Update: Oxford/United and Mt Sinai Health Systems Split
Mount Sinai, UnitedHealthcare dispute terminating contract March 1, 2024 . What Oxford/United members need to know.
AI Could Detect Cancer in Chest X-Rays
Artificial intelligence can help spot early signs of cancer in chest x-rays. AI tool identified abnormal chest X-rays with a 99% sensitivity.
Montefiore and Oxford Reach Agreement
Good news Bronx/Westchester. Oxford and Montefiore Health System announced moments ago that they have reached an agreement effective December 1, 2021 for UnitedHealthcare and Oxford employer-sponsored plans, as well as UnitedHealthcare’s Medicare Dual Special Needs Plan.
2022 Open Enrollment Checklist
2022 Open Enrollment Tools. A handy checklist of Employers s for the upcoming 2022 renewals. PLAN DESIGN CHANGES, ACA EMPLOYER MANDATE 855-667-4621.
2021 Open Enrollment Checklist
2021 Open Enrollment Checklist To download this entire document as a PDF, click here: Open Enrollment eBook This Compliance Overview is not intended to be exhaustive nor should any discussion or opinions be construed as legal advice. Readers should contact legal... 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.
HealthPass Adds Oscar
HealthPass Adds Oscar
HealthPass New York will start offering OSCAR Health Plans effective Sept 1, 2017 to small employers. Oscar will offer eight plans with varying benefits package with 1 to 100 employees. The plans are available to small businesses located in New York City, Long Island, Westchester and Rockland counties. NJ residents can also access Hospitals & physicians through the NJ Qualcare PPO Network
HealthPass New York, a private insurance exchange for small employers. The addition of Oscar gives small businesses access to 3 health networks – Oxford, CareConnect and Oscar. Also, Guardian is the insurer of record for the ancillary benefits comprising dental, vision, life insurance, disability and accident 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
Why a Private Exchange? The advantage of a Private Exchange is the ability to empower employees with choice. Much like a 401K your employees can use a defined contribution allocation for benefits. As affordable health plan networks are increasingly smaller with specific coverage areas the one size show for all approach to benefits no longer works.
- Private Exchange White Papers
- Sample 3Q 2017 Oscar rates click here.
- Oscar Service Map
Is a Private Exchange Right For My Group?
If you’re a small business owner who has concerns about payroll, filing paperwork, and complying with government regulations, co-employment may be the service you’ve been looking for. In some cases, a Private Exchange may NOT be right for you. With Health Care Reform your company may qualify for a small business tax credit or a be eligible for a large group discount under a PEO.
Try us on a custom demo, contact us at (855)667-4621.
test MMS quoting
Small Business Tax Credit
Find out if you are eligible for a Small Business Tax Credit.
Full-time Equivalent (FTE) Employee Calculator
Use the full-time equivalent employee (FTE) calculator to count the number of FTEs you have.
messages[“SELF”] = “Employee Only”;
messages[“SELF_SPOUSE_DEPENDENT”] = “Employees and Dependents”;
messages[“medical”] = “Medical Insurance”;
messages[“dental”] = “Dental Insurance”;
messages[“vision”] = “Vision Insurance”;
messages[“HRA”] = “HRA”;
messages[“HSA”] = “HSA”;
messages[“FSA”] = “FSA”;
messages[“DCFSA”] = “DCFSA”;
messages[“LPFSA”] = “LPFSA”;
messages[“BASICLIFE”] = “Basic Life Insurance”;
messages[“SUPPLEMENTALLIFE”] = “Supplemental Life Insurance”;
messages[“BASICADD”] = “Basic AD&D Insurance”;
messages[“SUPPLEMENTALADD”] = “Supplemental AD&D Insurance”;
messages[“STD”] = “Short Term Disability Insurance”;
messages[“LTD”] = “Long Term Disability Insurance”;
messages[“commuter”] = “Commuter”;
Small Business Tax Credit
Find out if you are eligible for a Small Business Tax Credit.
Full-time Equivalent (FTE) Employee Calculator
Use the full-time equivalent employee (FTE) calculator to count the number of FTEs you have.
Empire Strikes Back – 2017 Plans
Empire Strikes Back 2017 Plans
Empire Strikes Back 2017 Plans. Empire recently announced their re-entry back into the New York small group market for 2017. A legendary broad networked PPO is welcome news especially in the NY small group market of 1-100 employees. Recently, the broad national networks have diminished to only 2 national health insurers, Aetna and Oxford. As a result of Empire Blue Cross participation in the BlueCard PPO program members enjoy unparalleled national access network to 96% of hospitals and 93% of doctors across the country. This national program will be on 18 of 28 plans below.
Network Overview
3 distinct networks:
PPO Network Savings
- PPO/EPO Network – traditional non-gatekeeper large network of approximately 85,384 physicians, 160 facilities and the BlueCard PPO
- Blue Priority Network – hybrid of broad PPO/EPO 160 facilities and similar Pathway’s 65,796 physicians network.
- Pathway Network – HMO value based narrower gatekeeper referral network of 109 facilities and 60,535 physicians. Limited to 28 NYS Counties.
Additional Features:
- Telemedicine will be available on all products
- Vision – Limited adult vision will be available on all products at no additional cost.
- Pharmacy – All plans use their large BCBS formulary Except the HMOs, and the Silver and Bronze Blue Priority Plans. They will be utilizing what they call the Select Formulary.
- Clinical Programs – health coaching/advocacy, disease management, behavioral health, maternity and Gaps in Care
- Online Resources – wellness coaching, discounts, health assessments and The Weight Center.
- Healthy Support – Wellness program offers easy ways to earn up to $900 per member, per year. Gym Reimbursement $400 single/$600 couple, $100 Wellness + Flu Shot, Online Wellness toolkit, up to $150 and $50 Tobacco-free certification online.
DOCTOR SEARCH: Click Here
BENEFITS SUMMARY: OXFORD Platinum, Gold, Silver AND Bronze
Small Group Rates: 1st Quarter 2017
Drug Formulary: Click Here
Blue Priority FAQ: Click Here
Pathway FAQ: Click Here
Ask us about Empire’s flexible low participation voluntary group dental, vision, disability and life insurance plans. Stay proactive and contact us today for a customized consult on how your organization can prepare ahead for ACA, Benefits, Payroll and HR @ (855) 667-4621 or info@medicalsolutionscorp.com.
