Dep 29, $0 PCP Office Visit
Empire HMO 2750 for HSA, Silver, NS, INN, Pediatric Dental, Dep 25
Empire HMO 2750 for HSA, Silver, NS, INN, Pediatric Dental, Dep 29


NY Individual 2017 Proposed Rate Change/Notice of Filing

05/2016

We have submitted a rate change request to the New York Department of Financial Services (NYDFS) to modify rates for our individual plans effective 1/1/2017 upon renewal. The requested amount of the increases ranges from 15.5% to 29.8%, depending on the plan and rating area, which is based on the county the subscriber, resides in. If approved, the rate increase will be effective January 1, 2017. The final, approved rates may differ from what we have requested.

2016 INDIVIDUAL PRODUCTS 
 
Member Letter 
Narrative Summary 


NY Small Group 2017 Proposed Rate Change / Prior Approval Initial Notice

05/2016

We have submitted a rate change request to the New York Department of Financial Services (NYDFS) to modify rates for our Small Group plans effective 1/1/2017 upon renewal.

New York State law requires that health insurance carriers provide an initial notice to you when we submit requests for rate changes to the NYDFS. The law also requires that we explain any proposed rate change. Therefore, the below grid outlines the requested rate changes for specific small group products. The submitted rate change requests are pending NYDFS approval. A narrative, which explains the proposed rate change requests, can be found in the below grid.

Since the NYDFS must approve all community rates, the actual rate increase will not be available until approval is received. At that time, we will send you another notice. The second notice, which we will send to you at least 60 days prior to the effective date of the rate change, will include the approved rate changes. You have 30 days from the date of our May 2016 filing to contact Empire or the DFS to ask for more information about the rate-change filing, or to submit written comments to the DFS. If you have any other questions, you can contact us by sending an email to Empire at premiumratechange@empireblue.com. If you are an employee, call the customer service number on the back of your member ID card. Written comments submitted to the DFS will be posted on the website of the DFS with all personal identifying information removed. Comments may be submitted to the DFS online at www.dfs.ny.gov/healthinsurancepremiums or by contacting:

NYS Department of Financial Services
Health Bureau - Premium Rate Adjustments
One Commerce Plaza
Albany, NY 12257

You may also reach the DFS at premiumrateincreases@dfs.ny.gov.

To view and compare other Empire plans, use our Plan Comparison Tool at the below links and follow the steps to get a side-by-side comparison. You can compare copays, deductible or out-of-pocket maximums.

For EBC: http://ebcplancomparison.com/
For EBCBS: http://ebcbsplancomparison.com/


2016 Small Group Products 
Employer and Member Letter 
Narrative Summary 
January - May 2016 renewed Small Groups 
   
Empire Silver Pathway EPO 1500/30%/5500
Empire Gold Pathway HMO 1250/10%/6000
Empire Gold Healthy New York Pathway HMO 600/0%/4000
June - December 2016 renewing Small Groups 
   
Empire Silver Pathway EPO 1500/30%/5500; Empire Gold Pathway HMO 1250/10%/6000; Empire Gold Healthy New York Pathway HMO 600/0%/4000
 


2016 Notification of Rate Change Request for Individual Grandfathered Plans

11/9/2015

Individual Grandfathered Products - Sample Member Letter


2016 Notification of Rate Change Request for Large Groups

10/9/2015

We have submitted a rate change request to the New York Department of Financial Services (NYDFS) to modify premium rates for our Large Group HMO plans. New York State law requires that health insurance carriers provide an initial notice to you when we submit requests for premium rate changes to the NYDFS. The law also requires that we explain any proposed rate change. Therefore, the below grid provides a link to employer and subscriber letters that outline the requested rate changes for specific large group products. The submitted rate change requests are pending NYDFS approval. A link to the narrative, which explains the proposed rate change requests, can be found in the below grid.

Requested rate changes are as follows:

April 2016 renewing groups: 25.6%
May & June 2016 renewing groups: 21.6%
3Q 2016 renewing groups:22.2%
4Q 2016 renewing groups: 22.8%
1Q 2017 renewing groups: 23.4%

Since the NYDFS must approve all community rates, the actual rate increase will not be available until approval is received. At that time, we will send you another notice. The second notice, which we will send to you at least 60 days prior to the effective date of the rate change, will include the approved rate changes. You have 30 days from the date of our October 9, 2015 filing to contact Empire or the DFS to ask for more information about the rate-change filing, or to submit written comments to the DFS. If you have any other questions, you can contact us by sending an email to Empire at premiumratechange@empireblue.com. If you are an employee, call the customer service number on the back of your member ID card. Written comments submitted to the NYDFS will be posted on the website of the NYDFS with all personal identifying information removed. Comments may be submitted to the NYDFS online at http://www.dfs.ny.gov/healthinsurancepremiums or by contacting:

NYS Department of Financial Services
Health Bureau - Premium Rate Adjustments
1 State Street
New York, NY 10004

You may also reach the DFS at premiumrateincreases@dfs.ny.gov or by calling 1-800-342-3736.

