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NJ Office - 973-257-5558


New York News

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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.

PDF-icon2SM Click here to download the full pdf document

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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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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


PDF-icon2SM Click here to download the full pdf document

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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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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.



Prestige Employee has announced a 2Q Broker Contest. Find out how you can EARN!!

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UHC Broker Connection 3/8/17 - Topics include ACA Update for Aggregate groups, Broker & Client Suppoprt update, Reform & Compliance updates and Pharmacy authorization.
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First came core benefits, then voluntary benefits and now you have the ability to offer identity theft plans. Symantec’s acquisition of LifeLock is now complete combining the best of Norton’s digital security with LifeLock’s identity theft protection and remediation services. Best of all, there’s no change in how HealthPass works with LifeLock.

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Please see the link below for the updated 2017 NY Oxford Product Grid. Please note, that the Emergency Room benefit for the Bronze EPO HSA $6,550 Liberty Non-Gated was the only change that was made to reflect the correct benefit.

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Now you can cash in for 2017 with Prestige's broker Bonus program.  Valid for start dates 1/1/2017 through 3/31/2017. Plus there is a chance to earn a 7 day Caribbean cruise! Click below for details.

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Important Message from the Management of Empire BCBS

On behalf of the Empire Small Group sales team, Ethel Graber joins me in sincerely thanking everyone who wrote business with us this past January, and in extending our gratitude for sticking with us through some early ‘re-launch pains’. We genuinely appreciate your willingness to reunite with Empire, and will continue to work to regain your trust and develop a superior Small Group product.
We hope that you can begin to see differences this go-around, with a renewed and dedicated commitment to this market segment. This first year is about coming back with the right partners and the right strategy. We look forward to future and continued growth alongside you all.  
I welcome any and all feedback. We need it and want folks to know that we are listening.
Thank you all.
Jordan Vidor, Manager | Ethel Graber, VP & General Manager

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Many comprehensive preventive services are covered under health insurance plans? These services include, but are not limited to: adult physicals, mammograms, colorectal cancer screenings, diabetes screenings, and immunizations — at no cost to the member!

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As a reminder, New York small groups that currently only offer an Oxford Health Plans (NY), Inc. (OHP) HMO plan need to take action 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.

For your convenience, suggested OHI replacement options have been loaded to our online enrollment tool (IDEA). These options have similar cost shares and benefits to the current OHP HMO plans and are at the same metallic levels.

PDF-icon2SM Click here to download the full pdf document

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A Special Invitation from Oscar to Key FNA Brokers.

Hi Brokers,

We are launching Oscar for Business, our small group product. And we can’t do it without you!

We hope you’ll join us for an exclusive broker kick-off to share the details on Oscar for Business and how Oscar is making health insurance simple and reliable. There will be events at both Oscar HQ in Soho and at the Marriott Uniondale on Long Island.


Please click through below to select your preferred date by Friday, February 3rd:


Here's a preview of the agenda:

•    Breakfast, lunch, or happy hour meet-and-greet
•    Oscar's vision and strategy, presented by Mario Schlosser, Oscar's CEO
•    Plans, network, pricing, and tools for Oscar for Business

What’s the difference between the NYC and Long Island events? The Long Island event will be a large conference-style presentation. The sessions in our NYC office will be intimate seminar-style events with an opportunity to engage more closely with the Oscar Team, including our leadership. Also, for those of you commuting from Long Island to a NYC seminar, we'll provide a $100 AmEx gift card to cover travel and parking.

Once you’ve completed the form, keep an eye out for a formal invite with more details. And don’t worry, if you need to change your response you will be able to. If you have questions, please reach out to OscarForBusiness@hioscar.com.

Looking forward to seeing you,
- The Oscar for Business Team

Call your FNA Representative with any questions you may have.

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 EmblemHealth Broker Focus Newsletter- New for 2017 - Emblem is looking toward a productive 2017.  This exclusive broker newsletter includes new HMO offerings, large group bonus program, new opportunities and a sneak peek at the EPO Value plan.