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New York News

Aetna

Aetna is making changes to their 2019 Small Group ACA portfolio.  These updates  include deductibles, in-network out-of-pocket maximums, out-of-network maximums, ER benefits, and pharmacy benefits in specific states.  Please read the document below for the full update and download Aetna's Small Group Out-of- State Access Grid.

 PDF icon2SM Click here for the full pdf document

 

PDF icon2SM Out-of-State Access Grid

Cigna logo

 In Cigna's October newsletter read about their 2019 Wellness Incentive Program Planning, listen to a podcast on America's mental health crisis, and more!

 

PDF icon2SM Click here for the full pdf document

emblemhealth2014

In this broker update from EmblemHealth,  please find their first quarter plan rates for 2019 along with plan highlights and rate information.

 

UHC Oxford 2015

UHC Oxford wants to advise brokers that Risk Management has recently updated the required documents needed to pass audit. Moving forward the Oxford verification (OVF) is no longer required, in its place are the Employer Information Form (EIF) and the Common Ownership Certification (COC). These forms are now included in both letter requests that go out for each audit. They are both attached for your reference. The goal here was to simplify the process for all as brokers who cross sell UHC and Oxford products are used to seeing the EIF and COC. Nothing else in the process has changed as far as IDEA or Annual Certification forms. These are still the same. The goal here was to simplify the process for all as brokers who cross sell UHC and Oxford products are used to seeing the EIF and COC. Nothing else in the process has changed as far as IDEA or Annual Certification forms. These are still the same. 

 

Click below for the Full Update, Employer Information Form, Common Ownership Certification Form, and Sample Audit Document:

UHC Oxford 2015

As we head into 4th quarter and 2019, Oxford wanted to provide brokers with their cheat sheet which will link to their 4th quarter rate sheets and include other useful information on network, benefits and policy. Attached you will also find a revised 2018 to 2019 product grid.  The only changes are listed below:

Page 2

  • NY S LBTY GT 20/75/4000/70 EPO PA 19
  • Specialist copay now reflects $75 after deductible 

Page 3

  • NY S MTRO GT 15/70/3000/70 EPO PA 19
  • Specialist copay now reflects $70 after deductible

 

PDF icon2SM Click here for the 2018 Q4 NY Small Group Cheat Sheet

PDF icon2SM Click here for the NY 2018 to 2019 Product Grid

 

Empire Anthem

Empire has a lot of updates and materials they would like to share with the broker community for 2019.  Included are a few pieces to help get you started:

 

 

 

  1. 2019 SG Product Guide
  2. 2019 SG Benefit Changes from 2018 plans
  3. Formulary Flyer – Rx
  4. SG Hospital Participation Flyer
  5. 2019 SG Eligibility Guide - which can also be found on the Forms Page
  6. 11/1 and 12/1 Term & Rewrite Form (to accompany new business paperwork)
  7. 2019 Q1 SG Rate Sheet with Contract Code - Region 4 Dep29
  8. 2019 Q1 SG Rate Sheet with Contract Code - Region 8 Dep29
  9. 2019 Q1 SG Rate Sheet with Contract Code - Region 4 Standard
  10. 2019 Q1 SG Rate Sheet with Contract Code - Region 8 Standard

Also, Please note the following key dates and milestones in our 2019 rollout calendar:

  • October 2nd – Broker webinar at 9 AM EST
  • October 8th – Youdemandmore.com will begin updating with Empire’s 2019 materials; plans will also go live on Health Connect
  • October 15th – Empire’s provider finder tool will be updated with all Blue Access providers (5,000+ more than Pathway)
  • October 26th – Plans go live for January enrollment on Empire’s SALES system and new features will be added (i.e. ability to pay online for binder payments)



Cigna logo

 Cigna is making changes to the DHMO network.  Same Network – but Network Name Change. Effective October 1, 2018, the existing DHMO Network will be called “Cigna Dental Care Access Network”. Click below for the full announcement along with information about a new ID card for members.

Empire Anthem

Commission checks for period ending 9/20 (with a check mail date of 9/25 and direct deposit date of 9/27) will be pushed out as we move to this new monthly schedule. These commission checks will now mail on 10/8 and direct deposit on 10/10. Going forward, your commission payments will be paid monthly as noted in the chart attached in the document below:

PDF icon2SM Click here to download the full pdf document

healthpass

The Current & Renewal Rates sheet contains incorrect Renewal Rates for Healthfirst. Incorrect kits will be pulled from your client's sites, and correct kits will be regenerated. Click here for the full notification and correct renewal rates.

