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Webinar: How Financial Wellness Transforms Your Workplace Culture

Webinar: How Financial Wellness Transforms Your Workplace Culture

Join Us for the March 21, 2024 Webinar!

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  1. Discover effective strategies to seamlessly incorporate financial wellness into your comprehensive employee benefits program.
  2. Learn how to enhance your employees’ financial literacy and capabilities by leveraging a combination of digital tools and personalized human support.
  3. Gain insights into tangible outcomes and actionable strategies to foster meaningful engagement among your employees on their financial well-being journey.

Learn

BE INFORMED TO BE EMPOWERED WEBINARS  World Insurance Associates PEO

 

About this Session:

Discover the transformative advantages of integrating financial wellness into your employee benefits package. Tackling financial stress among employees has a ripple effect, enhancing workplace culture, engagement, productivity, and the overall success of your organization.

Join us for an insightful discussion on strategically weaving financial well-being into your employee benefits strategy. Uncover how this approach not only nurtures individual well-being but also plays a pivotal role in cultivating a thriving and harmonious workplace.

Pensionmark, A World Company

Meet our Speaker

Emilio Vela

Meet our Speaker

Lindsay Fuhrman

Director of Population Health Management

Underwriting and Actuarial

Meet our Speaker

David Stoddard

VP, Director of Analytics and Actuarial Services

Blog

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info@medicalsolutionscorp.com

Update: Oxford/United and Mt Sinai Health Systems Split

Update: Oxford/United and Mt Sinai Health Systems Split

Recently, UHC/Oxford and Mt Sinai Health System had split effective January 1, 2024.  Since that time there have been a state-required cooling-off period and ongoing talks on resolution but that has not yielded a positive outcome yet.  The Mount Sinai Hospital, Mount Sinai Queens, and their related hospital outpatient locations will remain in-network for all patients until at least Friday, March 1.

According to UnitedHealthcare/Oxford: 

  • People enrolled in UnitedHealthcare fully insured commercial plans have continued network access to all of Mount Sinai’s hospitals through Feb. 29, 2024, due to New York cooling-off requirements.
  • Unless they obtain admitting privileges to another in-network hospital, the majority of Mount Sinai’s physicians will no longer participate in our network for employer-sponsored and individual plans, including the Oxford Health Plan, effective March 22, 2024.
  • This negotiation only impacts our relationship with Mount Sinai for employer-sponsored and individual commercial plans, including Oxford. All other active contracts, including Medicare Advantage and the Empire Plan, remain in place with no change.

The two organizations had a three-year agreement that took effect on Jan. 1, 2022, which was canceled before it was supposed to expire amid a dispute over payment rates. Both institutions are blaming one another for the standoff.

Mount Sinai claims UnitedHealthcare compensates it an average of 30% less for care than other health systems in New York. The insurer pays New York-Presbyterian $25,911 for a normal vaginal birth, and Mount Sinai $15,989, Mount Sinai said.

“Mount Sinai must be paid fairly,” spokeswoman Lucia Lee said in a statement. “As Mount Sinai costs substantially less than our peers, UHC/Oxford will actually end up paying more for patients to get care at other systems in New York. This cost — estimated to be at least $140 million more over the course of a year — will be passed on to employers and patients.”

UnitedHealthcare says Mount Sinai sought “outlandish price hikes” that would increase costs for services an average of 50% over three years or $600 million — an estimate disputed by Mount Sinai. For example, a regular, outpatient colonoscopy at South Nassau costs about $6,000 and would be about $8,700 in three years under Mount Sinai’s proposal, according to UnitedHealthcare.

    Mt Sinai Hospitals & Health System

    Facility NameCounty
    Mount Sinai Beth IsraelNYC
    The Mount Sinai HospitalNYC
    Mount Sinai MorningsideNYC
    The Mount Sinai WestNYC
    Mount Sinai-Union SquareNYC
    Mount Sinai Kravis Children’s HospitalNYC
    Mount Sinai-Behavioral Health Center (MSBHC)NYC
    Blavatnik Center, Medical CenterNYC
    New York Eye and Ear Infirmary of Mount Sinai NYC
    Mount Sinai BrooklynBrooklyn
    Mount Sinai QueensQueens
    Mount Sinai South NassauLong Island

     

    Neighboring Hospitals

    Bellevue Hospital Center

    NYC

    New York Presbyterian Queens

    Queens

    Elmhurst Hospital Center

    Queens

    New York Presbyterian Weill Cornell

    NYC

    Flushing Hospital Medical Center

    Queens

    North Shore University Hospital Manhasset

    Long Island

    Lenox Hill Hospital

    NYC

    NYU Langone Hospital Brooklyn

    Brooklyn

    Long Island Jewish Medical Center

    Brooklyn

    NYU Langone Hospital Long Island

    Long Island

    Maimonides Medical Center

    Brooklyn

    St. Francis Hospital

    Long Island

    Mercy Medical Center

    Long Island

    St. Johns Episcopal Hospital

    Queens

    New York Presbyterian Columbia

    NYC

    St. Joseph Hospital

    Queens

    New York Presbyterian Lower Manhattan Hospital

    NYC

    Wyckoff Heights Medical Center

    Brooklyn

     

    Both sides need each other as both are market leaders in their fields. It is our hope and most of our clients that they get this resolved soon. In the meantime, please bookmark our site for the latest updates.  And do reach out to us and learn the steps that you can take to smoothen this temporary roadblock.

    Resources:

    https://www.uhc.com/sinai

    https://keepmountsinai.org/

    For information about transparency providers and new tech tools contact us at info@medicalsolutionscorp.com or (855)667-4621.

    Put You & Your Employees in Good Hands

    Get In Touch

    For more information on PEOs or a customized quote please submit your contact. We will be in touch ASAP.

