Strengthening the future for CDPHP brokers and employer groups

CDPHP is merging with Excellus Health Plan, Inc., which currently manages health plans across 39 counties in central and western New York. When the merger is finalized, CDPHP will join Excellus Health Plan, Inc. as an additional not-for-profit health plan serving the Capital Region and surrounding areas.

The proposed merger is planned for early 2027.

Since affiliating with this new organization, we were able to integrate our people, systems, and vendors. Many employees and systems are already combined, leading to faster processes and easier experiences both internally and externally.

Our teams officially filed for merger in late 2025 and anticipate state approval within the next year.

We’re excited to team up with another company and expand our capabilities while preserving what makes CDPHP special: local roots, award-winning service, and high-quality coverage. CDPHP will still have:

• Local leadership
• Local, award-winning customer service
• Local account management team
• In-house pharmacy program
• In-house care management program
• A CDPHP network of more than 1 MILLION providers coast to coast*
• Member-friendly tools for cost transparency, locating providers, and more

*Applies to commercial plans with a national network only.

 Any changes or enhancements are intentionally being made to unlock greater buying power, allow us to introduce new products and services, and strengthen the quality and affordability of care

While many CDPHP programs, benefits, and processes are staying the same, we are adjusting others to better serve you. Notable changes will be shared with you throughout the year, some of which include:

• Broker/Group tool enhancements, reporting platforms, the electronic enrollment process, and portals (applies to commercial plans only)
• Pharmacy benefits, including a new pharmacy benefit manager, a stronger pharmacy network, and improved pricing tools
• New member ID cards with one phone number for pharmacy and medical benefits
• A member Monthly Health Summary replacing traditional explanation of benefits (EOBs)
• A new CDPHP.com online experience
• Updates to our medical cost comparison tool
• And much more

• Seamless System Integration:
  • We’ve made significant progress with the migration of CDPHP to Excellus Health Plan, Inc. systems, allowing key business processes, including enrollment and billing, provider registry, credentialing, appeals, and more, to be connected through one common platform.
  • Like CDPHP, our new parent company also uses the Facets system, so there is minimal member disruption in this area.
  • While much of this is “behind the scenes,” our accomplishments internally will set us up for success to provide you with a positive experience externally.
• Advancing Provider Partnerships and Care Delivery Models: CDPHP has long championed the development of an integrated care delivery system in upstate New York. To help further that mission, Dr. Martin Stallone was appointed as Executive Vice President, Chief Healthcare Services Officer of CDPHP and our parent company, The Lifetime Healthcare Companies (LTHC), to focus on enhancing provider partnerships across Upstate New York.
• More High Ratings: CDPHP continues to be one of the highest rated commercial and Medicare health plans in the nation, according to NCQA’s Commercial Health Plan Ratings 2025 and the Centers for Medicare & Medicaid Services Star Ratings program!

Our pharmacy program will continue to be managed by a team of local and regional, experienced pharmacists and health care experts, ensuring we have the best programs and partners in place. Together, our teams deliver smarter pricing, broader access, and innovative programs that proactively improve outcomes and lower total cost of care.

However, it’s time to evolve our pharmacy offerings based on market needs. Soaring prescription drug costs and volatility in drug pricing models require stability and the right long-term partners for us to provide the best coverage at the lowest price. By working with Excellus Health Plan, Inc. in this area, CDPHP can build on proven models while maintaining our in-house program, local focus, and hands-on service.

While a few legacy programs are retiring, we are replacing them with stronger, more intentional solutions. These powerful, clinically guided programs—with proven results—position CDPHP to deliver a more sustainable pharmacy experience and better health outcomes for the communities we proudly serve.

Some pharmacy program enhancements that will happen in 2027 include:

