Did They Pay?

Capital District Physicians’ Health Plan (CDPHP)

Healthcare payer profile

Capital District Physicians’ Health Plan (CDPHP)

Private Health Insurance Companies

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Identity and role: Capital District Physicians’ Health Plan (CDPHP) serves New York State including Albany and Columbia counties. New York nonprofit health maintenance organization offering commercial and Medicaid managed care products. This profile concerns the coverage organization rather than a government benefit program.

This independent directory invites patients and healthcare professionals to share factual experiences about coverage, authorizations, denied claims, appeals, reimbursements and payment delays. No wrongdoing is alleged. Do not disclose patient identifiers, medical records, claim numbers or other private information.

Official regulator/program source: Health plan listing.

Payer Accountability Report Card

Listed payer or program: Capital District Physicians' Health Plan (CDPHP, brand; exact legal issuer varies by product) · Scope: New York; HMO/Medicaid, Medicare, PPO and self-funded administration use distinct CDPHP entities

Verified public metrics and source references; these measures are not interchangeable.
Measure Reported value Year and source
NY DFS complaints closed 25 NY DFS 2025 Consumer Guide to Health Insurers, 2024 Overall Complaint Ranking, p. 75 (2024) · New York HMO; Capital District Physicians Health Plan legal issuer (not all CDPHP products)
NY DFS complaints upheld 3 NY DFS 2025 Consumer Guide to Health Insurers, 2024 Overall Complaint Ranking, p. 75 (2024) · New York HMO; Capital District Physicians Health Plan legal issuer (not all CDPHP products)
NY DFS upheld complaints per $1M premiums 0.0045 NY DFS 2025 Consumer Guide to Health Insurers, 2024 Overall Complaint Ranking, p. 75 (2024) · New York HMO; Capital District Physicians Health Plan legal issuer (not all CDPHP products)
NY DFS reported premiums 668.50 million USD NY DFS 2025 Consumer Guide to Health Insurers, 2024 Overall Complaint Ranking, p. 75 (2024) · New York HMO; Capital District Physicians Health Plan legal issuer (not all CDPHP products)
NY DFS complaints closed 5 NY DFS 2025 Consumer Guide, 2024 EPO/PPO Complaints, printed p. 6 (2024) · New York EPO/PPO; CDPHP Universal Benefits, Inc. legal issuer only (not CDPHP HMO, Medicaid, Medicare or entire brand)
NY DFS complaints upheld 1 NY DFS 2025 Consumer Guide, 2024 EPO/PPO Complaints, printed p. 6 (2024) · New York EPO/PPO; CDPHP Universal Benefits, Inc. legal issuer only (not CDPHP HMO, Medicaid, Medicare or entire brand)
NY DFS upheld complaints per $1M premiums 0.0017 NY DFS 2025 Consumer Guide, 2024 EPO/PPO Complaints, printed p. 6 (2024) · New York EPO/PPO; CDPHP Universal Benefits, Inc. legal issuer only (not CDPHP HMO, Medicaid, Medicare or entire brand)
NY DFS reported premiums 599.60 million USD NY DFS 2025 Consumer Guide, 2024 EPO/PPO Complaints, printed p. 6 (2024) · New York EPO/PPO; CDPHP Universal Benefits, Inc. legal issuer only (not CDPHP HMO, Medicaid, Medicare or entire brand)
Regulator-confirmed complaints 0 NY DFS 2025 Consumer Guide — 2024 Prompt Pay Complaints, printed p. 11 (2024) · 2024 New York EPO/PPO and commercial business; CDPHP Universal Benefits, Inc. legal issuer only; NY DFS upheld prompt-payment complaints (late claims processing), not overall complaints or claims-denial rate; excludes affiliates, Medicare and Medicaid
Regulator-confirmed complaints 0 NY DFS 2025 Consumer Guide — 2024 Prompt Pay Complaints, printed p. 10 (2024) · 2024 New York HMO; Capital District Physicians Health Plan reporting row only; NY DFS upheld prompt-payment complaints; excludes EPO/PPO, Medicare, Medicaid and other affiliates

Official complaint, appeal and oversight resources

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