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New York News

Aetna

In Aetna's international newsletter "Coverage", read about Aetna's International current affairs, news and thought-leading opinions from around the region and beyond.  This month's newsletter dicusses a recap from the annual Healthcare Revolution conference, a look at the challenges employers face with an increasingly mobile workforce, and more!

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United Healthcare

UnitedHealthcare is pleased to tell you that their Sweat Equity physical fitness reimbursement program is now available to UnitedHealthcare members enrolled in New York large group (101+) plans, beginning with members of plans that renew or become effective in December 2018.  Start the new year off right by getting paid to sweat!

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emblemhealth2014

Hi brokers!  Please see the attached letter being sent to Individual and Small Group members who will have a change of network upon 2019 renewal from Prime to Select Care. Please note members were already notified of this change in their renewal letters in October, so this will serve as a second reminder.  Please feel free to send to any of your Individual & Small Group members.

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UHC Oxford 2015

It has been uncovered that the Oxford Connecticut Small Group New Business Cover Letter in our online enrollment tool, IDEA, contains an incorrect email address for documentation submission. In order to advise impacted brokers and clients the attached blast will be going out to CT brokers and clients.  We truly apologize for the inconvenience and are working to have the email address corrected on the letter in IDEA. In the meantime, please note that the correct email address for new business documentation submissions is: oxfordnewbusinesssubmissions@uhc.com.

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emblemhealth2014

As the 2019 selling season gets underway, EmblemHealth wants to be sure you're fully equipped to present their plans to your clients. Emblem's small group plans fit the needs and budgets of small businesses. Each plan offers quality coverage with comprehensive benefits and network access. Click below for plan highlights and first quarter rate information on the various Emblem plans available. 

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Empire Anthem

More security measures are being added to Producer Toolbox.  Next time you log into the Producer Toolbox, a new two-factor authentication security process will prompt you to enter a one-time password.  Read about this and more in Empire's December newsletter.

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United Healthcare

Motion members can use their current Apple Watch, purchase a new one or choose to "Walk-it-Off" and pay in steps.  Read more about this great benefit offered through UnitedHealthcare and more in last  month's BrokerConnect newsletter.

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UHC Oxford 2015

We wanted to ensure that you were aware of the 12/15/2018 deadline to submit enrollments for New York Essential Plan members for an effective date of 1-1-19. As a reminder the New York Essential Plan offering is a gap product for individuals above the Medicaid threshold and below the ACA Bronze affordability threshold. It may be a great opportunity for clients with a large population of part time employees. This product allows qualified individuals to enroll if they earn between 138% and 200% of the federal poverty level. 


Please also note that it is commissionable to brokers at $15PEPM if you are appointed on the New York individual exchange. 

  • Premium either $20, or $0 (depending upon income)
  • Eligible for ages 19-64
  • Must be an NY resident
  • Part Timers, 1099’s, Hourly Employees are eligible if they fit income requirements
  • Dental and Vision rider available for additional premium
  • Not eligible for Medicaid or minimum essential coverage
  • $200 Gym reimbursement
  • Network is “Essential Plan Program” on provider search (mirrors our Medicaid network with the exception of no Stonybrook)

Below, please find the NY Essential Plan Proposal, Fact Sheet, & and an "At A Glance" look at the plan. For any questions please let us know.

healthfirst

Effective immediately John T. Mather Memorial Hospital is now in-network with Healthfirst’s Commercial EPO plans, further supporting our expansion into Suffolk County. I have attached an updated network listing that shows this for your convenience. Click below for Healthfirst's Updated Small Group EPO Network flyer.

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UHC Oxford 2015

As a reminder, effective January 1, 2019 Oxford will be changing the pharmacy access for the Oxford Garden State Network to the OptumRx Value Pharmacy Network. This change is one more way we are seeking to provide more cost-effective solutions for New Jersey employers. To help manage costs, the OptumRx Value Pharmacy Network allows access to select pharmacies, including major chains like Walgreens, Rite-Aid®, and Walmart, as well as mass merchants and supermarkets. All new and existing Garden State Network members will have access to the OptumRx Value Pharmacy Network beginning January 1, 2019. 