Large Group HMO Products:
� Empire Direct Connection HMO
� Empire HMO Employer 
Employer
Letter
 
Subscriber
Letter
 
Narrative
Summary
 
 
Upstate  
Upstate  


Prior Approval Decision Notice - Effective January 2016 upon Renewal

10/2015

In May 2015, we communicated our rate increases planned for 2016. Since then, Empire has received approval from the DFS to modify medical premium rates for new and renewing groups starting on January 1, 2016 for Small Group & Healthy New York. The second round of required notifications to impacted Small Groups will be sent as part of their renewal package. Notifications will be mailed 60 days prior to the group's renewal date, starting with January 2016 renewals.

To view and compare Empire's small group plans, use our Plan Comparison Tool at the below links and follow the steps to get a side-by-side comparison.

For Upstate: http://ebcplancomparison.com/
For Downstate: http://ebcbsplancomparison.com/


2016 Small Group Products 
Approved
Medical Rates
 
Employer and
Member Letter
 
� Empire Gold Pathway HMO 1250/10%/6000 Plus  
� Empire Gold Healthy New York Pathway HMO 600/0%/4000 
Letter  
 
� Empire Silver Pathway EPO 1500/30%/5500 Plus  
� Empire Silver Pathway EPO 1500/30%/5500 Plus
with adult dental 
� Empire Silver Pathway EPO 2600/20%/4500 Plus
with H.S.A. 
� Empire Bronze Pathway EPO 3500/50%/6550 Plus with H.S.A. 
� Empire Bronze Pathway EPO 4500/30%/6550 Plus with H.S.A. 



NY Small Group 2016 Proposed Premium Rate Change / Prior Approval Initial Notice

05/2015

We have submitted a rate change request to the New York Department of Financial Services (NYDFS) to modify premium rates for our Small Group plans effective starting 1/1/2016 upon renewal. New York State law requires that health insurance carriers provide an initial notice to you when we submit requests for premium rate changes to the NYDFS. The law also requires that we explain any proposed rate change. Therefore, the below grid outlines the requested rate changes for specific small group products. The submitted rate change requests are pending NYDFS approval. A narrative, which explains the proposed rate change requests, can be found in the below grid.

Since the NYDFS must approve all community rates, the actual rate increase will not be available until approval is received. At that time, we will send you another notice. The second notice, which we will send to you at least 60 days prior to the effective date of the rate change, will include the approved rate changes. You have 30 days from the date of our May 2015 filing to contact Empire or the DFS to ask for more information about the rate-change filing, or to submit written comments to the DFS. If you have any other questions, you can contact us by sending an email to Empire at premiumratechange@empireblue.com. If you are an employee, call the customer service number on the back of your member ID card. Written comments submitted to the DFS will be posted on the website of the DFS with all personal identifying information removed. Comments may be submitted to the DFS online at www.dfs.ny.gov/healthinsurancepremiums or by contacting:

NYS Department of Financial Services Health Bureau - Premium Rate Adjustments 1 State Street New York, NY 10004

You may also reach the DFS at premiumrateincreases@dfs.ny.gov.

To view and compare other Empire plans, use our Plan Comparison Tool at the below links and follow the steps to get a side-by-side comparison. You can compare copays, deductible or out-of-pocket maximums.

For EBC: http://ebcplancomparison.com/
For EBCBS: http://ebcbsplancomparison.com/


2015 Notification of Rate Change Request for Large Groups

11/2014

We have submitted a rate change request to the New York Department of Financial Services (NYDFS) to modify premium rates for our Large Group HMO plans. New York State law requires that health insurance carriers provide an initial notice to you when we submit requests for premium rate changes to the NYDFS. The law also requires that we explain any proposed rate change. Therefore, the below grid provides a link to employer and subscriber letters that outline the requested rate changes for specific large group products. The submitted rate change requests are pending NYDFS approval. A link to the narrative, which explains the proposed rate change requests, can be found in the below grid.

