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New York News

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Care Connect has released an updated facilities list that reflects City  MD's departure from the CareConnect network. Please download the document below for the  most up to date information.

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UnitedHealthcare Broker Connection 7/16/17  - The most recent UHC Broker Connection covers the following: July 31 PCORI Fee Due; 2018 Medical Necessity Requirement, Updates for N, Broker training and much more.

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CareConnect Broker Alert - CareConnect has released their Small Group (1-100) 4th Quarter Rates on their Broker Sales Materials page.

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HealthPass September 2017 Renewal Window is Now Open! - The HealthPass Online Portal (HOP) is now open to accept September 2017  renewal applications! If your group is not making changes at renewal,  their policy will be automatically renewed and you do not need to take  action. If you wish to make changes, please refer to the instructions below. Changes to the following group criteria will require you to submit the renewal application and most recent notated NYS45/Quarterly Wage & Tax Statement on the HOP:
 

 

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Updated ACA Small Group new case submission dates.  Aetna is implementing updated 4th quarter new business submission deadlines for Small Group Affordable Care Act (ACA) plans: This applies to:

States included in the updated ACA new sales submission dates are: Colorado, Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Missouri, Nebraska, Nevada, New York, North Carolina, Ohio, Oklahoma, Pennsylvania, South Carolina,  Tennessee, Texas, Utah, Virginia, West Virginia and Wisconsin.

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 Updated Participation Requirements - HealthPass New Particpation Guidelines - Effective 10/1/2017 there will be an additional requirement to enroll or renew a group with the HealthPass New York Exchange. Click below to view the updated Eligibility Guidelines.
 

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To keep you informed about current and future changes in health care,  Emblem is providing you the most recent information about key federal and state developments. Senate Still Aiming For Pre-Holiday ObamaCare Repeal and Replace Vote - Senate Republican leaders are still hoping to vote on legislation to repeal and replace the Affordable Care Act (a.k.a. Obamacare) before July 4. However, legislative language has not been made public and several key Republicans said they had not yet reviewed the text.

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Action Required forNew York Small Groups: : Enroll July 1, 2017 OHP HMO Groups in an OHI Plan by June 30, 2017 As a reminder, New York small groups currently offering only an Oxford Health Plans (NY), Inc. (OHP) HMO plan with a coverage end date of July 1, 2017 need to purchase a new  Oxford Health Insurance, Inc. (OHI) policy before their current OHP plan ends. These groups did not receive a renewal package from us and need to apply as a new group.

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UHC Broker Connection 6/15/17 UnitedHealthcare has released their Broker Connection Newlsetter,  covereing the 2017 Medical Loss Ratio (MLR) report schedule and key dates are now available. MLR only applies to fully insured plans. See how your fully insured clients may be affected. Other topics include:

Broker & Client Resources
Plans & Services
Sales Support and Employee Wellness

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We have exciting news from HealthPass.  Oscar and Healthpass have formed a new partnership and Oscar is offering 8 plans, available through HealthPass. This is great news. Click below to read the details and access the press release. This will be going into effect 9/1/17,

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Oxford through HealthPass - Use this informative and convenient guide to choose the right care center for services: Doctors offices, covenience clinic, urgent care or ER. Click below:
 
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UHC -Broker Connection Newsletter - View the process to be used by new business clients for submitting the required 1095-B information, PCORI Notice Scheduled for All Savers® Clients, New Vision Network Includes Target and Sears and much more. Click below.
 
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Aetna Life Insurance Company has submitted a rate change request to the New York State Department of Financial  Services (DFS) for new and renewing Small Group plans effective January 1, 2018.  Proposed rate changes have been submitted for groups with 100 or fewer full-time equivalent employees in New York.While the exact rates requested will vary by plan and region, they have requested rate increases ranging from -2.54% to 39.98%.

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Technology Upgrade at EmblemHealth - To better serve you and our members, EmblemHealth is upgrading our internal technology. This will affect HIP Small Groups/Members renewing between July 2017 and June 2018 and HIP Large Groups/Members renewing between August 2017 and July 2018. This upgrade will not affect GHI Large Groups/Members until 2018.

