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New York News

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9/16/11 Welcome to The Big Picture. The Big Picture reports for CIGNA® business enterprise-wide, so you may find that details in the “Latest News” updates may not always be relevant to your business or apply to all health plans.

UnitedHC

9/14/11 - Prescription Drug List Updates for January 2012  Effective January 1, 2012, the attached Prescription Drug List (PDL) and pharmacy benefit updates will take place on our Advantage and Traditional PDLs. (Click the link)Oxford Advantage PDL and Benefit Plan Updates Summary   Oxford Traditional PDL and Benefit Plan Updates Summary
Please review these summaries to determine which changes affect your clients. You may also access this information in the Broker Highlights section of our broker website at www.oxfordhealth.com.

9/14/11 - New Health Reform Videos Help Explain Provisions of the Bill View new videos on our United for Reform Resource Center explaining key provisions of the health care reform act including Preventive Care, Dependent Child Coverage to Age 26, FSA and HSA changes.

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8/10/11 - Notice to Tri-State Brokers: Pharmacy Benefit Mail Order Cost Correction. It was recently discovered that certain members were undercharged for their pharmacy mail-order benefit.
Please note that the error has been corrected and several documents have been sent out to the members. The three documents are as follows:  The official communication from UnitedHealthcare/Oxford, the member letter and the letter to the employers. Affected members will not be required to pay retroactive payments but they will be charged the correct amount the next time they use their pharmacy mail-order benefit.

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8/2/11- Important notice from UnitedHealthcare Regarding Commission Structure Changes for NY Sitused business.  Effective October 1, 2011, for new and renewing New York sitused business, United Healthcare will be making two important changes to their commission structure for the following group business:

New York Small Group (2-50 eligible employees) - The new standard commission structure will be 3.5% of the premium paid.
New York Large Group (51 or more eligible employees) - The new maximum commission will be 4% of the premium paid.

Be sure to review the Notice and the Letter for additional details and guidelines.


8/1/11 - Follow-up communications regarding New York rate filings. As previously communicated, we submitted rate applications with the New York State Insurance Department (NYSID) seeking rate increases for 2011. An initial notice was sent to all impacted policy and certificate holders at the time of the rate filing as required by the New York state prior approval law. We are now sending the required second notice advising of the increases approved by the NYSID for customers renewing in the fourth quarter of 2011.


8/1/11 -  - Employee count is now required for some new business applications. Aetna will now need one more piece of information with their new business applications for smaller customers. They are asking employers for their average total employee count. We need this number to comply with the Medical Loss Ratio (MLR) requirements of the Accountable Care Act.


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7/28/11 - Aetna Small Group Communications Broker Alert -  Improving Communications With New Small Group Clients. Effective with cases sold for 9/1/11, we will now collect and store plan sponsor email addresses from our employer application. The company email address is an existing field on the Aetna Small Group Employer Application. Please ensure that your clients include their email address when they are filling out the necessary information to purchase Aetna group health plans.


7/25/11 -In June, UHC sent a notice regarding a potential contract termination with East End Health Alliance (EEHA). EEHA hospitals include Eastern Long Island Hospital in Greenport, NY; Peconic Bay Medical Center in Riverhead, NY; and Southampton Hospital in Southampton, NY.  Although they continue to negotiate a new agreement that is acceptable to both parties and meets their commitment to keep health care affordable, the current agreement with EEHA, which affects all commercial products (i.e., Oxford, UnitedHealthcare Medicare and Medicaid), terminated on July 15, 2011.

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7/22/11 - Keeping Valued Partners Informed regarding pharmacy benefits and aware of some changes that will be occurring UHC has released a special Broker Connection. Medco announced an agreement to merge with Express Scripts. At the same time, Medco announced that it will not renew its contract to provide pharmacy benefits administration services to UnitedHealthcare customers. The contract ends December 31, 2012 and includes a transition period thereafter.

 

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7/14/11- UHC Receives High Grades in AMA Report Card. UCH releases Broker Connection with updates on AMA report card, Dr. Oz Video, changes to CT Law and much more.

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7/11/11 - The LIA has just released their Hot Plan selections for the 3rd Quarter of 2011. The offering includes HIP, Emblem, Atlantis, Colonial and Davis Vision.


Due to a recent update to group affiliations for some physicians, the release date for the UnitedHealth Premium physician designations has been extended from March 30 to June 1. Beginning March 21, Oxford will notify all physicians whose designation will change as a result of the new information. The June 1, 2011 public display date provides physicians more time to review their assessment results.

7/1/11 - REMINDER Effective July 1, 2011, the Prescription Drug List (PDL) and Benefit Coverage updates will take place on Oxford's Advantage and Traditional PDLs. You may also access this information in the Broker Messages and Highlights sections of their broker site at www.oxfordhealth.com.

6/29/11-Effective July 1, 2011 - In an effort to better serve your business needs Oxford will be making several changes to their contact information for the Oxford Broker Commissions Department. Please see the most recent Special Producer Notice for further details.

6/8/11 - As a valued partner with FNA, committed to Long Island, the NY Islanders have made a special offering available exclusively to our FNA Broker Partners. When you purchase season tickets you will receive TWO fantastic exclusive benefits as an FNA Broker Partner!

6/3/11 - Note Emblem Health will no longer market High Deductible Health Plans for 2+ new business. Going forward existing HSA's will renew with an HSA option but will only be illustrated on the renewal letter to the group. They will no longer be available on the Emblem portal or Healthconnect for quoting.

4/13/11 - UHC has released a Broker Connection Newsletter with details about Federal Government Issues New Health Reform Notices. The first quarter brought a wave of new activity at the Federal level as government agencies issued guidance including a range of notices affecting various provisions of the Patient Protection and Affordable Care Act of 2010.

3/24/11- UnitedHealthcare has released the Broker Connection, an informative newsletter. Topics include New broker tools, new COB services, smartphone updates and much more.

3/18/11 - UnitedHealth Premium® Physician Designation Refresh Extended to June 1, 2011. Due to a recent update to group affiliations for some physicians, the release date for the UnitedHealth Premium physician designations has been extended from March 30 to June 1. Beginning March 21, UnitedHealthcare will notify all physicians whose designation will change as a result of the new information. The June 1, 2011 public display date provides physicians more time to review their assessment results.

3/16/11 - We have two exclusive self-funded products that are going to help you open doors, start a conversation with your clients and help you increase your revenue stream. Let FNA show you how. We can also provide you with materials that you can customize to help with your marketing efforts. Call your FNA Representative for more information

3/4/11 - The LIA Health Alliance/NY Health Insurance Exchange has released 2011 2nd Quarter Rates for Small Group & Sole Proprietors

3/11/11 - In March, A mailing was sent out to all fully insured customers with 150 or fewer employees requesting that they complete and return a survey. The survey can be completed online or by faxing the completed survey to the number provided in the letter. The mailing is requesting, by federal definition, "the average number of employees as employed by the employer's company during the preceding calendar year." Customers will have until May 16, 2011 to respond at which time the survey will be closed and Oxford will report on already existing data.

3/1/11 - IMPORTANT UPDATE from Emblem regarding the release of 2nd Quarter rates. Please be sure to read this very important update regarding the 2nd Quarter rate release from Emblem. They just received approval from the NYS Insurance Department for final premium increases. This also impacts any groups renewing in April or May 2011. Please be sure to read the very important update regarding the 2nd Quarter rate release from Emblem.