On Sept. 1, Karen Ignagni started a new chapter in her career far from Washington, D.C., where she spent two decades as one of the most powerful lobbyists in the country.

As the head of the health insurance industry's lobbying group, America's Health Insurance Plans, she was the voice of the nation's health plans. Now she is the caretaker of EmblemHealth, which insures 3.2 million people.

Crain's New York Business sat down with Ms. Ignagni, 61, during her second week at EmblemHealth, which is the parent company of Group Health Inc., better known as GHI, and HIP Health Plan of New York.

After moving to the Upper West Side in late July, this new New Yorker is still finding her way around the city's subway and neighborhoods.

But there are some things she is clear on: EmblemHealth will not convert to a for-profit insurer under her watch. Years ago, the city's budget proposals actually booked revenue from a conversion that never happened.

“Our board has made a very clear decision we are and will be a nonprofit plan. We have a wonderful tradition to build on,” she said. “I'm very comfortable with the decision they made.”

Ms. Ignagni said during her first two days at EmblemHealth she held town hall introductory meetings, first with its 4,000 employees, and then with another 2,500 clinicians and staff at its affiliated medical group, Advantage Care Physicians.

Those workers are the key, she said, to EmblemHealth being a market leader in a shrinking insurance industry. The country's top five insurers are morphing into the top three, with two major mergers pending. Can a New York nonprofit insurer compete with them?

“The answer revolves around the people who work at Emblem,” she said. “I've been so impressed by the training and commitment of our people.”

Ms. Ignagni fielded questions from them about EmblemHealth's financial health. Its HIP unit lost more than $365 million on $5.1 billion in revenue last year. GHI lost almost $129 million on $1.9 billion in revenue.

Her strategy for getting the insurer's finances under control, she answered, is sticking to EmblemHealth's mission.

"We are known for affordable health coverage," she said. "That's what people expect. That's what we will deliver."

Barbara Benson writes for Crain's New York Business, a sister publication of Business Insurance.