See exactly how this will impact you.This change starts with HIP Small Group July renewals.

  • Group numbers are changing to a 11-digit format
  • Member ID numbers are changing to a 11-digit alpha-numeric format
  • Emblem Health will be contracting ALL selling agents directly, which means Emblem will pay selling agents directly
  • Brokers will need to fill out new Emblem Health contracts, the target date is 6/17 for all contracts to be back in Emblem's office (Watch for new forms as soon as they are finalized).
  • All Brokers need to complete the new forms regardless of group’s renewal month.
  • Lock Box will be changing. Emblem will provide new information as soon as possible.
  • Old HIP/EH group and member ID numbers will be on the portal for 18 months.

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July 2017 Renewal Window is Now Open! The HealthPass Online Portal (HOP) is now open to accept July 2017 renewal applications!
 
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UnitedHealthcare Oxford Connecticut Rate Filings

Initial Notices to Mail May 4 to Impacted UnitedHealthcare and Oxford Customers Renewing in 2018  Following Connecticut Insurance Department guidelines, we are mailing notice of our rate filings on May 4, 2017 to our affected Connecticut commercial small group, fully insured customers with renewal dates in 2018.
 
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Effective immediately, Healthfirst will extend our small group new business deadline from the 15th to the 23rd of the month. Please note that Healthfirst only accepts 1st of month effective dates.
 
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Empire Producer On Line News - Small Group Application and Binder Payment - Binder payments must be submitted before we can activate small group benefits coverage. Beginning with April 15, 2017 effective dates, if we don’t receive payment within 5 days of our receiving the completed group application, the case will not be processed, and group implementation may be delayed. Be sure to reach out to your FNA Representative to make sure you do not delay your client's application.
 

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The Ancillary Charge Program
Guiding you to lower-cost generic medication options, while preserving choice and access.The Ancillary Charge Program from UnitedHealthcare. Guiding you to lower-cost generic medication options, while preserving choice and access. The materials have been revised for NY.

"Upon your 2017 policy effective or renewal date, the ancillary charge will not apply toward your maximum out-of-pocket amount unless through our review process we determine that the lower-tier prescription drug is not medically appropriate for you."

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An important Message from Oscar CEO Mario Schlosser:  We are excited to announce that we’ve removed participation requirements for Oscar for Business plans, effective immediately. This means that any employer can offer Oscar side-by-side with another carrier. We will accept even a single employee from a group, provided the group meets all of our other underwriting requirements. MORE
 
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Emblem Health Broker News - We want to continue to keep you informed about current and future changes in health care. Click below to find the most recent information we have about Federal and State developments that may affect you or your clients.
 
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Empire New Business Reference Sheet -  Reminder that we no longer require payroll/941 on stand-alone HMO. Click to access the New Business reference sheet.
 
 

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The HealthPass Online Portal (HOP) is now open to accept June 2017 renewal applications! If your group is making changes for your renewal open enrollment, several transactions must be completed in the HOP. MORE

 

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Imoprtant Message from AETNA - We want you to know about a change we’re making to our medical plans in 2017. This information will help notify your clients and their members about this change.
As you know, we mail printed ID cards to new Aetna members when they enroll. Beginning April 1, 2017, members will receive durable paper ID cards. Less plastic cards produced are better for our environment.
This change applies to new members and to critical ID card updates for existing members. Paper ID cards have the same member and plan information as the plastic card format.
 
We encourage members to access their digital ID card through:
•    Aetna Navigator:  Visit Aetna.com to register. Once registered, members can access and print a copy of their digital ID card by visiting the ID card section of Navigator.
•    Aetna Mobile Application (iPhone and Android):  Available in app stores when a user searches for “Aetna.”
•    Aetna.com mobile web
 
Remember that certain updates, such as a name or dependent change or a primary care provider (PCP) change, result in a paper ID card mailed to the member. When we have a member’s email on file, less critical ID card updates are only applied to the digital ID card. Printed cards are mailed when there is no email on file for the member.