• New pharmacy benefit manager (PBM): Express Scripts® Pharmacy Benefit Services (ESI) will be the new CDPHP PBM. Capital Rx was the right solution years ago, and ESI is the right solution for where pharmacy is going next. Aligning with a national PBM strengthens our ability to manage rising costs, respond to market trends, and expand the solutions available to our members and employer groups.
• Stronger pharmacy network: Fully insured commercial and self-funded groups with pharmacy benefits administered by CDPHP will gain a stronger pharmacy network with a standard cost share model across all participating pharmacies, including CVS retail pharmacies. Standard cost share model means member pharmacy costs, like copays or coinsurance, are based on their health plan structure, instead of a preferred vs. non-preferred pharmacy network structure. This change expands members’ access to pharmacies and gives them more freedom of choice. Please note: 2027 plan-year updates for CDPHP Medicare Advantage (MA) are still in review. In line with prior years, we will update you on MA plan benefits once finalized with CMS.
• Easier prescription drug shopping: Members will have access to real-time drug pricing through a new price check tool (replacing CDPHP ConnectRx, On the Go), making it easy to find the best drug at the best price.
• Additional mail order options: Members will continue to have access to Wegmans Mail Order, plus ConnectRx pharmacy and Express Scripts.
• More details about these pharmacy changes will be shared in the coming months.

CDPHP® members enrolled in health plans for all lines of business will receive new member ID cards for their 2027 plan year.

New ID card mailings are set to begin on October 1, 2026, and will continue through the end of the year based on plan renewal dates.

ID cards will look different and have a new subscriber ID number. Members should present their new cards in 2027 to ensure claims are processed properly when they receive health care services like:

• Doctor visits
• Lab work and screenings
• Inpatient and outpatient hospital treatment
• Prescription drugs* at the pharmacy or by mail

Please note: For fully-insured commercial plans, each dependent in a member’s household will receive a separate mailing with their individual member ID card. This includes dependents under 18. Members should be sure to keep all cards.

Members will continue to use their current member ID card through December 31, 2026. After the year is up, members should keep their 2026 card in a safe place in case they need to submit or follow up on a 2026 claim.

*Applies if CDPHP administers pharmacy benefits.

Updated 9/1/2026

Group structure updates will be implemented for commercial, self-funded, and Medicare groups effective January 1, 2027.

Updates will include:

• A new group ID for every commercial, self-funded, and Medicare group.
• A new member ID for every commercial, self-funded, and group Medicare member.
• Separate group IDs for medical and dental products.
• A standardized subgroup and class ID structure for more cohesive reporting and billing.
• A separate invoice for each subgroup (groups will be billed at the subgroup level with enhanced billing capabilities).
  • Group Medicare
    o Classification methodology changing from “eligible” to “enrolld
  • Large Group = 100+ enrolled member
  • Small Group = fewer than 100 enrolled member
  • Groups will automatically renew into mapped plans for both Small and Large Group
  • Small Group portfolio of nine packaged plan options now includes embedded drug coverage and dental reimbursement

CDPHP will provide the new group, subgroup, and class IDs to each group in advance.

New ID cards will be issued to members beginning November 2026.

More details about these updates will be communicated to employer groups and members in a timely fashion throughout 2026.

Updated 8/27/2026

As part of planned merger with Excellus Health Plan, Inc., CDPHP will transition to an in-house platform for electronic enrollment and maintenance effective January 1, 2027.

This only impacts groups that use EDI for enrollment. The change applies to all groups on January 1, 2027, regardless of renewal date.

Benefitfocus will continue processing all files with 2026 effective dates through December 31, 2026.

Each CDPHP employer group 834 file will be sent to an in-house platform for effective dates beginning January 1, 2027.

CDPHP will help with the transition by assigning a CDPHP implementation analyst to each employer group and/or electronic enrollment file submitter to help:

• Provide new SFTP requirements
• Provide a new 2027 companion guide and account structure
• Complete testing and provide approval for production
• Answer questions and troubleshoot issues

CDPHP will begin making outreach to impacted groups/submitters in April 2026.

More details about these updates will be communicated to employer groups in a timely fashion throughout 2026.

Updated 9/23/2026

CDPHP is implementing enrollment, billing, and small group underwriting process updates for 2027. Check out the highlights in the dropdown sections below and read the 2027 Group Administration Guide.

Updated 9/23/2026

Beginning October 1, 2026, enrollment and eligibility inquiries will transition from email-based submissions to a new Enrollment Inquiry & Support tool. This secure web-based platform within the employer and broker portals will be used for enrollment-related requests and support activities moving forward. The tool creates cases that can be tracked and followed by external users. This is a significant advantage over blind email requests because the inquiries are tracked in a case management system.

Groups that currently submit enrollment transactions through 834 file exchanges and the enrollment portal will continue to have those options. However, changes will be required as part of the transition. Groups using 834 file exchanges will work with our EDI team to implement updated file formats and processes. Groups using the enrollment portal will transition to the new portal, as previously shared in the September 9 Broker Blast about the digital and portal updates.

