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Changes to Members' 2017 Prescription Drug Coverage Formulary  - We want to help members get the most from their pharmacy benefits coverage. Every year, we review the drugs on our Preferred Drug List. These drugs are chosen based on sound medical data, safety and cost.

PDF-icon2SM Click here to download the full pdf document

UHC Oxford 2015
 
UHC Oxford Age off termination letters.   As you know, we term dependents at the end of the calendar year who no longer meet our age requirements. During our process this year, some of these members were not terminated. This impact was to NY Small Group members only. We are required by law to provide members with 30 days advance notice of termination. We are sending affected members the attached termination letters and terming them effective 1/31/2017, as opposed to the original term date of 12/31/2016.
 
HFirst New Logo R2015

Healthfirst is launching new small group health plans and brokers can begin earning commissions April 1st 2017.  Save the date for a broker seminar January 25th in Garden City or January 27th in NYC.  Detail are below.  Registration and breakfast will start at 8am, broker session will begin at 9am. If you have any questions, contact your FNA Broker representative direcly. 
 

UHC Oxford 2015

Oxford Update on Binder Check Payments and Paper Applications

An Update on the Oxford Binder Check Payments and Paper Application Submission Changes. UHC Oxford has made a few adjustments to the submission process for new Oxford small group payments and applications since our previous notice in early November.

For New York (1-100), New Jersey and Connecticut (1-50) new small groups, we have added a third payment option. Below is an overview of all three options for submitting new Oxford small group payments and applications.

PDF-icon2SM Click here to download the full pdf document

 

emblemhealth

Emblem RX formulary
Emblem has shared their 2017 RX formularies. Please note that there is one for large group (101+) and one for small group (1-100). Please be sure them with your clients.
 

 

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TriNet Launches New Product to Address the HR Needs of Financial Services SMBs
SAN LEANDRO, Calif. – Nov. 1, 2016 – TriNet (NYSE: TNET), a leading cloud-based provider of HR services, today introduced TriNet Financial Services, a product tailored to address the critical HR needs of small and midsize businesses (SMBs) in the Financial Services industry. Drawing on TriNet’s deep industry expertise and established market presence, TriNet Financial Services is an industry-specific HR solution that allows Financial Services firms to deliver a premier employee experience and manage a complex set of employment-related risks and regulations. Click below for access to Key features of the TriNet Financial Services product:

PDF-icon2SM Click here to download the full pdf document

 


 

UHC Oxford 2015

UHC December is Holiday Wellness Month

This month’s Wellness Online Newsletter features:

• Easy Ways to Reduce Holiday Stress
• How to Keep Your Heart Healthy & Your Waistline Trim at Holiday Meals
• Alone for the Holidays? Ways to celebrate you.
• Online Seminar: Enjoy the Holidays without Gaining Weight
• Test Your Health Care Knowledge
• December Health Tip
• Monthly Recipe – Winter Crisp
 

CareConnect Logo 4CSM

Care Connect Broker Update
Important information for new and existing business.  As we approach December, CareConnect wants to share some updates for your new and existing business regarding finalizing renewals. You must act. If action is not taken, groups with a status "renewal Aplication in Progress will be automatically renewed  as is at the end of the day 11/30. Click below for the full details.

PDF-icon2SM Click here to download the full pdf document

UHC Oxford 2015

UnitedHealthcare has shared updated information concerning their new binder check process. The group will need to wait the below timeframes when sending online payments, depending on when they submit the group via IDEA.
 
Please see below, the following change will take effect today.
 
•    If a group enrolls in the online small group enrollment tool prior to 10am ET, the group can make their payment through the Oxford Payment Center after 12pm ET the same day
•    If a group enrolls in the online small group enrollment tool between 10am and 2pm ET, the group can make their payment through the Oxford Payment Center after 4pm ET the same day
•    If a group enrolls in the online small group enrollment tool after 2pm ET, the group can make their payment through the Oxford Payment Center after 12pm ET the next business day

Ultimately UHC is confident this process will be more efficient and they appreciate your cooperation & patience.

 

PDF-icon2SM Click here to download the full pdf document

 UHC Oxford 2015

January 1, 2017 PDLs for New York and New Jersey Clients,
 and Tristate Summary Flyers

The Prescription Drug Lists (PDLs) below are effective on January 1, 2017 for Oxford plan members in New York and New Jersey with an Advantage or a Traditional prescription drug plan, as well as any new Oxford pharmacy benefit business in those states effective on or after January 1, 2017.

PDF-icon2SM Click here to download the full pdf document

 

 

Empire BCBS Anthem Co 8-2016 

Empire BCBS has released their 1Q small group rates for Dep age 29. Age 29 rates are on HC and SALES. Below is a PDF of the Downstate and Upstate Age 29 rates. 

PDF-icon2SM Click here to download the full pdf document

PrestigeEE

At Prestige, our objective is to surround our clients with the highest quality of Human Resource Services. In addition to the many benefits we provide to our clients, you will also have access to a monthly newsletter that will update you about important changes to federal and state employment practices. We encourage you to read below and take advantage of all the great resources provided to you. Please feel free to reach out to us with any questions. Below is the November Newsletter with important HR and Employment Law updates.
 
