A long-time leader in the health care industry
Established in 1934, Empire has grown from a New York City-based hospital insurance provider to one of the largest health insurers in the United States. We offer a broad portfolio of managed care plans and health plan products, including HMO, POS, PPO, EPO and CDHP plans, available through a variety of funding arrangements.
Empire has more than 80 years of experience serving accounts in all market segments and of all sizes. Unlike other health insurers that rent their networks, we directly own and manage our networks at the local level. That's why Blues plans are able to collaborate directly with providers to give employers customized benefit designs, access to the highest level of care and new opportunities for cost efficiencies. With Empire, you’ll enjoy all the big company advantages without the infamous big company approach. We live and work here in New York, too, with more than 4,000 front-line associates state-wide. We “get” what companies want, and really understand their needs.
We stand out from the competition through the following key differentiators:
Our large provider networks
A diverse product portfolio
Our Health & Wellness total management solution
Robust member and employer websites
Strong business partnerships with data integration
A seamless implementation process
Large, top-quality networks of accredited providers
As a leader in the industry, we team up with our network physicians and hospitals on ways to help promote, encourage and reward quality care. We believe access to quality care ultimately leads to lower health care costs and a healthier health care system.
We provide access to 96% of hospitals and 92% of physicians across the country through the BlueCard® Program—more than any other insurer.1
Our HMO/POS networks give members access to nearly 90,000 providers.2
Blues® currently serve 85% of Fortune 100 companies and 76% of Fortune 500 companies.3
We provide network access to more than 150 hospitals in our local service area.
Our EPO/PPO networks give members access to more than 94,000 providers.2
Our pharmacy network includes an extensive retail network of approximately 56,000 participating pharmacies, including most major chains as well as many independent neighborhood pharmacies.
Our dental network offers employees access to one of the largest networks of dentists and specialists with competitive discounts.
Our vision network offers a broad, convenient, national network of more than 44,000 providers and provider locations. The network includes independent optometrists, ophthalmologists and national retail locations like LensCrafters®, Target Optical®, Sears OpticalSM, JCPenney® Optical, Pearle Vision® and New York based Empire Vision and Davis Vision Centers.
Empire networks include more of New York Magazine’s Top Doctors (16 years running),4 along with access to the highest quality providers in the U.S.,5 including 95% of U.S. News and World Report’s “Best Hospitals in America.”6 What’s more, all acute care hospitals participate in our local network.
Network size relates to network usage = a healthier bottom line
Access to a robust provider network equals value. And we have the proof. Due to the size and strength of our PPO network, we have seen an average of 94% in-network utilization, which can lead to healthier employees and a healthier bottom line for employers.
Plus we offer access to care when traveling abroad BlueCard Worldwide is the international hospital and provider network of the Blue Cross and Blue Shield Association, with in-network facilities available in most tourist destinations. So your employees can feel confident they can get the care they need when out of the country.
Every company's needs and objectives are different.
That's why our integrated portfolio of health, prescription drug, dental, vision, disability and life benefits is flexible enough to meet the ever-changing requirements of New York businesses. We work closely with our clients to understand their needs and provide affordable, convenient benefit plans that can address total health.
Empire offers a wide portfolio, including HMO, POS, PPO, EPO and Consumer-Driven Health Plan (CDHP) products, through a variety of convenient funding arrangements. All plans are designed to help members improve their health while also helping to improve our clients' bottom line.
Working with the strength of our parent company, we manage our networks at the local level, allowing us to collaborate directly with providers. What does this mean for our clients? Customized benefit designs, access a high level of care, and new opportunities for cost efficiencies.
Learn more about our products today. Visit our Group Health Plan page.
Health care management
Our Health & Wellness total solution program is a comprehensive suite of integrated health care programs and services that work together to help achieve optimal health outcomes. Member information is gathered from pharmacy, lab, medical and other sources to help identify members' needs. Then we provide many ways for members to get engaged with the specific types of care and services they need, whether it's by phone or online. We also do targeted direct outreach to members who may benefit from additional coaching and guidance.
Health & Wellness total solution empowers and engages members so they can take control of their health. This innovative program takes a proactive approach to help members get healthy, stay healthy and live better lives by surrounding them with the resources, tools, guidance and support they need to help make better health care decisions.
Prescription drug plans
Our prescription drug plans include an extensive retail network of approximately 56,000 participating pharmacies, including most major chains as well as many independent neighborhood pharmacies. An Empire Prescription Drug Plan can also include drug list, home delivery, and generic pricing programs - all with one ID card and customer service number.
Dental, vision, life and disability for a complete benefits package and a single point of contact.
If you're offering only health coverage to your employees, you're just getting part of the rewards, savings and benefits that could be available to you. In addition to our health plans, innovative wellness and care management programs, and pharmacy capabilities, we also offer total health solutions that include dental, vision, life and disability - all with a single point of contact. By eliminating the hassles of working with multiple carriers, we make plan administration a snap. Not to mention the savings and security that comes from our integrated benefits portfolio served by an experienced staff.
There may be times when we use other companies to give our members and providers certain types of services, like Utilization Management or Case Management. We would always make sure that it was approved by law and allowed by our contracts beforehand.
Radiant Services, LLC
Radiant Services, LLC may be part of the approval process for care you receive. Whether Radiant is involved or not, the process is the same. Radiant is owned by our parent company with some staff outside the United States. We want to help you get access to quality, efficient care that is backed by scientific research. Radiant shares that goal. If you have questions about Radiant, please contact Member Services.
NCQA is a private, non-profit organization dedicated to improving health care quality. NCQA evaluates the quality of key processes and systems health plans provide their members. Learn more about Empire's Accreditation