Updated 9/23/2026

Starting October 1, 2026, for payments effective with the 2027 plan year, new lockbox addresses will be used:

CDPHP Group Payments
PO Box 5266
Binghamton, NY 13902-5266

CDPHP Direct Payments
PO Box 5267
Binghamton, NY 13902-5267

Wire payments
For wire transfer transactions, groups may contact their CDPHP account representative to request Excellus Health Plan’s ACH/wire remittance information to facilitate direct payment.

Please update your records to ensure timely payment processing.

Updated 9/23/2026

CDPHP notified brokers and employers of employer group structure changes in March. Beginning January 1, 2027, enrollment submissions will utilize plan-specific enrollment codes. These codes link employee classes and benefit package selections and will be required for online and electronic enrollment transactions.

Updated 9/23/2026

Employer billing statements will have a new format and additional functionality, including expanded electronic billing options and support for subgroup-level billing where applicable.

Updated 9/23/2026

Upon renewal, premium calculations will move to a daily proration methodology. Rather than billing based on mid-month add/termination rules, premiums will be calculated based on the actual effective date of the change.

Updated 9/23/2026

To ensure member ID cards are produced and mailed before a January 1 effective date, enrollment changes must be received by December 1, 2026. Requests received after this date may delay ID card delivery. This is an ongoing, monthly deadline (i.e. for a February 1, 2027, effective date, changes must be received by January 1, 2027.

Updated 9/23/2026

Effective January 1, 2027, the allowable retroactivity period for fully insured groups will change from 90 days to 30 days. Requests submitted outside the new timeframe may require additional review or may not be approved.

Updated 9/23/2026

• Group Medicare: Group Medicare is “auto-renewed” at approximately 91 days prior to the group’s renewal billing date.
• Small group: All small groups will be auto-renewed systematically, seven days prior to the group’s renewal billing date. (i.e., a February 1, 2027 group has their February bill generated on January 18, 2027. The group will auto renew on/around January 11, 2026.) Only groups that have submitted an approved AGIF (group size attestation) will be auto-renewed/available for manual renewal.

Updated 9/23/2026

Beginning January 1, 2027, social security numbers will be required for subscribers and dependents entered through online enrollment tools, including dependents under 12 months of age.

Updated 9/23/2026

Brokers can no longer attest or sign on behalf of the group. All group implementation documents must be signed by the employer and uploaded during the submission process.

Updated 9/23/2026

Members approaching Medicare eligibility (age 65) and turning 26 will receive enhanced communications regarding enrollment considerations. Employer groups may also receive notifications when employees become Medicare eligible/turn 26.

Updated 9/23/2026

Beginning October 1, 2026, for 2027 enrollments, paper enrollment applications should be mailed to:

Membership Department
P.O. Box 21494
Eagan, MN 55121

Updated 9/23/2026

Small group employers will experience additional underwriting review and documentation requirements starting for Q1 2027 groups as part of the new Salesforce renewal process. See highlights below or check out the latest underwriting guidelines.

Updated 9/23/2026

The list of documents that must be uploaded at the time of new group submission are as follows:

• Commercial new group application
• Proof of payroll (NOT required for large groups):
  • NYS-45, or other state equivalent.
  • Payroll – when NYS-45 is not available, an applicant does not appear on the NYS-45 or an applicant’s wages do not support the minimum number of hours to be eligible
• Most recent business tax documentation when (NOT required for large groups)
  • Related entities or parent/subsidiary companies exist
  • Owners/shareholders own multiple entities
  • There are multiple business locations, company is fully remote and/or HQ or physical location is unclear
  • Business is a start-up, operating for less than one year
• 1094-C when:
  • Group is part of an applicable large employer
  • Group has 85 or more full-time equivalent employees
• Subscriber application forms
• Rate sheet(s) and benefit summary
• If applicable:
  • Disabled dependent application
  • SHOP eligibility letter from NYS

Updated 9/23/2026

All groups will be required to complete an annual group information form (AGIF) as part of the renewal process.  We are implementing this in phases.

• Phase 1: For groups that renew in Q1 2027, an abbreviated AGIF intake and attestation will be sent by sales to brokers. Sales will reach out to non-brokered groups to obtain this information from the groups directly.
• Phase 2: For groups that renew April 1 and after, the underwriting department will send the AGIF and Healthy NY renewal notifications via mail to applicable groups prior to renewal.

