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New York News

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Check out National General's new and improved offerings
Here at National General Benefits Solutions, we're committed to providing you with innovative products and selling tools to help you land more small-group sales. And now, we just rolled out some enhancements we think you'll find useful with future clients.
Aetna SM for Web

Attention All Brokers Placing NY Business:
We are discontinuing our 2017 Small Group Platinum Plans- Aetna regularly assesses our product and plan options to ensure that we provide a competitive offering. By continually assessing and refining our product offering, we are able to focus our energy and investments on the products that our customers are most interested in.

 Effective January 1, 2017, Aetna will discontinue our five platinum small group plans offered in New York. This will effect small groups cases that renew on or after January 1, 2017.
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Below, please find attached Oscar's 2017 NY commission document for your reference.
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Empire BlueCross BlueShield is planning a systematic re-entry into the small group market. As you may have already heard, Empire has spent a tremendous amount of time and resources evaluating this segment and developing a go-forward plan that ensures success over the long-term. They believe in their strategy and are committed to supporting the GA, the broker and their clients again.
Below, please find links the Downstate Q1 2017 rates. Premiums are consistent across the NYC (4), Long Island (8) and Mid-Hudson (3) rating areas. Also below attaching the 2017 Small Group Product Guide, which includes some of the higher-level benefit and plan details. SBC and SOB docs will be available in early October.

Benefits and rates will be available for quoting Health Connect by early October, and they will begin accepting new business through Empire’s online SALES portal, their new Small Group quoting and enrollment system, on 10/17.

With strong rate approval comes strong compensation. Empire will pay 5% of premium on EPO/PPO sales and renewals in 2017. 4% of this is a base amount which Empire envisions continuing to pay into 2018. HMO sales will pay a 2% of premium commission in 2017
With 28 new plans, three provider networks and an enormous investment in technology/efficiency, we feel properly equipped to re-enter Small Group, and to support the broker community the right way.

Empire has also made available a new library of materials to help you support your clients and make selling these new products in the small group market easier. It includes selling tools, plan and network education as well as employee on-boarding materials.  Be sure to reach out to your FNA Representative for the materials and additional details! We look forward to working together with Empire as they re-enter the small group market.
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CareConnect -  Get a Jump on November & December Renewals  -CareConnect understands that the fourth quarter is a busy time for our brokers. To help alleviate some of the stress, both 11/1 and 12/1 renewals will be mailed within the next week to ensure you have an extra 30 days to plan December renewals with your clients.
Prestige PEO Broker Happy Hour Prestige is hosting a Happy Hour in NYC on September 28th at 5:00 pm AT Legends in NYC. Click below for the full invitation with details.
UHC Oxford 2015
UHC Broker Connection Newsletter - News to help you grow your business. Topics in this issue include:
  • Renewal Option Advantages for Transitional Relief
  • Broker Support
  • HealthCare Reform
  • Compliance Notice
  • Plans and Services and much more

PDF-icon2SM Click here to download the full pdf document

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Please join CareConnect at one of their 2017 Broker Seminars.  Here’s your chance to learn about CareConnect’s corporate updates, our 2017 rates and all the other great things in store for the future.
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Aetna Urgent Update   Urgent: An e-mail titled "Reminder: New York ACA Small Group new case submission dates and termination policy," was distributed on Thursday, August 25th at approximately 10:30 a.m. If you received this message, we have gotten an urgent update regarding this information. Click below for the updated message.

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Good news! Care Connect has set their commission schedule for the remainder of the year, so you’ll know exactly when you can expect to receive your payments. July commissions will be released on August 22nd.  For the rest of 2016 click below.

PDF-icon2SM Click here to download the full pdf document


Prestige is THE Solution for Groups 51 - 99

Under New York law, the definition of "Small Group" has become 1-99 employees as of January 1, 2016. This means your groups with 51-99 employees are losing their favorable Age/Sex rating and are being issued "Community Rated" policies. Find out how a PEO can be THE solution.

PDF-icon2SM Click here to download the full pdf document

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Empire BCBS Small Group Broker Webinars
You demanded plans with more doctors, specialists and choices. Done.
Register now for Empire’s Small Group broker seminars. The choice has never been more exciting for small businesses in New York. This is one seminar you should not miss. You’ll learn about the new plans and networks that can offer your clients more access1 and more choices. It’s all here for you. 

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A Letter from Care Connect's President & CEO

"Late last week, New York’s Department of Financial Services (DFS) mandated a 23 percent average premium increase for CareConnect small group plans – significantly more than the 16.8 percent we requested. While we are greatly disappointed with this outcome, I want to make sure you understand why it has occurred and what we’re doing to mitigate its impact." READ MORE BELOW

PDF-icon2SM Click here to download the full pdf document





UHC Oxford 2015

UHC Broker Connnection August 10th issue - Marketplace 90 Days Appeal Notice Guidance,  TriState news,  Agency rewards, and more including plan and service updates and MORE...
Aetna SM for Web