Requested rate changes are as follows:

2Q 2015 renewing groups: 8.8%
3Q 2015 renewing groups: 12.1%
4Q 2015 renewing groups: 15.4%
1Q 2016 renewing groups: 18.9%

Since the NYDFS must approve all community rates, the actual rate increase will not be available until approval is received. At that time, we will send you another notice. The second notice, which we will send to you at least 60 days prior to the effective date of the rate change, will include the approved rate changes. You have 30 days from the date of our November 5, 2014 filing to contact Empire or the DFS to ask for more information about the rate-change filing, or to submit written comments to the DFS. If you have any other questions, you can contact us by sending an email to Empire at premiumratechange@empireblue.com. If you are an employee, call the customer service number on the back of your member ID card. Written comments submitted to the NYDFS will be posted on the website of the NYDFS with all personal identifying information removed. Comments may be submitted to the NYDFS online at http://www.dfs.ny.gov/healthinsurancepremiums or by contacting:

NYS Department of Financial Services
Health Bureau - Premium Rate Adjustments
1 State Street
New York, NY 10004

You may also reach the DFS at premiumrateincreases@dfs.ny.gov or by calling 1-800-342-3736.

Large Group HMO Products:
� Empire Direct Connection HMO
� Empire HMO
Employer
Letter

Subscriber
Letter

Narrative
Summary

 
Upstate  
Upstate  



Prior Approval Decision Notice - Effective January 2015 upon Renewal

10/2014

In June 2014, we communicated our rate increases planned for 2015. Since then, Empire has received approval from the DFS to modify medical premium rates for new and renewing groups starting on January 1, 2015 for Small Group & Healthy New York. We began mailing the second round of required notifications to impacted Small Groups as part of their renewal package. Notifications will be mailed 60 days prior to the group's renewal date, starting with January 2015 renewals.

Small Group Products
Employer
Letter

Member
Letter

Approved Medical Rates
Empire Gold Pathway HMO 1300/10%/6000 Plus with HSA 
Empire Bronze Pathway EPO 3500/20%/6350 Plus with HSA 
Empire Bronze Pathway EPO 4500/30%/6350 Plus with HSA 
Empire Silver Pathway EPO 2500/20%/4500 Plus with HSA 
Empire Silver Pathway EPO 1500/30%/5500 Plus 
Empire Silver Pathway EPO 1500/30%/5500 Plus (with adult dental) 
Empire Gold Healthy New York Pathway HMO 600/0%/4000 



2015 Notification of Rate Change Request for Small Groups

06/2014

We have submitted a rate change request to the New York Department of Financial Services (NYDFS) to modify premium rates for our Small Group plans. New York State law requires that health insurance carriers provide an initial notice to you when we submit requests for premium rate changes to the NYDFS. The law also requires that we explain any proposed rate change. Therefore, the below grid outlines the requested rate changes for specific small group products. The submitted rate change requests are pending NYDFS approval. A narrative, which explains the proposed rate change requests, can be found in the below grid.

Since the NYDFS must approve all community rates, the actual rate increase will not be available until approval is received. At that time, we will send you another notice. The second notice, which we will send to you at least 60 days prior to the effective date of the rate change, will include the approved rate changes. You have 30 days from the date of our June 2014 filing to contact Empire or the DFS to ask for more information about the rate-change filing, or to submit written comments to the DFS. If you have any other questions, you can contact us by sending an email to Empire at premiumratechange@empireblue.com. If you are an employee, call the customer service number on the back of your member ID card. Written comments submitted to the DFS will be posted on the website of the DFS with all personal identifying information removed. Comments may be submitted to the DFS online at www.dfs.ny.gov/healthinsurancepremiums or by contacting:

NYS Department of Financial Services
Health Bureau - Premium Rate Adjustments
1 State Street
New York, NY 10004

You may also reach the DFS at premiumrateincreases@dfs.ny.gov or by calling (800) 342-3736.

SMALL GROUP PRODUCTS
Employer
Letter

Member
Letter

Narrative
Summary

� Empire Preferred Guided Access Plus
HMO with HSA - ghab 
� Empire Core Guided Access Plus
EPO with HSA - gugb 
� Empire Essential Guided Access Plus
EPO - gwoa  
� Empire Essential Guided Access Plus
EPO (with adult dental) - gwoa 
� Empire Essential Guided Access Plus
EPO with HSA - gbcb  
� Empire Core Guided Access Plus
EPO with HSA - gwgb  
� Healthy New York HMO - gpbf