AGIF Form

AGIF Instructions

HNY Recertification Form

Updated 9/23/2026

Certain small group transactions that may have previously been processed administratively will require underwriting review beginning in 2027.

Updated 9/23/2026

During the January 1, 2027, Facets migration, January renewing small group plans will be mapped to current coverage. January renewing groups wishing to make plan changes after migration should contact their account manager for assistance.

Updated 9/23/2026

Welvie My Surgery: Digital decision-support program that helps members prepare for surgery by guiding them through treatment options, risks, and questions to ask their doctor (self-funded add on).

Maternity care program: A maternity and NICU support program that gives expectant and new parents education and guidance to promote healthy pregnancies at no cost for fully insured groups (self-funded add on).

Vori Health: Virtual musculoskeletal health care and physical therapy services to diagnose, treat, and manage pain in the back, neck, and joints at no cost for fully insured groups (self-funded add on upon renewal).

Wellframe: Digital care management app that delivers personalized care plans, education, and messaging at no cost for all groups to help members stay engaged in their care.

24/7 Nurse Line: 24/7 phone access to registered nurses for education and support at no cost for all groups.

Healthwise: Evidence-based health education materials on the CDPHP website and online member accounts. Available to all groups at no cost.

Expanded provider network: Upon merger, members can use the CDPHP network providers they know and trust, plus those contracted directly with Excellus Health Plan, Inc.

CDPHP Vision will offer an expanded vision network (small and large groups 1/1/27, coming later for self-funded).

For more information on how these benefits will apply to your plan, check out the fully insured and self-funded tip sheets.

TruHearing will move to DME cost share upon renewal for fully insured groups (embedded for small group, add on for large group and self-funded).

The Embrace Health Flex Card will transition from NationsBenefits to Lifetime Benefits Solutions.

Estimate Medical Costs will replace CDPHP Price Check and will be integrated with the provider search tool, allowing members to search for doctors and compare prices at the same time.

MD Live Virtual Care will replace Doctor On Demand and will include teledermatology.

Transform for Prediabetes will sunset after 2026. For 2027, members will have access to diabetes and pre-diabetes tools through the Wellframe app, as well as access to diabetes care managers through the Diabetes Management Program.

For more information on how these benefits will apply to your plan, check out the fully insured and self-funded tip sheets.

Plan designs (community rated small group cost share may be modified to align with New York state actuarial value).

Reimbursements including for fitness, weight management, doula, parenting preparation, dental, vision hardware, LASIK, and Ciccotti Center MyFitRx and Kids on the Move.

Ovia Health cycle tracking, pregnancy, parenting, and menopause app. 

Dental benefits from Delta Dental.

Virtual mental health from Valera Health and aptihealth.

CDPHP Health Hub digital wellness platform.

For more information on how these benefits will apply to your plan, check out the fully insured and self-funded tip sheets.

Self-funded pricing

The 2027 self-funded pricing documents (base administration and add-on / pharmacy) are now available and include several new medical and pharmacy program options.

Your broker or CDPHP representative can review pricing and discuss program opportunities that may be of interest to you.

Claim funding process

We are updating portions of our claim funding process for 2027 as detailed below.

• Funding schedules
  • Medical claim funding will continue its current schedule, with no change to payment turnaround times.
  • Pharmacy claim funding, if administered by CDPHP, will move from every other week to a weekly cycle, providing more timely alignment between claim activity and funding requests.
• Funding requests
  • Beginning in 2027, funding requests will distinguish claims by incurred plan year.
  • One funding request will include any applicable 2026 runout. A separate funding request will include 2027 dates of service. Clients will make a single funding payment covering both requests.
  • Funding requests will be delivered via email, and reports will be available in the new Information Connection reporting portal when the funding request is delivered. Details about Information Connection are coming later in 2026.
  • Claims with 2027 dates of service will utilize a new claim payment check number series, while 2026 claims will continue to use the existing series.
• New York State HCRA surcharge
  • The New York State HCRA surcharge will transition from a monthly billing cycle to a weekly billing cycle, aligning more closely with claim activity. The Covered Lives Assessment will continue being billed monthly with no changes to its current structure.
• Enhanced Funding Reporting
  • Beginning in 2027, you will receive weekly reporting packages that align with funding requests and provide comprehensive visibility into claim activity. Reports will continue to prioritize accuracy, transparency, and usability, and will include:
  • Medical claims, including HCRA surcharges and savings program fees
  • Pharmacy claims, if administered by CDPHP
  • Program participation fees
  • Capitation payment detail
  • Additional supporting information and reporting components
  • More detailed implementation timelines and supporting materials will be shared later this year.

