|
| Oxford
Health Plan News |
Oxford
Health Plans has extended the January 1, 2003
effective date deadline to Friday, January
10, 2003. This means that all Oxford Cases
with a January 1, 2003 effective date can
be in FILCO's office up to Thursday, January
9, 2003 as long as they are complete. If you
have any questions please contact Ann Marie
at abrignolo@filco.net
.
|
| GHI
FLEX SELECT AND ONE LIFE GROUPS |
| Please
note that effective January 1, 2003 the GHI
Flex Select product will no longer be available
to NEW groups of any size.
For
Groups of One and Groups with One enrolling
employee only the GHI EPO plan will be offered
on a TWO TIER basis.
The
rates for effective dates of January 1,
2003 through March 31, 2003 with the $10/25/40
VMO Rx card are:
| Co-pay |
Single
Rate |
Family
Rate (2 or more) |
| $10 |
$364.45 |
$929.36 |
| $15 |
$350.69 |
$894.27 |
| $20 |
$343.27 |
$875.35 |
Rates
are guaranteed for one year from effective
date.
FILCO
is also pleased to offer our producers the
opportunity to use the Healthsearch Quote
system as well as the Pro Access physician
search system at NO charge to you, our producer.
This system is available either on line
at our web site or you can request a quote
disk to download on your personal computer.
Updates for the quote system are available
at our web site. For further information,
please contact us.
|
| TO
ALL FILCO AGENTS |
NOW
AVAILABLE FOR GROUPS OF ONE AND GROUPS WITH
ONE ENROLLING EMPLOYEE - THE GHI EPO PLAN,
beginning December 1st, 2002.
Remember, the EPO plan uses GHI’s large
CBP network.
The
rates are two tier only and these rates
include the 10/25/40 VMO RX card.
Rates
for December 1, 2002 to December 31, 2002
Downstate are:
| Co-pay |
Single |
Family |
| $10 |
359.07 |
915.63
|
| $15 |
345.51 |
881.06 |
| $20 |
338.20 |
862.41 |
Rates
for January 1, 2003 to March 31, 2003 Downstate
are:
| Co-pay |
Single |
Family |
| $10 |
364.45 |
929.36 |
| $15 |
350.69 |
894.27 |
| $20 |
343.27 |
875.3 |
Rates
are guaranteed for one year once the plan
is inforce.
|
| OXFORD
EXTENDS SMALL GROUP DEADLINE FOR NEW BUSINESS |
| The
recent hospital network disruptions in Long
Island experienced by one of Oxford’s
competitors might have affected some of your
groups. Oxford is sensitive to groups that
might be impacted by the recent changes.
In
light of this development Oxford is extending
the deadline for Small Group new business.
They will allow any new groups seeking 9/1
effective enrollment dates to get the appropriate
paperwork to Oxford by 9/13 (Please have
to FILCO by 9/12).
We
would like to assure all producers that
the Oxford network in Long Island is stronger
than ever. Oxford believes that their recent
multi-year agreements with some of the area’s
major hospitals provide the stability that
Oxford Members and employer groups want.
Oxford is focused on making quality healthcare
affordable and convenient for their customers.
To achieve this Oxford remains highly committed
to maintaining the strength and stability
of their hospital and provider networks.
|
| CIGNA
EXTENDS SMALL GROUP DEADLINE FOR NEW BUSINESS |
The
recent hospital network disruptions in Long
Island may have affected some of your groups.
In light of this CIGNA is extending the deadline
for NY Small Group new business to September
6th (Please have to FILCO by 9/5).