As a follow up to the Aetna e-mail we shared with our brokers earlier this week,  below is information regarding the 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. We’re implementing the following new business submission dates for 4th quarter.
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New Small Group ACA termination policy effective October 1.
As an important Small Group partner, we want to keep you informed of upcoming policy changes. Starting October 1, Aetna has notified us that they must receive written confirmation of customer renewal acceptance in advance of the customer renewal date for all Aetna small groups.  This means that beginning with all October 1 renewal dates, Aetna must receive written confirmation in advance of the policy renewal date.
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HealtPass 2016 Solstice DentalBroker Bonus program - Your HealthPass/Solstice dental enrollment (which includes both EPO and PPO plans) counts towards the broker bonus program effective 1/1/2016! Find out more below.
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Care Connect New Enrollment Feature  -Broker Update

Care Connect is excited to announce enhancements to their enrollment portal that will make it easier for you to manage your book of business. Directly within the portal, you will now be able to:
Make Adds, Terms, Changes & More.
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Three important issues that may affect some of your clients in one way or another.

You may be familiar with them, but just in case….

1.    5500 filings—The DOL is proposing that every business offering employee benefits will have to file 5500s for 2019.  We can do these filings for your clients on a standalone basis.  Do you have any groups who should have filed in the past, but are now delinquent?  These are not going to fly under the radar any longer now that ACA is in full force.  Let me know if you have clients who need assistance with delinquent filings.  More info on what the DOL is aiming to do is attached.

2.    Fair Labor Standards Act (FLSA) was updated in May and has changed the minimum salary exempt employees must make in order to still be considered “exempt” from $23,660 to $47,476.  Why is this important?  Because employers now have to consider whether they’re going to bring their exempt employee’s salaries in line with the new regulations or reclassify them as hourly (and therefore have to pay them overtime wages when they work more than 40 hours a week).  For more info, see here:  https://www.dol.gov/whd/overtime/final2016/overtime-factsheet.htm

3.    Long Term Care Facilities to Submit Payroll Based Journal Reporting—this one is for brokers who handle nursing homes.  In accordance with ACA, the Centers for Medicare and Medicaid (CMS) will be requiring such facilities to submit detailed staffing info electronically.  Payroll Based Journal Reporting (PBJ) is designed to promote accountability and consistency in reporting throughout the industry.  As of July 1, 2016, this reporting is mandatory.  This info will help the CMS monitor staffing levels and provide transparency to consumers when considering nursing homes for their loved ones.  This info can be provided manually or automated via time and attendance systems…..and, of course, we sell those!  More info on this one is attached as well.

Please reach out to your FNA Representative to discuss these or any other issues you may have questions about regarding your clients.
UHC Oxford 2015
UnitedHealthcare Oxford Client survey
As a valued partner of UnitedHealthcare/Oxford, this is to let you know that UHC/Oxford is issuing online surveys by email this week to a portion of their customer base in both small business and key accounts. They strive to provide the highest level of service to members and as part of this effort, this survey will obtain customer feedback regarding service, products, and network.  The survey should take 10-12 minutes to complete.  Should your clients contact you, please encourage them to complete the survey. Thank you.

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Mark your calendar for one of the 2017 CareConnect Open Enrollment Broker Seminars. Here’s your chance to learn about all of our 2017 updates.

PDF-icon2SM  Click here to download the full pdf document

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Starting in 2017 Oscar will be direct contracting their network, rather than utilizing Magnacare's. The new network will be focused around Sinai, Montefiore, and LIHN, with around 20,000 physicians in total. NYU and Northwell will be out of network effective 1/1.
They are making this change for two reasons. First, the direct relationship with the systems will allow Oscar to build out great tools that will improve access to care. This is the core of what they do and these deals will put them in a position to build some very cool new features. Second, it will significantly improve their unit cost structure and help keep premiums stable in the future. A similar email is going out to NY members as well. We encourage you to read the blog (linked in the email) – there are a lot more detail in there.
Link to the official broker announcement email is below.
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Convenient access to benefits information - One of our goals for 2016 was to deliver a simpler, more connected experience for your clients and their employees. On January 1st, we launched an educational campaign to improve member interaction  with Aetna’s self-service online tools. Our continual commitment is to provide our members with available resources that will help them manage their health care benefits. And access these resources as soon as they enroll.

UHC Oxford 2015

Oxford Handbook - Made Simple

Discover how Oxford plans from UnitedHealthcare can help bring you cost control, convenience, choice and a compelling health plan for your business.

The 2016 direct marketing campaign targeting business decision-makers in Oxford Markets with 4-100 employees is launching mid-July. The campaign is designed to better educate prospects, which may help grow your business with UnitedHealthcare.

Messaging suggests to prospective employers that UnitedHealthcare may have a health insurance plan to meet their business' needs, and includes an offer to obtain additional informational materials.
Prospective businesses may receive one of the following informational materials:

  • Oxford Handbook: Group Health Plans Made Simple

 The campaign includes a prospect "Call-to-Action" including:

  • Contacting their broker
  • Visiting a website
  • Calling a toll-free number
  • Mailing a business reply card

Below is the Oxford Handbook:  Group Health Plans Made Simple for your review.

PDF-icon2SM Click here to download the full pdf document