New Coordination of Benefits (COB) approach

Effective January 1, 2027, CDPHP will adopt a new Coordination of Benefits (COB) approach, leveraging an industry-leading solution that helps identify overlapping coverage through secure data exchanges with participating health plans. This updated approach provides several benefits, including:

• More timely and accurate coverage information
• Reduced reliance on annual member questionnaires
• Fewer unnecessary member communications
• Improved efficiency and accuracy in COB administration

Summary Plan Description (SPD) service enhancement

CDPHP is transitioning Summary Plan Description (SPD) document services to Lifetime Benefit Solutions (LBS), with implementation expected to be completed later in 2026.

LBS provides an enhanced solution for the creation and maintenance of SPD documents. After this transition, eligible employer groups will receive SPD documents in a modernized format designed to improve usability, accessibility, and ongoing administration.

To support a smooth transition, SPD-related fees will be waived through 2027 as eligible groups are migrated to the new process and document format.

CDPHP representatives will introduce LBS services and discuss available options with eligible groups during the implementation process.

HealthHelp

CDPHP will continue its partnership with HealthHelp in 2027 and will provide prior authorization services for high-tech radiology, cardiac devices, genetic testing, musculoskeletal services, and radiation therapy when selected by the self-funded plan.

CDPHP Health Hub (Personify Health)

As previously communicated, several enhancements are being made to the CDPHP Health Hub experience beginning in 2027 including:

• The program now works on a plan year basis rather than calendar year. This change only impacts off-cycle groups.
• Groups offering CDPHP Life Points Rewards will be billed based on rewards earned rather than rewards redeemed.
• Members will be able to carry over unredeemed rewards year after year.
• The Transform Prediabetes program will be sunset on December 31, 2026.
• Existing CDPHP Health Hub users will not need to re-register for the CDPHP Health Hub with their new member ID. Existing login credentials will apply.

Please note the CDPHP Health Hub will be unavailable for a short time for scheduled maintenance in early January. All users will regain access using their existing login credentials after the downtime. Any additional updates will be communicated as needed.

Update 9/3/2026

Welvie My Surgery: A digital decision-support program to help members prepare for surgery by guiding them through treatment options, risks, and questions to ask their doctor.

Vori Health: Virtual musculoskeletal health care and physical therapy services to diagnose, treat, and manage pain in the back, neck, and joints at no additional cost.

Wellframe: Digital care management app that delivers personalized care plans, education, and messaging at no cost to help members stay engaged in their care.

24/7 Nurse Line: 24/7 phone access to registered nurses for education and support at no additional cost.

Healthwise: Evidence-based health education materials on the CDPHP website and in online member accounts for all members at no additional cost.

Updated 8/27/2026

Hearing benefit: Members may see changes to the TruHearing hearing aid benefits they currently have. Members should be sure to review plan benefits for details.

Fitness benefit: Silver&Fit will replace SilverSneakers. Members still get a monthly gym membership and at-home workouts.

Medical cost estimates: Estimate Medical Costs will replace CDPHP Price Check and will be integrated with the provider search tool, allowing members to search for doctors and compare prices at the same time.

MD Live will replace Doctor On Demand and will include teledermatology.

Transform Prediabetes will end after 2026. For 2027, members will have access to diabetes and pre-diabetes tools through the Wellframe app, as well as access to diabetes care managers through the Diabetes Management Program.

Help at home: The Papa benefit will end after 2026. If members have questions about in-home support coverage or benefits, they can contact customer care at the number on the back of their ID card.

CDPHP Health Hub: This program will end after 2026. Members can visit cdphp.com/classes to see a full list of exercise and educational classes they can take from the comfort of home.

Updated 8/27/2026

CDPHP Medicare Advantage plan members will receive an Annual Notice of Change (ANOC) in late September. Please review this important document with your clients to learn about changes to 2027 benefits, costs, and more.

If a member is happy with the changes, no action is needed. They’ll be automatically re-enrolled in their current plan.

