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Page numbers referenced within this brochure apply only to the printed brochure

Health Insurance Plan (HIP/HMO)

www.EMBLEMHEALTH.com
Customer Service 800-HIP-TALK (800-447-8255)

2024



IMPORTANT:
  • Rates
  • Changes for 2024
  • Summary of Benefits
A Health Maintenance Organization (High and Standard Option)

This plan's health coverage qualifies as minimum essential coverage and meets the minimum value standard for the benefits it provides. See page 7 for details. This plan is accredited.  See page 12.

Serving: Greater New York City Area (including Long Island and surrounding counties)  

Enrollment in this plan is limited. You must live or work in our geographic service area to enroll. See page 13 for requirements.

Enrollment codes for this Plan:
   511 High Option – Self Only
   513 High Option – Self Plus One 
   512 High Option – Self and Family

   YL4 Standard Option – Self Only
   YL6 Standard Option – Self Plus One 
   YL5 Standard Option – Self and Family

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