Study: Single Payer Aftermath
Research Report: Medicare for All Aftermath. New study shows Impact of Medicare for America On The Employer Market and Health Spending.
2020 NY Small Group Health Plans
2020 NY Small Group Health Plans-See latest plans for SMB offering plans w/national ranked Providers.Call 855-667-4621 or info@medicalsoluionscorp.com
2020 Oxford Metro Network NY
2020 Oxford Metro Network NY-For 2020 the network has expanded 15% in NY and added NJ network last year. In 2019 most Metro plans stayed flat and for 2020 increasing single digits. Best oxford value on the market.
2020 New Oscar Circle Plus
2020 New Oscar Circle Plus
Background:
The Google of health insurance? Oscar entered the NY market on Jan 1, 2014 and had around 16,000 members. In 2015, it expanded coverage to New Jersey and grew to about 40,000 members. In 2016, Oscar had 145,000 members in New York, New Jersey, California, and Texas. Oscar’s cutting edge technology and pioneering benefits have simplified the consumer health insurance experience propelled easier access and understanding of health plans. Examples of success have been ease of physician locator, online appointment setting and no cost telemedicine 24/7. Additionally, some plans have $0 Copay generics and annual 3 free office visits
The Numbers:
- NY based with 900+ employees
- 260,000 members across 6 states
- $890M raised from top investors (Fidelity, Goldman Sachs, Google, etc.)
- $375M investment from Alphabet Inc. (Google parent company)
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- For more details, check out our CEO Mario’s interview in the Wired story: Health Care is Broken. Google Thinks Oscar Health Can Fix It)
- Delivered an underwriting profit in 2017
- Expecting $1B in revenues in 2019
- After doubling footprint for 2019, Oscar is on-track for 2x growth
Oscar Member Engagement:
- 27% of Oscar members utilize DocOnCall vs. industry average of 3%
- 35% of first time doctor appointments start with Oscar
- 2x customer satisfaction score vs. the industry average
- 48% of all Oscar members use the Oscar app, compared to 7% of other health insurance carriers
- Doctor on Call has led to approximately $600 in savings per member
- Concierge Team has led to an approx. $3,600 in savings in member OON claims
- Pre-medicare population almost 2x Concierge Team utilization vs. the “younger” demographic
New Oscar 2020
- Oscar’s current network will be rebranded as Circle Network. Circle Network – 27,000 Providers, 298 Urgent Care Centers and – Mt. Sinai, Montefiore, LI Health network
- 15 plans across 4 metal tiers
- NEW Circle Plus Network include. 45,800 Providers, 298 Urgent Care Centers and the following hospitals in addition to Circle Network.
- Northwell (formerly North Shore LIJ)
- Memorial Sloan-Kettering
- Multiplan National Network for out of state
- Westchester Expansion – Northern Westchester Hospital (Mt. Kisko), Phelps Hospital (Tarrytown) and the Westmed Medical Gorup added.
- Northwell (formerly North Shore LIJ)
- NEW: Only $0 deductible required Silver Plans!
Additional Features:
- Step Rewards Program – a step rewards program that links to the mobile app. Members are rewarded when they meet their step goals for the day with $100 Amazon gift cards.
- Mobility – simple and easy to use. Oscar has the highest member engagement. Example: members can also renew Rx through the dr. on call feature on their app.
- Pharmacy – No more Dyane Reade, Walgreens and Rite Aid.
- Concierge Service: Every member is placed on a team of 5 care guides and 1 nurse that help members achieve better health outcomes and lower costs.
- Doctor on Call: 24/7, free and unlimited telemedicine that works nationwide. This is a great way to care of basic primary care at the member’s convenience
- Member Experience –
2020 Group Rates – Click Above
Doctor Search: click here
Hospital Map click here
Group App (editable PDF): click here
Employee App (editable PDF): click here
Contact us TODAY for a customized analysis for your group-specific needs at info@medicalsolutionscorp.com or Call (855) 667-4621.
2020 Healthfirst Plans
2020 Healthfirst Plans-Non-profit Health Insurer owned by hospitals. 2020 4.7% DECREASE for 2020. Best value.Call 855-667-4621 info@medicalsolutionscorp.com
2020 EmblemHealth
2020 EmblemHealth expanded to 3 networks -Prime, Select & Millennium. Prime TriState now has 110,000 Probviders. Accupuncture covered. Call 855-667-462.
Empire Strikes Back – 2020 Health Plans
Empire Strikes Back – 2020 Health Plans. . Empire Blue Cross Blue Shield has added 3 networks for NYS – EPO/PPO, Blue Access & Connections. Empire Blue Cross Enhanced Embedded Dental and Vision Plans **New for 2020** at 50% discount. Call 855-667-4621.
Healthy NY 2020
Are you a start-up? Can’t afford coverage? Is your Aetna Healthy NY ending?
Healthy NY insurance program was designed to promote and provide affordable insurance coverage to eligible small businesses without health insurance coverage for their employees and, also, for eligible working uninsured.
The Healthy NY program includes benefits that cover essential health needs including:
- Inpatient and outpatient hospital services
- Physician services
- Maternity care
- Preventative health services
- Diagnostic and x-ray services
- Emergency services.
Applicants may now also choose a benefit package with a limited prescription drug benefit or a benefit package without a prescription drug benefit.
RECERTIFICATION: Healthy NY will only be available to groups with 1-50 FTE’s in 2018 per guidance from the NYS DFS. Please see the attached guidance released. It is important to note that while the definition of “small employer” is increasing from an employer with 50 or fewer employees to an employer with 50 to 100 employees as of January 1, 2016, only employers with 50 or fewer employees will be eligible for Healthy NY. Please see on page 2 of the attached here
| Metallic Level |
Gold
|
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| Product/Network/Gatekeeper | G HNY HMO Metro Gated OHP | ||||
| InNetwork Copayment | $25/$40 | ||||
| Out of Network Reimbursement | N/A | ||||
| InNetwork Coinsurance % | 80% | ||||
| InNetwork Maximum Out of Pocket | $4000/$8000 | ||||
| InNetwork Deductible | $600/$1200 | ||||
| Out of Network Coinsurance % | N/A | ||||
| Out of Network Maximum Out of Pocket | N/A | ||||
| Out of Network Deductible | N/A | ||||
| Deductible Accumulation Period | Contract Year | ||||
| Pharmacy | $10/$35/$70 | ||||
| Dependent Cutff Age | 26 Dependent – Standard | ||||
For rates and eligibility
2020 Open Enrollment Checklist
In preparation of 2020 open enrollment, Employers should review their plan documents to confirm that they include these required changes. Learn how our Agency is helping businesses thrive in today’s economy. Please contact us at info@medicalsolutionscorp.com or (855)667-4621.
NYS 2020 Final Rates Approved
NYS 2020 Final Rates Approved. Small group rates increase 7.9% and 6.8% for individuals.Learn about Private Exchange and PEO Partnership (855)667-4621.