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Apr 3, 2013 9:37 AMPublication: The Southampton Press

Empire, Alliance Fail To Reach Contract Agreement, Go Out Of Network

Apr 3, 2013 10:41 AM

Empire BlueCross BlueShield, the once-biggest health insurer on the East End went out of network with the East End Health Alliance hospitals on Monday, April 1, after the two sides failed to reach a contract agreement.

Only emergency care and other approved procedures and treatment will be covered at the Alliance hospitals—Southampton Hospital, Peconic Bay Medical Center and Eastern Long Island Hospital—for Empire policyholders.

Unlike three years ago—when Empire and the Alliance had a high-profile impasse that left thousands of East End residents who are Empire subscribers out of network at the local hospitals—fewer people are affected this time, since the insurer eliminated most of its small group plans in the New York market last year.

A request sent to Empire seeking the number of people affected was not immediately returned.

But few people—mostly those who work for a municipality, as well as some small businesses—still have Empire, noted Kevin Luss, a health insurance broker and financial planner at The Luss Group in Southampton Village.

Empire sent letters to plan members last month informing them that it may not participate with East End hospitals effective April 1, if an agreement on reimbursement rates was not reached by then.

Empire policyholders who are affected by the plan can call 726-FACT for the latest updates.

The number lets callers listen to a prerecorded message by Bob Chaloner, the president and CEO of Southampton Hospital, speaking on behalf of the Alliance. He says the sides are making every effort to resolve the issue through ongoing, good faith negotiations that will hopefully lead to an equitable contract.

Those with questions regarding their coverage are encouraged to call their hospital: Southampton Hospital at 726-8555, Peconic Bay Medical Center at 548-6018 or Eastern Long Island Hospital at 477-5711.

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From the Southampton Hospital website:

IMPORTANT NEWS ABOUT EMPIRE: A tentative settlement was reached, bringing the three East End Health Alliance hospitals back in network with Empire Blue Cross as of April 6, 2013.
By Robert I Ross (250), Hampton Bays on Apr 7, 13 8:42 AM