EmblemHealth, formerly GHI and HIP, has recapitalized and reloaded dynamic plan offerings for 2019. They have had recent 3 years of single digit increases. Emblem has added significant new small group plans for 2019 thats fits the needs and budgets of small businesses. Each plan offers quality coverage with comprehensive benefits and network access.
New Expanded Prime Network: Access to a narrow and broad network
NYS – EmblemHealth has expanded small group Prime Network to include both the QualCare Network in New Jersey another ConnectiCare Network in Connecticut. This is in addition to the current HIP Prime Network in New York. Members can choose from over 90,000 private and group practice health professionals, facilities, and 144 hospitals in 28 New York State counties — all five boroughs of New York City (the Bronx, Brooklyn, Manhattan, Queens, and Staten Island), plus Nassau, Suffolk, Orange, Rockland, and Westchester counties, and upstate areas that stretch north of Albany.
CT – The ConnectiCare HMO Network has 17,000 primary care providers and specialists, and 33 hospitals in all eight counties in the State of Connecticut.
NJ – The QualCare HMO Network includes 26,000 primary care providers and specialists, and 76 hospitals in all 21 counties across the State of New Jersey.
New Select Care Network
It is a smaller subset of the larger Prime Network. It includes over 41,000 health care professionals, facilities, and hospitals throughout 28 counties in New York State. PRIME vs. SELECT NETWORK: Click Here
New Plan Features
3 free copays for PCP on selected plans.
Urgent Care no deductible
Labs no deductible
Adult & pediatric preventive dental no deductible
FREE Telemedicine through Teledoc. Members can get non-urgent medical care. It’s convenient, immediate, and available 24 hours a day, 365 days a year. Telemedicine doctors can even prescribe certain medicines.
FREE Acupuncture
Vision Included – free annual exam and lenses at 20% coinsurance.
Gym Reimbursements – up to $400 for member and $200 for spouse.
Emblem has been a NYS mainstay for 80 years. They insure 612,000 members. Notable clients are Union plans such as the NYC Teachers Union.
Sign up for upcoming webinars and newsletters. Please contact us TODAY for a customized analysis for your group-specific needs at info@medicalsolutionscorp.com or Call (855) 667-4621.
Starting the New Year can be a perfect opportunity to change something about your life or behavior or do something you have always wanted to do. 4 New Years Resolution Tips. Here are a few examples of popular health related resolutions:
Lose weight
Get fit
Eat more healthily
Start a new sport
Run a marathon
Many people start strong in January, but by the time summer comes around resolutions are often long forgotten. Here are four tips to help you set and stay on track with your goals in the year ahead.
1. Choose your goals wisely
Your chances of success are much greater if you channel all of your energy into changing just one thing. Your resolution should be something reasonably achievable but also not a quick or easy fix. For example, rather than aiming to cut out all refined sugar in your diet, try cutting back gradually, or find healthier alternatives to your favorite snacks. Avoid setting any overly ambitious goals as this will just discourage you and may encourage unhealthy practices. If you are taking up a new sport, sudden over-exertion can cause discomfort and lead to excessive muscle ache in the following days, which could cause you to give up all together. Try to build up slowly and work on making your new regime a sustainable lifestyle change.
2. Tell people or find a buddy
Telling your family and friends about your goal means you are more likely to get support and want to avoid failure. You may find that someone else has the same resolution as you – this can keep you motivated and you can resolve to take the first steps of your lifestyle changes together, such as joining a group exercise class. You are more likely to push on through the more difficult days when you have a supporting partner.
3. Have a plan and track your progress
Break your end goal into a series of steps; focus on creating sub-goals that are measurable and time based. If you are taking up a new sport, start small and build up at regular intervals. If you are jogging, challenge yourself to run five minutes longer each week until you reach your distance goal. Once you have accomplished this, you can work on improving your timing, or even set a new, bigger distance goal. This can also help you monitor your progress and give you a periodic sense of accomplishment, which can give you the motivation to work towards your next milestone.
