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What you need to know in 2026

EmblemHealth·NY·Provider News
Effective date
Jan 1, 2026
We identified it
Jun 20, 2026
Days to comply

Summary

EmblemHealth has released their 2026 annual provider notice with network changes, new pharmacy benefit management through Prime Therapeutics, and special guidance for NYC Employees PPO plan members. The NYCE PPO will use The Bridge Program for 13 downstate NY counties and UnitedHealthcare's Choice Plus Network elsewhere.

Action Required

Action needed
Before January 1, 2026: Review the complete annual provider notice at the source URL to understand specific network and benefit plan changes. If not already completed, register for Prime Therapeutics training sessions (Dec 17 at 10 a.m. or 2 p.m.) to understand the new pharmacy medical benefit utilization management program. Update provider directories and referral processes for NYCE PPO members based on geographic location (Bridge Program for 13 downstate NY counties, Choice Plus Network elsewhere).