CommercialAdministrativeHigh impact
2024 Commercial Networks and Benefit Plans
EmblemHealth·CT·Provider News
Effective date
Jan 1, 2024
We identified it
Jun 20, 2026
Summary
EmblemHealth is changing network configurations for 2024, with ConnectiCare members getting a new Connecticut-only Value Network and EmblemHealth members having network options based on location. Providers not in a member's new network may qualify for care extensions in specific situations like pregnancy, requiring authorization from utilization management.
Action Required
By January 1, 2024: Billing team must verify network status for all EmblemHealth and ConnectiCare patients during eligibility checks. Update patient registration to capture member location and network type. For patients whose network is changing and provider is not in new network, contact utilization management team immediately to request authorization for care extensions (especially pregnancy cases). Must agree to current fee schedule and plan policies to continue treating these patients.