Empire BCBS NY Group Health Insurance Pros and Cons, Reviews and Complaints 2018

Empire Health BCBS: Strong Provider Network for Small Business Group Health Plans

Empire  Health Blue Cross Blue Shield is one of the largest insurers in the nation and actually consists of 37 companies. In New York, it has around 4 million members– almost half the population of New York City. Empire Health offers access to 90,000 participating doctors and over 160 hospitals in New York State.

Since they are all independently operated, its impossible to give one review that applies to all of them. However, with its large variety of plans and coverage, we think it is one of the better insurance companies available. The Empire BCBS network offers coverage in the New York Metropolitan area as well as a few upstate counties. However, employees living outside of this area can still receive services using the nationwide Empire BlueCard Network. In New York, the biggest BCBS company is Anthem. For other large companies with extensive plans, see UnitedHealthcare Oxford.


empire bcbs insurance

About Empire Health BCBS

The Bue Cross Association and Blue Shield merged in 1982 to form Blue Cross Blue Shield. They then licensed their name to smaller countries all over the country. Some of these companies include Wellmark, Anthem, and Highmark. There is at least one Empire BCBS company operating in every state and Puerto Rico.

Empire Health Insurance Small Group Health Plans

As Empire Health is comprised of many smaller companies, they offer a variety of health insurance plans. These plans are grouped in 3 main Empire Health Programs: the Empire BlueCard Program, Blue Priority Program, and Pathway Program.

Empire BlueCard Program: This program was formerly called the Prism plan and is Empire BCBS’s premier health plan. It offers nationwide access to EPO and PPO health insurance plans for small companies in New York. BlueCard’s provider network includes over 85,000 doctors and 150 hospitals.

The BlueCard network is actually one of the largest provider networks in the US. Under this network, members can access more than 96% of hospitals and 93% of medical providers across the entire country. Furthermore, there is actually a BlueCard Worldwide Network, which offers international insurance coverage.

Blue Priority Program: Blue Priority is an EPO network with comprehensive coverage and access to doctors that participate in the Empire BCBS Enhanced Personal Health Care program. Keep in mind that like any EPO plan, there is no coverage for non-network doctors. Furthermore, members are able to see a specialist with a referral.

For small business owners, Empire Health requires 60% of full-time employees to enroll excluding valid waivers. (Valid waivers include Medicare, Medicaid, Spousal, Veterans, and Parental)

Pathway Program: The Pathway Program is an EPO network offers coverage throughout Empire’s 28-county service area.  Members of this program receive lower or no copays.

Within these programs, you have several plan options. You can choose from PPOs, HMOs, and EPOs, as well as Consumer Driven Health Plans (CDHPs) and Health Savings Accounts (HSAs).

Since so many companies make up Empire Helath BCBS, it is difficult to give a summary of their plans. It may be easier for you to compare plans by taking a look at our Empire Health comprehensive rate sheet.

Empire Health BCBS Reviews

On Top Ten Reviews, Empire Health BCBS as a whole received a 9.9/10 rating. However, we mentioned previously, BCBS consists of many companies.

In New York, the biggest Empire Health BCBS company is Anthem. On Consumer Affairs, Anthem has around 2.5 stars. Most of its negative reviews are because of claims being denied. However, complaints like these often come from members overlooking provider network changes. On Best Company, Anthem has a 4.6 overall rating. They say Anthem is good for the types of plans offered, their member resource, unique features, and customer service. However, they also add that Anthem is not the best in terms of their limited availability.

In general, Empire BCBS health insurance offers a large degree of flexibility and has a strong provider network. Before you make a decision, you may want to find doctors that accept Empire Health, compare Empire Health to other companies, and view their plans and rates. If you have any questions or would like to learn more about any insurance carrier, don’t hesitate to call us at 212-484-9888.

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