Empire Blue Cross Blue Shield is the local NYC area Wellpoint-owned Blue Cross Blue Shield plan. Empire has many different plan designs available to the local market including PPOs, POSs, HMOs, EPOs, HRAs, and H.S.A’s. In addition, Empire has one of the largest networks in the metro NYC area, and even boasts of a contract with the world’s leading cancer care center Memorial Sloan Kettering.

Empire has traditionally not been the least expensive product in its market, but with vastly rising health insurance costs in the NYC market, now Empire is actually quite competitive. In 2008, Empire introduced its Empire Prism EPO and took the market by storm. The product offered their national PPO network, and an EPO plan design. As such members must stay in-network with the product, however, nationally the PPO network has about 90% of hospitals in the US and over 600,000 participating physicians. The Prism EPO continues to sell very well, but now other carriers have caught on and are now offering similar products and similar pricing points.

In 2009, with the Empire Prism EPO renewals coming out above trend (12%), the Empire Value EPO was introduced which still allows access to the national PPO, though the out-of-pocket costs for hospitalization increased from the previous Prism EPO plan. The product is still one of the richest benefit designs for the lowest premium in the market. The Empire DIrectChoice POS plan is still one of the better priced and well selling point-of-service plans in the NYC metro area, though the in-network benefit accesses the Empire HMO network which is smaller than the national PPO network. The product allows for out-of-network coverage as well.

Historically Blue Cross Blue Shield Plans have grown from an indemnity plan basis. These plans are usually pretty good at paying claims, but because they have been around since the beginning times of health insurance, they can also be considered a bit bureaucratic and slow moving. Having said that, Empire continues to be a market leader in metro NYC and continues to make improvements in their offerings – recently having had success with the Prism EPO, Empire BCBS has now updated their Value EPO plans to include manageable deductibles and coinsurance to bring down the first year of renewals for the Prism plans of 2008. The Value EPOs are very similar products, and their pricing continues to lead the market.

Empire also has a very nice offering for dental and vision products (Blueview Vision, formerly EyeMed) for groups of 5 or more employees. This also makes it easier for employers to bundle products and billing for ease of administration.