NYC Health Benefits Program

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Introduction

Through collective bargaining agreements, the City of New York and the Municipal Unions have cooperated in choosing health plans and designing the benefits for the City’s Health Benefits Program.

These benefits are intended to provide you and your eligible dependents with the fullest possible protection that can be purchased with the available funding.

 

The OLR website and the NYC Health Benefits Program Summary Program Description (SPD) provide you with information about your benefits under the New York City Health Benefits Program. 

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HEALTH PLAN COVERAGE FOR EMPLOYEES HIRED ON OR AFTER JULY 1, 2019

City of New York employees, and employees of Participating Employers, hired on or after July 1, 2019, and their eligible dependents, will only be eligible to enroll in the EmblemHealth HIP HMO Preferred Plan, and must remain in the HIP HMO Preferred Plan for the first year (365 days) of employment.

After 365 days of employment, the employee will have the option of either remaining in the HIP HMO Preferred Plan or selecting a different health plan within 30 days before the end of the 365 day period. If a new health plan is selected, the new plan will be effective on the 366th day.

Only after the 365th day can the employee participate in any Annual Fall Transfer Period.

An employee who needs to request an exemption from the required enrollment in the HIP HMO Preferred Plan can do so by submitting an Opt-Out Request Form to EmblemHealth. An employee, or eligible dependent, must meet certain criteria and the request must be approved by EmblemHealth before the exemption is granted. The Opt-Out Request Form is available on the EmblemHealth website. 

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Health Plan Websites

Use the links below to visit your health plan where you will be able to find an in-network doctor, urgent care center, lab or pharmacy.

 

Learn more about MetroPlus Gold for City Employees. Now available in all 5 boroughs! Play the video

 

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		Important Changes to the HIP HMO Plan Effective January 1, 2019. Learn More
		NOTE: Hospitalization coverage for GHI CBP is underwritten and administered by Empire BlueCross BlueShield (EBCBS). View the EBCBS Directory of participating NY, NJ, CT hospitals*
*Provider information contained in the Empire BlueCross BlueShield Directory is updated on a regular basis and may have changed. Therefore, please check with your provider before scheduling your appointment or receiving services to confirm participation.

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Expert Medical Review for Those Diagnosed with Cancer with Best Doctors

(For Those Covered Under the EmblemHealth GHI-CBP Plan)

Best Doctors will provide a free expert medical review from an oncologist¹ as well as Oncology Insight With Watson, the world’s most advanced cognitive technology for Emblem GHI-CBP members. For more information call Best Doctors at 844.282.4994 or visit BestDoctors.com/NYC

 

1. Gallup® has audited and certified Best Doctors, Inc.’s database of physicians, and its companion Best Doctors in America® List, as using the highest industry standards survey methodology and processes.

Please be advised that you will not be a patient of Best Doctors or of any Best Doctor Expert that reviews your medical information, and that no doctor-patient relationship will be created between Best Doctors and you or between any Best Doctors Expert and you. Any treatment decisions will be made solely by your treating physician(s) and you.

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24/7 Telemedicine Program with Teladoc

(For Those Covered Under the EmblemHealth GHI-CBP Plan)

With Teladoc, you can talk with a doctor within minutes rather than days or hours. Teladoc doctors can diagnose, treat and prescribe medication (when medically necessary) for non-emergency medications. This includes treatments for the flu, sore throat, allergies, stomach aches, eye infections, bronchitis, and much more. The copay is $10 per consultation. To set up your account now so you can talk with one of Teladoc’s board-certified doctors anytime when you don't feel well, call 1-800-Teladoc (1-800-835-2362) or visit Teladoc.com/emblemhealth

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List of Health Plans

Listed are the non-Medicare Health Plans offered by the New York City Health Benefits Program to its employees and non-Medicare retirees.  View the List of Health Plans

 

View the Summary of Benefits and Coverage (SBC) for each Plan.

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Form 1095-C

Form 1095-C is a tax form under the Affordable Care Act ("ACA") which contains information about your health care insurance coverage. Form 1095-C is distributed to all full-time employees working an average of 30 hours or more per week, for all or part of the calendar year. For information about Form 1095-B, please contact your health care provider directly.

Learn more about Form 1095-C

 

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2015 Cyber-Attack Impacting Empire Blue Cross Blue Shield

Anthem, Inc., the parent company of Empire Blue Cross and Blue Shield, one of the City’s health insurance providers, was the victim of a highly-sophisticated cyber-attack in 2015. Visit the Anthem website – www.anthemfacts.com, or call their hotline, 1-877-263-7995, for updated information.

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