Stony Brook hospital to accept EmblemHealth's exchange plan

Stony Brook University Hospital announced Tuesday that it will be accepting EmblemHealth insurance on the state's health exchange.

Previously, Stony Brook had taken only Health Republic from the New York State of Health. But on Sept. 25 the state Department of Financial Services announced that Health Republic was going out of business, potentially leaving about 10,500 Health Republic enrollees in Suffolk with no in-network exchange option if they needed to go to the 603-bed hospital, the largest in the county.

"We are pleased to have been able to amend our existing agreement with EmblemHealth which will allow thousands of Long Islanders who are enrolled in its Select Care Network to access Stony Brook University Hospital and its physicians on an in-network basis," Dr. L. Reuven Pasternak, Stony Brook's chief executive officer, said in a statement.

Attempts to reach EmblemHealth were unsuccessful.

Health Republic is the most popular insurer on the exchange in Suffolk, accounting for 25 percent of policies for individuals and families and 87 percent of small-business policies.

Three percent of Suffolk's individual and family enrollees and 1 percent of small businesses on the exchange have EmblemHealth.

Stony Brook spokeswoman Melissa Weir said the hospital remains in discussions with other insurers on the exchange.

In the meantime, she said, Stony Brook continues to work with patients with other exchange plans in which Stony Brook is the only health care provider or for specialty care through individual negotiations with their insurers.

Existing individual and family Health Republic insurance policies remain in effect through Dec. 31, the state has said. Enrollment for next year begins Nov. 1.

Health Republic's small group plans for businesses -- which, unlike individual plans, do not all have calendar-year policy terms -- also remain in effect. "Any future determinations made on small group plans will be announced with appropriate notice to help provide a transition period to new coverage and protect policyholders," the state said.

Health Republic was one of 23 nonprofit Consumer Operated and Oriented Plans (CO-OPs) created under the federal Affordable Care Act to increase competition and offer low-cost health care.

It is one of eight so far to go out of business nationwide. The National Alliance of State Health CO-OPs, a trade group, blamed the closings on underfunding by the federal government and an inability to borrow money the way for-profit businesses do.