If a member would like to change their plan, you can help them review premiums, benefits, and covered medications to find a plan that best fits their needs with our easy-to-use online shopping tool starting October 1, 2026.

Updated 8/27/2026

$0 Preventive care including wellness visits, cancer screenings, and more

$0 for most vaccines including flu, RSV, pneumonia, and shingles

Weight loss reimbursement: Get up to $100 for participating in a qualified program

Virtual mental health from Valera Health and aptihealth.

Vision benefit: Get frames, lenses, and contacts at any U.S. vision provider.

Updated 8/27/2026

$0 Preventive care including wellness visits, cancer screenings, and more

$0 for most vaccines including flu, RSV, pneumonia, and shingles

$0 Tier 1 prescription drugs on most plans at preferred pharmacies

Dental benefit: Dental spending amount on a flex card can be used at any dentist in the U.S.

Virtual mental health from Valera Health and aptihealth.

Updated 8/27/2026

CDPHP is thrilled to offer COBRA administrative services through Lifetime Benefit Solutions (LBS) beginning January 1, 2027. This service helps employers reduce compliance risk and provides members with a more stable, consistent experience during life transitions.

LBS makes administering COBRA simple and ensures groups are compliant by managing the full process, including member elections and premium collection. With COBRA, administered by LBS, members have access to a member portal, and can set up recurring payments for their LBS COBRA billing account at no additional cost, or can make payments through the COBRA & Premium Billing Mobile app.

See below for more information specific to small, large, and self-funded groups.

Small group
COBRA, administered by LBS, will be embedded at no extra cost for existing small groups beginning January 1, 2027. Groups wishing to opt out must do so by completing this form by September 1, 2026.

New small groups with an effective date of January 1, 2027, or later will be auto enrolled in COBRA at no charge unless they opt out during implementation.

Small groups can also purchase a buy-up contract with LBS to have LBS administer COBRA for non-CDPHP lines of coverage for $25 per group per month.

Groups that purchase the buy-up will have access to on-demand reporting through an employer portal.

Large group and self-funded
Large and self-funded groups can offer COBRA through a direct contract with LBS. Groups that provide this service will have access to on-demand reporting through an employer portal.

All premiums collected for self-funded will be remitted back to the group.

Please contact your CDPHP representative for large group and self-funded pricing.

Small, large, and self-funded

If a group will be transferring active COBRA participants to LBS, they must download and complete the Legacy Member form prior to their effective date, and submit it to LBS at LBSMember@lifetimebenefitsolutions.com.

Updated 7/24/2026

Aligning with ESI strengthens our ability to manage rising costs, respond to market trends, and expand the solutions available to members in 2027 by combining national scale with local and regional expertise. CDPHP members will have access to a wide variety of clinically integrated pharmacy programs aimed to:

• Enhance member experience
• Improve quality of care
• Increase cost savings

These programs will continue to be managed in-house by the experienced, local CDPHP Care Management and Clinical Pharmacy teams collaborating in real time to provide coordinated, personalized support that members can trust.

Fully insured commercial and self-funded groups with pharmacy benefits administered by CDPHP will gain a stronger pharmacy network with a standard cost share model across all participating pharmacies, including CVS retail pharmacies. Standard cost share means members’ pharmacy costs, like copays or coinsurance, are based on their health plan structure, instead of a preferred vs. non-preferred pharmacy network structure. This change expands our members’ access to pharmacies and gives them more freedom of choice.

(Legacy programs sunsetting on December 31, 2026, include CDPHP Preferred Rx Network and CDPHP Rx for Less prescription discount program.)

Please note: 2027 plan-year updates for CDPHP Medicare Advantage are still in review. In line with prior years, we will update you on MA plan benefits once finalized with CMS.

Members will have easier access to real-time pricing for prescription drugs and more through the new Check Drug Prices tool accessible via their CDPHP online member account. This streamlined digital experience will make it easier for more members to save money and get the most out of their pharmacy benefits.

With one simple login, members will be able to:

• Check drug prices in real time
• Find a retail, home delivery, or specialty pharmacy
• Access prescription claim history
• Get non-emergent online support from health plan pharmacists

(This replaces CDPHP ConnectRx, On the Go which will sunset on December 31, 2026. App users will be notified by CDPHP in Q4 2026.)

