Important PCORI Deadline Information: Fees Due July 31, 2019

Email Sent: 6/12/19 Below is a summary of PCORI fee requirements so you can advise your clients about this upcoming compliance deadline. What is the PCORI Fee? The Affordable Care Act (ACA) created the Patient-Centered Outcomes Research Institute to study clinical effectiveness and health outcomes. To finance the nonprofit institute’s work, a small annual fee… Read More

Important Message about our Individual Life Insurance Division

Email Sent: 6/10/19   At Professional Group Plans our core purpose is to empower our Broker Partners so they can grow their Benefits Business in a constantly evolving marketplace. Over the years, we have continually re-evaluated our strategy to ensure we are always meeting the changing needs of our Broker Partners.   After an extensive… 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

Horizon Will Extend Grandmothering for Pre-ACA Plans Into 2020

Email Sent 6.6.19 Horizon Blue Cross Blue Shield of New Jersey has advised that groups with health plans that preceded the Affordable Care Act (“pre-ACA plans”) and that renew between October 1 and December 31, 2019, will be permitted to renew within those pre-ACA plans. If a group leaves its pre-ACA plan, it must move… Read More

ADEHP Has a New Name: Members Health Plan NJ

Email Sent: 6/5/19 Affiliated Physicians & Employers Health Plan is now Members Health Plan NJ  ADEHP is now Members Health Plan NJ for all new business on the Aetna Platform. Please see below for important information: All 7/1/19 renewals have been extended to 10/1/2019 Rates and services will remain the same until 9/30/2019 Renewal packets for… Read More

Healthfirst Rate Change Request Notification

Email Sent: 6/5/19 Please see below notification from Healthfirst regarding a rate change request to the New York State Department of Financial Services (DFS) Healthfirst Broker Alert Healthfirst has submitted a rate change request to the New York State Department of Financial Services (DFS) to modify premium rates for its new and renewing Small Group… Read More

Our New Website Has Launched!

Email Sent: 6/4/19 Check it out at   Note: You will continue to use your existing login to the PGP Website. CLICK HERE for login instructions and an overview of the new enhanced Broker Portal.