EmblemHealth is set on being the mark of good health in the Northeast. The not-for-profit company provides health insurance through subsidiaries Group Health Incorporated (GHI) and the Health Insurance Plan of Greater New York (HIP). Collectively, the two health insurers cover some 2.8 million New Yorkers, primarily state government and New York City employees. The two companies cover upwards of 90% of Big Apple city workers and retirees. Both provide a variety of managed health plans to their members, including prescription drug and dental coverage, and Medicare plans. GHI and HIP joined together under the EmblemHealth banner in 2006.
Along with its operations in New York, EmblemHealth offers health coverage in Connecticut and western Massachusetts through ConnectiCare, which has about a quarter of a million members.
The insurer's revenue declined 1% in 2011 vs. 2010, on a drop in premium income. Net income fell nearly 12% over the same period. While the cost of benefits provided declined in 2011 vs. 2010, administrative costs and a loss on the sale of real estate holdings squeezed the EmblemHealth's bottom line.
EmblemHealth is expanding its menu of care management programs for members with chronic and acute medical conditions. In 2011 it simplified its portfolio of commercial plans and introduced new products to better meet its customers' needs. It launched a mobile version of its find a doctor search tool with built-in GPS and further enhanced its mobile site with new functionality that lets members view or email their ID cards from their smartphones. Members can also pay premiums online. Also in 2011 the insurer discontinued some products and updated its EPO (Exclusive Provider Organization) and PPO plans with new cost-sharing options favored by many businesses seeking to maintain coverage at a lower cost.
Following the 2006 merger, EmblemHealth began exploring transforming itself into a for-profit, publicly traded company. (Under state law governing for-profit conversions, the company's stock would at first belong to the state, which would reap the benefits of the initial stock sale. Going public could potentially give the insurer easier access to capital, which it believes would enhance its ability to compete against large national insurers.) However, concerns raised by the city of New York and some health care activists and unfavorable market conditions stalled the long-talked about IPO. – less