In 2027, CDPHP will offer more mail order pharmacy options, providing members with greater access to cost-savings and convenience. Members with mail order benefits will be able to choose from three options based on their unique needs and preferences:

• Wegmans Home Delivery
• Express Scripts^® Pharmacy
• ConnectRx pharmacy, powered by CDPHP

(Costco Mail Order Pharmacy will be out of network January 1, 2027. Approximately 1,000 members currently using this service will be notified in Q3 2026 with details about the transition to a new mail order provider.)

On January 1, 2027, CDPHP will launch an enhanced version of our website. While the website will feature a refreshed look and improved navigation, you will continue to use the same web address you use today (cdphp.com).

However, existing bookmarks and saved links may change due to the new website navigation and functionality.

Updated 9/9/2026

To provide a more seamless digital experience, CDPHP is introducing new online accounts:

• Broker: Launches September 15, 2026, with limited data available until October 1, 2026
• Employer: Launches October 1, 2026
• Member: Launches January 1, 2027

These updated online accounts will continue to offer access to plan information, eligibility details, administrative tools, and account management resources, while providing enhanced user experience and new functionality.

Updated 9/9/2026

Members and employers will be prompted to pre-register for their new 2027 online account within their existing CDPHP account. It is the easiest way for employers who manage a single group under their existing account access, to ensure uninterrupted access when the new online accounts become available.

• Employers will be prompted to pre-register for the new employer account beginning September 15, 2026.
  • Employers who manage multiple groups under their existing account access can register for a new online employer account after receiving new group information.
• Members will be prompted to pre-register for the new member account beginning December 1, 2026.

Brokers do not need to pre-register for the new broker online account, but credentialing is required for access. As previously shared, brokers not yet credentialed with Excellus Health Plan, Inc. (EHP) must complete the credentialing process before receiving account access. Once credentialing requirements are met, we will establish the accounts on your behalf and will send login instructions, in early-mid September.

Updated 9/9/2026

To help protect sensitive information and ensure users have the appropriate level of access, new roles will be assigned for enrollment administrators and commission administrators. Each will have access to plan comparison and quoting tools.

Brokers will no longer attest or sign on behalf of the group. All group implementation documents must be signed by the employer and uploaded during the submission process.

Updated 9/30/2026

CDPHP will transition to the EHP version of InstaMed for online payment services across member, employer, and broker online accounts.

Key updates for 2027 include:

• Members will still have the ability to make payments without logging in to their account using “Express Pay” (formerly known as “Quick Pay”)
• Employers must log in to Bill Pay to make a secure payment. Employers will not be able to use “Express Pay.”
• Members and employers using automatic payments will need to re-enter their banking information, as existing banking data will not transfer to the new platform.
• Brokers will have view-only access to invoices and payment information and will not be able to make payments on behalf of employer groups.

Additional details and timing information will be communicated as the transition approaches.

Updated 9/9/2026

CDPHP is launching a new sales and enrollment broker platform for 2027 enrollment. Beginning Q4 of 2026, CDPHP brokers can navigate between two online accounts to manage enrollment and quoting for 2026 and 2027 effective years. For 2026 enrollment, you will be able to log in using your existing username and password. For 2027 enrollment, you will need to be credentialed and register for an online account. Once both are established, you’ll be able to toggle between them.

CDPHP is launching a new employer secure site for 2027 plan years. Beginning Q4 of 2026, CDPHP employers can navigate between two online accounts to manage employees for 2026 and 2027 effective years. For plans effective in 2026, you will be able to log in using your existing username and password. For plans effective in 2027, you will need to complete pre-registration for an online account.

Over the coming weeks, you’ll receive additional communications with more detailed information, including:

• Information on key features and functionality
• Training opportunities and educational resources
• Additional milestones and important dates

Updated 9/16/2026

For 2027 renewals, CDPHP is implementing updated group underwriting requirements and a revised Annual Group Information Form (AGIF) process. These changes are intended to improve data accuracy and support regulatory compliance.

A significant change for groups is that renewal will increasingly depend on the timely submission of required renewal information. Quoting and selling will include an underwriting step for new prospects and some renewing groups. Unlike today’s automatic renewal process, groups that do not complete required documentation may risk coverage termination.

Employers and brokers will receive additional guidance and support regarding new requirements and timelines.

Updated 9/16/2026

Beginning January 1, 2027, members with spending accounts administered by Lifetime Benefit Solutions (LBS) will enjoy a more integrated experience within the CDPHP online account and mobile app, making it easier to manage health benefits and spending accounts from one centralized location.