Here is how to find a participating pharmacy:
Current or prospective Oxford Garden State Network members can search for a participating pharmacy on the oxfordhealth.com Member website:

  1. 1. Under Messages, select “Pharmacy Locations for Oxford Members.” 
  2. 2. On the next screen, select “OptumRx Value Pharmacy Network Search.” 
  3. 3. Complete the search criteria on the next page and select “Search.”

Below, please find the Oxford Broker eBulletin that fully explains this network update, the Oxford Garden State Network Pharmacy Options Flyer, Employer Letter and Member Letter

Empire Anthem

Empire BlueCross BlueShield and NewYork-Presbyterian have agreed in principal on a new multiyear agreement. The agreement will allow Empire BlueCross BlueShield members who receive care at any NewYork-Presbyterian hospital, or from NewYork-Presbyterian Medical Groups, ColumbiaDoctors or Weill Cornell Medicine clinicians, to continue to be covered at the in-network level of benefits without disruption.  Please click below for the full update from Empire.

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UHC Oxford 2015

UHC Oxford is currently working to continue our contractual relationship with CityMD. Unfortunately, they have not yet reached an agreement, and the deadline for the contract is rapidly approaching. Member and broker letters will be sent to impacted clients by the end of the week notifying them of this update.wanted to reach out to advise that we are currently working to continue our contractual relationship with CityMD.  Unless a new agreement is reached, CityMD will be an out-of-network provider as of Jan. 1, 2019. Please click below for the full update

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Empire Anthem

Empire is currently in negotiations with New York Presbyterian Health System (NY Presbyterian) for a new multiyear agreement. They are actively working to reach a reasonable agreement, but if this does not occur, NY Presbyterian will be considered an out-of-network hospital for dates of service beginning January 1, 2019.  With that being said, please join Empire for a webinar hosted by President & CEO, Alan Murray to disucss these changes.  Click below for more information and to register.

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OSCAR

With Thanksgiving last week, Oscar is extending their New York Small Group December 1st deadline to Wednesday, December 5th.

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emblemhealth2014

Hi Brokers!  Please see Emblem's revised Small Group Prime and Select Care Network brochure that will help your clients pick a plan that's right for them.

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Empire Anthem

Empire launched a new email campaign that focuses on helping members feel confident in choosing their health care plans.  Read about Empire's helpful enrollment tips in the article below.

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emblemhealth2014

Please submit all new large group proposals to LargeGroupProposals@EmblemHealth.com. A sales representative will reach out to you to discuss next steps.

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Empire Anthem

Brokers, please be aware of an error that occurred with Empire's commissions payments this past week. A series of internal tests inadvertently resulted in a number of brokers receiving erroneous payments directly to their bank accounts.  The accidental payments range from a few dollars to many thousands.  Please click the link below for the full update.

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Empire Anthem

What are the advantages of connecting medical with ancillary benefits from Empire? Find out in Empire's Integrated Health Care Report, Edition 3.  

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emblemhealth2014

As the 2019 selling season gets underway, EmblemHealth wants to be sure you're fully equipped to present our EmblemHealth plans to your clients.  They’ve added significant new benefit plans for 2019.  Click below for their 2019 small group plans to help your clients find a plan that best fits their needs.

 

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Empire Anthem

Empire's Small Group Eligibility Guide has been updated for 2019 and should be referenced for additional details on our credentialing and eligibility policies.  Please note that this applies to commercial business only, and not to Healthy NY applications.  Click below for the full update.

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Empire Anthem

It has never been easier to sell more small group dental, vision, life and disability coverage with Empire BCBS!  Their team of experts and 100% focus on serving brokers.  Also, don't forget that dental portfolio begins 10/1/18 for 1/1/19 effective dates.  Read more about Empire's Ancillary Update in the link below!

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Empire Anthem

Empire has NEW bonuses for brining in Large Group business.  Their 2019 Large Group Broker program has enhanced incentives for top selling brokers in NY.  All this and more in their latest newsletter!

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OSCAR

With fourth quarter being the busiest time of year, Oscar has decided to extend their New York Small Gorup November 1st Deadline to Monday, November 5th. 

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