    NYS 2023 Final Rates Approved

    NYS 2023 Final Rates Approved

    Yesterday, NYS Dept of Financial Services approved 2023 health insurance rate requests yesterday. Small group rates increased by 7.9% and  9.7% for individuals.

    As per NY State Law, Health Insurers are required to send out early notices of rate request filings to groups and subscribers see original –2023 NY Small Group Carrier Rate Filings.  Despite only 3 months of mature claims data experience for 2022  health insurers’ original requests were noticeably above the average of 16.5%/individuals and 19% for small groups. For example, regulators last year approved average rate increases of 3.7% for individuals and 7.6% for small group plans. Over 1.1 million New Yorkers are enrolled in individual and small group plans impacted by the rate increases, the state agency noted.  

    The recent COVID-19 surge irony reflected a lower cost utilization due to COVID-19. The average medical-loss ratio, which represents the portion of premiums spent on medical claims and quality improvement, was 70% in recent years years. That said, in an anticipation of spikes in claims submissions + overall inflation, a larger than average increase is needed. This is in addition to increases in pricing by hospitals, consolidated IPA groups, and pharmaceuticals.

    Rate Factors

    The state noted that the premiums increase main drivers are medications.  “Rising medical costs and inflation continue to put upward pressure on premiums,” said Superintendent Harris. “With our rate actions announced today, we continue to prioritize the financial wellbeing of consumers while ensuring that New Yorkers have access to a robust, stable health insurance market.”  Also, DFS, recognizing the continued uncertainty of the pandemic’s effect on consumers’ health care costs and the economy, held insurers’ profit provisions to a historically low 0.5%. 

    Health Insurers

    Oxford/Unitedhealthcare, notably, got only a 6% rate increase approval for next year. This is a sharp reduction from the original 16.8% request in part by disagreed anticipated costs, held reserves, overall market pricing, and reinsurance gained from ACA’s Risk Corridor.  See more info here, https://medicalsolutionscorp.com/risk-adjustment-reinsurance-and-risk-corridors/.

    Small Group Market   

    Almost 850,000 New Yorkers are enrolled in small group plans, which cover employers with up to 100 employees. Insurers requested an average rate increase of 16.5% in the small group market, which DFS cut by 52% to 7.9% for 2023, saving small businesses $632.4 million. A number of small businesses also will be eligible for tax credits that may lower those premium costs even further, such as the Small Business Health Care Tax Credit.

    DFS SMALL GROUP MARKET RATE ACTIONS   

    NYS DFS Approval 2023 Health Insurance Rates

    *Indicates the Company will offer products on NY State of Health Marketplace in 2023.

    PEO Alternatives to Small Group

    Before you consider renewing automatically, you should first find out what is a PEO so that you can know exactly what to expect from it. PEO’s are large-group markets underwritten.  With the right PEO, you will be able to manage your business’s demand for growth and your employees as well.

    Clients on average save 15-40% off the small group market. If you are looking for a complete insurance solution for your business, go to our website and check out our business insurance solutions. Contact us for more information today.

    Learn how a PEO can make a difference for your group. For more information on how Employer-Sponsored Insurance and a PEO can make difference for your small business please contact us at info@medicalsolutionscorp.com or 855-667-4621.

     

     

     

     

    Put You & Your Employees in Good Hands

    Get In Touch

    For more information on PEOs or a custiomized quote please submit your contact. We will be in touch ASAP. 

    Oxford Liberty National Network Changes

    Oxford Liberty National Network Changes

    Oxford Liberty National Network Changes

    Starting with September 1, 2022 plan effective dates, Oxford members of a Liberty Network plan will have the UnitedHealthcare Core Network for out-of-area coverage. They will no longer use the UnitedHealthcare Choice Plus Network for national network access. This change applies to all Oxford Liberty members. 
     

    UnitedHealthcare Core Network Overview 

    • The Core Network has 90% physicians and 93% of hospitals overlap with the Choice Plus Network
    • The Core Network includes 895,806 physicians and health care professionals and 5,001 hospitals

    Click here for the Core Network Availability Map

    What this means for New York and New Jersey Oxford members enrolled in a Liberty Network plan

    • The out-of-area network for New York and New Jersey situs businesses with Oxford Liberty Network plans will change from the UnitedHealthcare Choice Plus Network to the UnitedHealthcare Core Network effective September 1, 2022 for new business and upon renewal for existing business
    • In states where the UnitedHealthcare Core Network is not available, Oxford Liberty network members will have access to the full network that mirrors the UnitedHealthcare Choice Plus Network
    • Liberty network access within the Oxford tri-state service area remains unchanged

    Provider search

    As always, please confirm a provider’s participation in the health plan network prior to seeking care. You can do this online, on myuhc.com, or by calling the phone number on their health plan ID card. Please note:

    • Members should sign in to myuhc.com® to search for Oxford Liberty Network providers
    • Upon renewal, beginning with September 1, 2022 plan effective dates, Core Network providers will appear in the provider search tool when Oxford Liberty members look for out-of-area providers
    • Non-members and affected members whose plan has not yet renewed will also be able to perform a search for Liberty with Core providers prior to September 1, 2022

    New Cards

    New Liberty Member ID with COREAll Oxford Liberty Network members will receive new member ID cards indicating UnitedHealthcare Core for out-of-area network access.

    We will continue to share additional communication tools as they become available from Oxford. 

     
     Learn more about how we are successfully helping navigate SMB for 25+ years. If you have any questions or would like additional information, please contact us at 855-667-4621 or info@medicalsolutionscorp.com.

    For information about transparency providers and new tech tools contact us at info@medicalsolutionscorp.com or