Horizon BCBS NJ Hospital Network Continues to Expand

Horizon Blue Cross Blue Shield of New Jersey has announced that Bergen New Bridge Medical Center (formerly Bergen Regional) in Paramus, New Jersey, is now part of the Horizon Hospital Network. This agreement allows Horizon BCBSNJ members to access care at an in-network level of benefits, getting the most out of their coverage, while keeping… Read More

Oxford Risk Management Audit/Eligibility Verification Update

Email Sent: 7/10/19 As previously communicated by Oxford, going forward Oxford will require strict adherence to the deadline for a group under a Risk Management Audit to submit documentation to Oxford confirming eligibility for renewal. Oxford will no longer have any flexibility in the process as per their legal team. Below is an example of… Read More

Amerihealth’s Local Value Network enhanced with the addition of Summit Medical Group and Penn Medicine

Email Sent: 6/27/19 Effective July 1, 2019, in addition to Children’s Hospital of Philadelphia, AmeriHealth’s Local Value Network will offer even more value as AmeriHealth welcomes Summit Medical Group for all segments and Penn Medicine for Small and Large group segments only. With this addition, AmeriHealth’s Local Value Network has over 90% overlap when compared… Read More

MinuteClinic® Services Now Available at No Cost* to Members

Email Sent: 6/19/19 Aetna has announced that they are now offering members access to MinuteClinic® services at no cost to them. They are currently offering this benefit to self-funded customers only. The benefit is scheduled to become available to Small Group AFA effective September 1, 2019 and all other segments effective January 1, 2020. Access… Read More

Oscar New York 2020 Rate Change Notification

Email Sent: 6/10/19   Oscar has advised that they have submitted a rate change for 2020 New York Small Groups and will be informing members. Below is their official announcement.  Oscar Update on NY Rate Change Letters to Members As you know, New York Insurance Law requires that we provide a notice to employers and… Read More

Aetna 2020 Proposed Rate Changes for New York Small Groups

Email Sent 6/7/19 Aetna Life Insurance Company has submitted a rate change request to the New York State Department of Financial Services (DFS) for new and renewing Small Group plans effective on or after January 1, 2020. Aetna has requested rate increases ranging from -1.17% to 23.70%. Exact rates requested will vary by plan and… Read More

Aetna Funding Advantage New Business Administrative Fee Credit

Email Sent 6/6/19   Starting with July 1 effective dates, your new business Aetna Funding Advantage (AFA) groups can get a one-time administrative fee credit of $45 per subscriber.  Please note – Aetna will be providing this administrative fee credit to any group that simply OFFERS a Whole Health Plan, even if there’s no enrollment into… Read More

Oxford/UHC Rate Adjustment Filing Notification

Email Sent 6/6/19 Oxford/UHC has advised that in compliance with New York law, their New York Rate Filling Initial notices went out yesterday afternoon June 5th, 2019 to Impacted Small Groups, Small Group Subscribers and Individuals Renewing in 2020. Click here for their June 6 Broker Connect Article with sample letters and additional information regarding… Read More