Members will be able to:

• View spending account plan details
• Check account balances
• Review recent transactions
• Access LBS through a convenient single sign-on (SSO) experience

Updated 9/9/2026

Existing CDPHP member app users will be prompted to update the app through the app store after January 1, 2027. New users will be able to download the app through the Apple and Google Play stores.

Updated 9/9/2026

Eligible commercial members will be able to continue submitting online reimbursement requests for a variety of medical, pharmacy, and wellness programs (including fitness reimbursement).

Medicare Direct Pay (Individual Medicare) brokers will have a new portal to serve as a single location to track and manage leads, view enrollment statuses, and request literature for their clients. With this new portal, brokers can easily access book-of-business reporting, disenrollment reporting, and pending applications.

Brokers should use this new portal for beneficiaries seeking enrollment starting January 1, 2027, and beyond.

Starting September 23, 2026, brokers can expect to receive their username and password via email.

To access the new portal, log in using your credentials at:

Broker Sign In – CDPHP Broker Portal (effective 1/1/2027)

Please note: The current Broker Community should continue to be used for enrollments effective October 1, 2026, November 1, 2026, and December 1, 2026.

Login | Capital District Physicians’ Health Plan, Inc. (until 12/31/2026)

Updated 9/23/2026

• Group Admin Guide
• SG Medical Commercial Community Rated Underwriting Guide

Updated 9/24/2026

• Annual Group Information Form
• Annual Group Information Form Instructions
• CDPHP HNY Eligibility Policy for New Employees
• CDPHP Lifestyle Reimbursement Form
• Commercial New Group Application Form
• Commercial New Group Form Instruction Sheet
• Community Rated Subgroup Application Form
• Delta Dental Plan Selection Form
• Eligibility Policy for New Employees
• FTE Calculation Worksheet
• HNY New Group Application Form
• HNY New Group Instruction Sheet
• HNY Recert Form

Updated 9/24/2026

Changes You Should Know Brochure

Updated 9/24/2026

Provider Network and Commercial Business Map

Updated 9/25/2026

• Individual Commercial Rate Sheet Albany
• Individual Commercial Rate Sheet Mid-Hudson
• Small Group Rate Sheet Albany
• Small Group Rate Sheet Mid-Hudson

Updated 9/24/2026

• Fully Insured Rx Benefits Brochure
• Self-Funded Rx Benefit Brochure
• Advanced Opioid Management Program Flyer
• Automatic Prescription Discount Employer Flyer
• Drug Price Transparency Tool
• HelpScript Employer Flyer
• Medication Assurance Program Employer Flyer
• Patient Assurance Program Employer Flyer
• Pharmacy Benefits Manager
• RationalMed Flyer
• SaveOnSP Employer Flyer
• Sempre Health Employer Flyer
• Site of Care Redirection Employer Brochure

Updated 9/24/2026

• CDPHP Health Hub Employer Broker Flyer
• CDPHP Health Hub Member Flyer – Life Points
• CDPHP Health Hub Member Flyer – No Life Points
• Embrace Health Member Flyer
• Find A Doctor Flyer
• LG Delta Dental Flyer
• MD Live Teledermatology Flyer
• MD Live Telemedicine Flyer
• Mental Health and Substance Use Flyer
• Ovia Health Sales Employee Flyer
• Ovia Health – Community Flyer
• TruHearing Flyer – Commercial
• Vori Health Group Flyer
• Wellframe Employer Fact Sheet

Updated 9/24/2026

• Self-Funded Pricing Flyer – Base Admin and Add-On
• Self-Funded Rx Pricing Flyer

Updated 9/24/2026

• Wellness Committee Toolkit – Application
• Wellness Committee Toolkit – Kickoff Agenda
• Wellness Committee Toolkit – Member Welcome Letter
• Wellness Committee Toolkit – Monthly Agenda
• Wellness Committee Toolkit – Solicitation Email
• Wellness Committee Toolkit – Strategy Session Agenda
• Wellness Committee Toolkit – Tip Sheet

Updated 9/24/2026

• LBS Value Story – Brochure
• Core Solutions Sell Sheet – Flyer – Employers
• COBRA Administration Overview – Brochure – Employers
• Compliance Services – Brochure – Employers
• Health Spending App Flyer

Updated 9/24/2026