PDF icon2SM Click here to download the full pdf document

healthfirst

Please join Healthfirst on October 3rd for a webinar regarding updates and offerings for 2019.  Click the link below to register!

Click here to register

healthfirst

Recently, December 2018 renewing groups were issued new Member ID cards in error. Please advise these groups to disregard that mailing. Your groups will receive their correct Member ID cards closer to their renewal date.

PDF icon2SM Click here to download the full pdf document

healthpass

Join HealthPass for one of their 2018 Broker Conferences!  They will review their 2019 portfolio, new products & services.will review our 2019 portfolio, new products & services. Click the link below to RSVP!

PDF icon2SM Click here to download the full pdf document

OSCAR

Oscar's product seminars start next week! They will discuss our 2019 small group plan portfolio, our competitive advantages in the market, and provide a refresher on our underwriting guidelines.  Click the link below and sign up for a seminar near you!

PDF icon2SM Click here to download the full pdf document

healthpass

The HealthPass Online Portal (HOP) is now open to accept November 2018 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.  Click the link below for futher details.

PDF icon2SM Click here to download the full pdf document

Empire Anthem

Join Empire to learn about their enhanced 2019 Small Group, Large Group, and Specialty Product Offerings.  For your convenience, The Broker Seminars will be offered at four locations.  Click the link for more information and to register!

PDF icon2SM Click here to download the full pdf document

Empire Anthem

Reminder: Empire moved Small Group Clients to electronic billing and online payment effective June 1st, 2018. The new Empire standard will be to issue bills online and accept premium payments online through Employer Access, also known as the Employer Portal.  Click the link below for the full details.

PDF icon2SM Click here to download the full pdf document

CareConnect Logo 4CSM

Please read this full Broker Update from CareConnect.  It includes additional detail regarding the termination notification that was emailed to all appointed CareConnect brokers earlier this week.  Click the link below for further information.

PDF icon2SM Click here to download the full pdf document

Aetna

Aetna has improved their Cross Sell Pricing Programs to reflect their belief that stronger, long-term relationships form when customers purchase multiple product lines. Some highlights include doubled discounts when you cross-sell medical for most products, expansion to include more products such as Voluntary Hospital Indemnity, Critical Illness, and Accident and much more!

PDF icon2SM Click here to download the full pdf document

emblemhealth2014

In this month's Broker Focus, Emblem invites brokers to sign up for their September broker seminars as well as releases third quarter group plan rates, information on their dental plan and more!

Click here to download the full pdf document

OCA

 

OCA is excited to announce the launch of a redesigned, next-generation benefit account experience - including a new and improved enrollment, claims processing, debit card, mobile app, and online experience.  They will be upgrading clients upon their OCA renewal date beginning October 1, 2018.  For more information, click the link below.

PDF icon2SM Click here to download the full pdf document

United Healthcare

In this month's BrokerConnect from UnitedHealthcare, read about their enhanced eye care program which includes a pediatric vision benefit that will provide members with a new pair of glasses and a second eye exam at no additional cost. Click the link below to download their BrokerConnect newsletter for more updates from the health insurance company!

PDF icon2SM Click here to download the full pdf document

healthpass

The renewal window for September groups will close on 8/20/2018.  Applications submitted after this date will require a manual process to re-open the window and may subject the entire group to delays of up to 2-3 business days from receipt. 

PDF icon2SM Click here to download the full pdf document

healthpass

HealthPass wants to remind brokers of Healthfirst's extensive provider network, which offers access to more than 29,000 primary care providers (PCPs), pediatricians and specialists throughout New York City, Long Island, and Westchester. Members can choose from a broad network of top-quality doctors, specialists, urgent care centers and hospitals including; Northwell Health, Montefiore and NYU Langone.

PDF icon2SM Click here to download the full pdf document

OSCAR

Google's parent company Alphabet announced yesterday that they plan to invest $375 million in Oscar! This investment will allow Oscar to continue to invest in and bring unique products to more people, markets, and business lines. For more information on this exciting new update, click the link below.

PDF icon2SM Click here to download the full pdf document