4. Don’t get disheartened, remind yourself of the benefits
Remember, setbacks are inevitable. Don’t be too hard on yourself and give yourself enough time to recover from momentary setbacks before working towards your next milestone. If you are trying to shed some weight for example, try to weigh yourself no more than once a week. If you have lapsed from your healthy diet or skipped a gym class, you may think the increase on the scales the next day is a direct result of that. However, it’s normal for weight to fluctuate on a daily basis for reasons beyond lifestyle. By limiting how often you check your progress, you can get a more accurate view of how effective your new, healthier lifestyle is progressing.
If your progress is slow, and you are feeling demotivated, it may help to remind yourself of the benefits associated with achieving your goals. Try creating a checklist of how life will be better once you obtain your aim.
HAPPY 2018! Wishing everyne good health and prosperity for the year to come.
Ever sneak a late-night snack after a big dinner, or binge late into the night? Eating a huge meal, then going to sleep, is the sumo wrestler diet. Your body can’t process or burn those extra calories. So it stores them as fat, leading to weight gain and prediabetes. In functional medicine, we look at root causes, like how powerful hormones can trigger your night-time food cravings. Learn how to stop them.
Do you have a sweet tooth?Break Your Sugar Addiction in 10 Days Infographic. Most of us will overindulge at times. But the more sugar we consume, the more we want, says Mark Hyman, MD. However, the good news is that people can break the sugar addiction in 10 days. Here’s how.
Break Your Sugar Addiction in 10 Days Infographic
For more information on setting up a Wellness Program for your group please call us (855) 667-4621
Dark, Milk or White – Which Chocolate Is Best for Your Heart? (Infographic)
From our wellness partner, Cleveland Clinic
Chocolate is good for blood flow, which means it’s good for your heart. But not all chocolate is created equal. Find out about the healthy antioxidants and what else is inside so you can make the best choice of chocolate for your heart health.
The NCQA believes its own health plan accreditation program and program data could useful to exchange programs, the NCQA says. With so much more individual choice on both, the Marketplace Health Exchange and off-Exchange along with new Health Insurers this is an important consumer tool.
About NCQA
NCQA is a private, non-profit organization dedicated to improving health care quality. NCQA’s Healthcare Effectiveness Data and Information Set (HEDIS®) is the most widely used performance measurement tool in health care. NCQA accredits and certifies a wide range of health care organizations and recognizes physicians in key clinical areas. NCQA is committed to providing health care quality information through the Web, media and data licensing agreements in order to help consumers, employers and others make more informed health care choices.
NCQA accreditation ratings are based on three sets of measurements HEDIS®, CAHPS® and NCQA accreditation standards. Health plans in every state, the District of Columbia and Puerto Rico are NCQA Accredited. These plans cover 109 million Americans or 70.5 percent of all Americans enrolled in health plans.
HEDIS is a set of standardized performance measures designed to ensure that purchasers and consumers have the information they need to reliably compare health care quality. The Consumer Assessment of Healthcare Providers and System (CAHPS) is a survey mailed to select members asking them to rate their experience with the care given by their doctors and the services provided by their plans.
How the Results of HEDIS and CAHPS Help Consumers
Results from HEDIS and CAHPS enable consumers to understand how well Insurers are fulfilling our clinical agenda to help members stay healthy, get better quickly or live effectively with chronic illness. In addition, the scores facilitate our ability to identify areas of care and service where we can continue to improve. The results also enable us to compare our companies’ performance with other local and national health plans.
The “Excellent” ratings our plans received demonstrate that members continue to receive high-quality health care and that they are satisfied with the service that their physicians, health care practitioners and health plans provide.
HEDIS® (Healthcare Effectiveness Data and Information Set) is a registered trademark of the National Committee for Quality Assurance (NCQA).
CAHPS® (Consumer Assessment of Healthcare Providers and Systems) is a registered trademark of the Agency for Healthcare Research and Quality (AHRQ).
For more information about these plans and the full range of offerings available through MMS Inc. contact us today at (855) 667-4621.
Your plans NCQA 2014 Rating
NCQA Health Insurance Plan Rankings 2014-2015
Click on any Plan Name for details.
Methodology and other information about the rankings is here