CIGNA’s
Long Island Hospital Network
|
NASSAU
COUNTY
Franklin
Hospital Medical Center
Long Beach Medical Center
Mercy Medical Center
Nassau University Medical Center
New Island Hospital
North Shore University Hospital
NSUH at Glen Cove
NSUH at Plainview
NSUH at Syosset
St. Francis Hospital
South Nassau Communities Hospital
Winthrop-University Hospital
|
SUFFOLK
Brookhaven Memorial Hospital
Brunswick Hospital Center
Central Suffolk Hospital
Eastern Long Island Hospital
Good Samaritan Hospital
Huntington Hospital
John T. Mather Memorial Hospital
St. Catherine of Siena Medical Center
St. Charles Hospital & Rehab Center
Southampton Hospital
Southside Hospital
University Hospital of Stony Brook
|
QUEENS
Catholic
Medical Center:
Mary Immaculate Hospital
St. John’s Queens (Elmhurst)
St. Joseph’s Hospital
Flushing Hospital Medical Center
Jamaica Hospital Medical Center
Long Island Jewish MC &
Schneider Children’s Hospital
Mount Sinai Hospital of Queens
New York Hospital MC Queens
NSUH at Forest Hills
|
| FILCO
NEWS – CIGNA July 2002 |
| CIGNA
has made a major change in their plan options:
– All plans are available on a Point
of Enrollment basis to all eligible employees.
Each employee can chose the plan of their
choice along with an Rx card of their choice.
There
are no limits to the number of combinations.
This
is truly a unique feature that gives the
Employer and Employee complete choice over
product and cost.
CIGNA
has streamlined their New York Small Group
Plan Designs and have Open Access POS as
well as Open Access HMO plans.
All
plans have a $20 Co-pay and are available
with 4 different Rx cards.
Please
see the attached Rate Card with all the
plans and options that are now available
from CIGNA. Remember, any eligible employee
may take the plan that best suites his or
her needs.
Please
do not hesitate to call us if you need further
information on this new and innovative approach
to managing health insurance costs.
FILCO
is also pleased to offer our producers the
opportunity to use the Healthsearch Quote
system as well as the Pro Access physician
search system at NO charge to you, our producer.
This system is available either on line
at our web site or you can request a quote
disk to download on your personal computer.
Updates for the quote system are available
at our web site. For further information,
please contact us.
|
| New
Plans - Aetna July 2002 |
Effective July 1, 2002 Aetna is introducing
two new Managed Choice Plans utilizing their
PPO network. These plans have In Network
co-pays as well as In Network coinsurance
and require PCP referrals. Commissions
on these new plans will be 5% in New York
as long as the new commission agreement
is signed. This new agreement will cover
all lines of Aetna business.
Plan
MC #1 is the less expensive program having
a $25/$50 PCP/Specialist co-pay In Network.
Inpatient Hospital Services, Outpatient
Surgery and other benefits In Network are
subject to an 80/20 coinsurance with individual
stop loss of $3,000 out of pocket. This
plan is priced at $271.30 per single.
Plan
MC#2 is similar but with a $20/$40 PCP/Specialist
co-pay and a 90/10 coinsurance with the
individual stop loss at $2,000. This plan
is priced at $298.51 per single.
Both
plans have out of network benefits after
deductibles of $2,000 for MC #1 (60/40 coinsurance)
and $1,000 for MC #2 (70/30 coinsurance).
The
Managed Choice Plans have different underwriting
rules from the HMO and QPOS plans.
Some
highlights of the underwriting rules are:
2-9 eligible employees requires 100% participation
excluding spousal waivers
10-50 eligible employees requires 75% participation
excluding spousal waivers
Employers must contribute 100% (2-9) or
75% (10-50) of the single cost or 50% of
the total cost of the plan
|
| Horizon
Healthcare Changes Effective July 1, 2002 |
Effective July 1, 2002 Horizon Healthcare
will be converting all Multiplan Network PPO
plans to their new Standard Network for all
existing plans. This
network is a combination of the Vista Network
and the acquired Anthem Network.
Please
note that this change will coincide with
Horizon's change in Rx Vendors from Merck
Medco to Advanced PCS.
Employees
with a chronic illness who do not find their
treating physician in the new network effective
July 1, 2002 can still be treated with their
non-par physician for an additional 60 days.
After that time, it will be considered out-of-network.
Employees
that are pregnant and in their second trimester
or later can continue to utilize their non-par
physician and receive in-network benefits
throughout their pregnancy.
We
will continue to monitor the Horizon changes
and as soon as information is available
will send out additional updates.
|