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At a recent broker seminar Care Connect discussed that all first quarter renewal letters would include a flyer encouraging groups to look at buy down options in order to lessen the sticker shock caused by larger
than normal rates increases.  Below are samples of the two flyers that Care Connect will be distributing.
 
emblemhealth2014

Emblem Helath releases updated RX formulary
Note – different formularies for small group and large group for 2017.  The only formulary documents maintained for LG (premier) and SG (Select) are the summary documents that are attached.  These documents show the preferred agents.  The documents get updated quarterly.  The ones for the 1/1 post are not currently available, however there will be no significant changes to the preferred agents starting 1/1.

The major difference is that certain non-preferred drugs will be excluded at POS and would require a determination if the members requires that medication.  Please see attached file of changes.

UHC Oxford 2015


UHC Broker Connection released on November 8, 2016.  Contains information about

  • IRS Releases New FSA and Transportation Services Amounts
  • Emergency Department Utilization Program
  • Myuhc.com® Promotion Underway
  • FML Administration Offer
  • Latest Prescription Drug List Changes: Review the latest PDL Tracker
  • Pharmaceutical Update

PDF-icon2SM Click here to download the full pdf document

Aetna SM for Web

Learn different ways to quote in Producer WorldSM
Don't miss this webinar. Are you a broker who sells Small Group ACA new business? We've moved to a broker self-serve model for new illustrative quotes with January 1, 2017 effective dates.  Attend our seminar to learn ways to quote for your 2017 new business. Join us for an important webinar and learn several ways to get an ACA quote.
 
You'll learn to:
•    Access Quoting and Renewal System (QRS) through Producer World to get a quote
•    Find our quoting tool, QRS, in different ways
•    Find ACA rate sheets on Producer World
We're offering webinars for three weeks in the hope you can find a convenient day to attend. Just click on "Register here" for your date and time.
Week 1: November 7 - 11, 2016
Week 2: November 14 - 18, 2016
Week 3: November 28 - December 2, 2016
 
Click below for details
 
 
 
Aetna SM for Web

Aetna Small Group ACA new business quotes transition to Producer World®

Use Aetna's online source to get fast new business quotes. Producer World is your online source for Small Group ACA new business quotes and rate sheets. Just go to the site and click on "Small Group," "Quoting and enrollment" and select "Get a Small Group quote" or "Rate sheets." Note that you must be appointed. Click the link below to find hout how to become appointed and licensed.
 
 
Aetna SM for Web

Aetna's New York and New Jersey Broker Commissions on ACA Business are Changing Effective January 1, 2017.  NJ Aetna Funding Advantage (AFA) 10-50 Broker Commissions increasing effective January 1, 2017. As of January 1, 2017, Aetna is changing its broker commission schedules for New York and New Jersey ACA business and is increasing its NJ AFA 10-50 broker commissions.

PDF-icon2SM Click here to download the full pdf document

UHC Oxford 2015

Important Updates from UHC Oxford

Due to the high volume of the 4th quarter UnitedHealthcare/Oxford sent out a reminder note so that you can encourage your groups to respond to audits as early as possible. Their risk team is currently working on a 2 -3 day turnaround time so in order to avoid the frustration of an unnecessary termination/non-renewal.  UHC is asking for a response as early as possible to these audits.

As a reminder in order for a New York group to pass audit we need the following

New York
UHC Oxford 2015

Oxford Binder Check Payments and Paper Application Submission Changes Effective November 15, 2016,  So you can get new Oxford small group payment and applications to us faster, UHC Oxford is changing the submission process. Beginning November 15, 2016, for New York (1-100), New Jersey and Connecticut (1-50) new small groups, and miscellaneous binder checks for the PULSE platform, you will have the following two options for making these submissions.
 

UHC Oxford 2015

 Revised Oxford 1Q 2017 Rates have been released.  Correction on Healthy NY plan design (25/40 copay is after the deductible)

UPDATE -Oxford Binder Check Payments and Paper Application Submission Changes Effective November 15, 2016
So you can get new Oxford small group payments and applications to us faster, we are changing the submission process. Beginning November 15, 2016, for New York (1- 100), New Jersey and Connecticut (1-50) new small groups, and miscellaneous binder checks for the PULSE platform, you will have the following two options for making these submissions.


New binder check process -changes effective 11/15

For the fastest processing, please follow the new procedures for all future submissions.

 

 

Aetna SM for Web

Clients earn financial incentive for early Aetna Funding AdvantageSM submissions. Great news! You can help your clients earn up to $1,000 in administrative credits for Aetna Funding Advantage (AFA) Small Group new December 1, 2016 sales. To qualify, completed new business paperwork must be submitted no later than Wednesday, November 9th via eList OR Aetna’s Springboard Marketplace (note: must complete enrollment within 5 days of Springboard set up). The credit amount awarded will depend upon the number of enrolled subscribers.

PDF-icon2SM Click here to download the full pdf document

Aetna SM for Web

Updated New York ACA Small Group new case submission dates and termination policy.   As you know, there’s a delicate balance between high year-end small group ACA new sales volumes and late or incomplete ACA case submissions. And our goal is to provide access to medical and pharmacy benefits for new members on their effective dates. Aetna is implementing the following new business submission dates for 4th quarter. Click below for details and dates:
 
 

emblemhealth

Emblem Broker Focus Newsletter for Fall 2016
Newsletter includes Network news, new HMO's coming for 2017, Preferred Ancillary rates and much more...

PDF-icon2SM Click here to download the full pdf document