Empire Changes Date for Dropping Small Business Plans

Empire Blue Cross Blue Shield announced changes to its company's policy that will affect small businesses that offer Empire's health insurance plans. Empire plans to issue a formal announcement in January regarding its decision, but I wanted to inform you immediately of the policy changes.

Empire intends to phase out approximately seven small group products on groups’ renewal dates starting with groups renewing on April 1, 2012. Groups renewing during the first quarter will have the ability to renew their plans with prescription changes and a rate increase. Empire's previously stated policy was to "simplify" its available plans for all groups by a hard date of April 1, 2012, regardless of groups' renewal dates.

Employer groups renewing April 1and thereafter with Empire HSA, EPO, Prism, or Point of Service plans among others will be terminated on their renewal dates. Empire has added two plans to the short list of those that it is keeping. It had said it was continuing PPO1 and 2, HMO/DHMO Option 12 and Healthy New York (with limited availability for new groups). Now it has added Blue Essential Option 10 and Total Blue Option 3 to the list. When this change becomes effective, members will not be automatically switched to another plan. The Group Administrator will be required to select another Empire product or change to another carrier. Pre-existing conditions will not apply to HIPAA compliant groups with a minimum of 12 months of continuous coverage.

For Empire groups with an upcoming renewal of January, February, or March, their plans will not be eliminated until the following renewal. Empire will alter the way its members pay prescriptions. Non-formulary drugs, and in some cases, brand named drugs will be reimbursed at a percentage. I expect an increase in rates despite the decrease in benefits. Participation and eligibility requirements will immediately apply.

Please call me with any questions or concerns at 516-682-8400. I remain committed to keeping you up to date with news from the health insurance industry. I am also available to discuss life, disability, and long term care insurance.