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)
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
NEWCircle 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.
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
Governor Cuomo announced yesterday that New York’s Health Benefits Exchange have been approved . Additionally, the New York Times yesterday published an article highlighting that the rates in the individual market that will be offered in 2014 are at least 50 percent lower than they are now. The article link and Governor’s office press release are included below.
5 things we now know about the NYS Exchanges:
Importantly, Insurers must still confirm that they will be in either the individual exchange and/ or shop exchange
The rates approved yesterday are subject to final certification of the insurers’ participation in the exchange.
Many of the networks used on the Exchange appear to be smaller than the group rated.
Some new insurers have eneter the marketplace such as OSCAR and Freelancers. While a few such as EmblemHealth have taken a wait and see approach.
Additionally, NYS individual market rate will drop significantly in 2014 but they have been historically always the highest. An individual/Direct Pay HMO is approximately $1,000-$1,200/month. They are still approximately 18% highest.
The Department of Financial Services (DFS) has approved New York’s Health Health Insurance Exchange rates for 17 insurers seeking to offer coverage including eight new entrants into the market that do not currently offer commercial health insurance plans. Please click the following links for the Governor’s Press Release and the Individual and Small Group rates.
The following companies had health insurance plan rates for the health benefits exchange approved today by DFS. The rates approved today are subject to final certification of the insurers’ participation in the exchange.
Aetna
Affinity Health Plan, Inc.
The cheapest you’ll pay for individual health insurance in NY
American Progressive Life & Health Insurance Company of New York
Capital District Physicians Health Plan, Inc.
Health Insurance Plan of Greater New York
Empire BlueCross BlueShield
Excellus
Fidelis Care
Freelancers Co-Op
Healthfirst New York
HealthNow New York, Inc.
Independent Health
MetroPlus Health Plan
MVP Health Plan, Inc.
North Shore LIJ
Oscar Health Insurance Co.
United Healthcare
If you have additional questions regarding how SHOP Exchanges and Individual Exchanges can benefit you please contact our team at Millennium Medical Solutions Corp. Stay tuned for updates as more information gets released. We’re inside of 75 days until exchanges open, and information will be coming quickly in the next few months. Sign up for latest news updates.