EmblemHealth's ConsumerDirect Program

What is a ConsumerDirect Plan?
EmblemHealth's ConsumerDirect Plan combines an employer-provided funding arrangement and a High Deductible Health Plan (HDHP). Employees can use the funds in their HRAs tax-free to pay for IRS-qualified medical expenses that are included in their employer's plan. EmblemHealth provides the HDHP and a Third-Party Administrator (TPA) administers the HRAs. EmblemHealth has preferred partner arrangements with select TPAs to provide seamless administration of ConsumerDirect funding options. You may also choose your preferred TPA to administer your HRA plan.

EmblemHealth's ConsumerDirect Plan features:

• EmblemHealth's Quality National Provider Network
• Optimum consumer savings
• EmblemHealth's health and wellness programs
• Unique flexibility with our shared-deductible feature

HRA advantages include:

• Employers save money on health insurance premiums
• HRA contributions are tax-deductible to the employer
• Employers can designate which benefits are included in the HRA plan, including medical, prescription drug, and dental
• Employers have the option of allowing unused HRA funds to roll over
• No pre-funding is required; members cannot use more than the available HRA funds

How does a ConsumerDirect Plan work?

• Basic preventive care is covered 100%
• Members can use the funds in their HRA tax-free to pay for qualified medical expenses not covered by the HDHP
• Qualified medical expenses, including pharmaceuticals, may count toward the HDHP deductible.
• Out-of-pocket limits protect members from catastrophic costs

Learn more about ConsumerDirect Plans.