| There
continues to be changes and improvements among
the carriers for the Fourth Quarter 2002.
Please review the highlights below and do
not hesitate to call us for further information
and clarification. |
| United
Healthcare:
United Healthcare has made two major changes
for the fourth quarter. Nassau and Queens
county will now be rated at the lower Manhattan
/ Suffolk county rates. In addition they
have lowered their participation requirements
to 60% of the eligible employees. This will
make United Healthcare even more competitive
in the Choice Plus product line. Remember
their Non-Gated plans have two distinct
programs – The Traditional Non-Gated
Plans with no in network deductibles and
their new Cost Share Non-Gated Plans with
in network deductibles and other cost sharing
options.
|
CIGNA:
Cigna has streamlined their New York Small
Group Plan Designs and now has Open Access
POS and HMO plans. All CIGNA plans are available
on a Point of Enrollment (POE) basis thus
creating a unique advantage for the employer
to have a complete menu of coverage options.
Three POS plans are offered either basic
or Open Access as well as two HMO plans
either basic or Open Access. Cigna’s
Open Access HMO with a 10/25/50 Rx card
is only $255.14 per single. Cigna is now
only 4 tier, however the family rate factor
is excellent at under 3 times the single
rate.
|
Horizon
Healthcare:
Horizon Healthcare now offers the “Slice”
(No participation requirements for Community
Rated Groups) Option on both their Vista and
Standard networks for the 100/90 and 90/80
EPO products. This option is available to
downstate NY and NJ residents. The Standard
Network is a combination of the Vista Network
and the acquired Anthem Network. This is also
available for groups of 51+ enrolling a minimum
of 10.
|
Oxford
USA:
This program allows out of area enrollment
of up to 30% of the total enrolled group utilizing
the First Health Network. Six plan designs
are available using the Manhattan Non-gated
rates for those out of the Oxford area. NEW
to Oxford USA - Employees who reside in Massachusetts
are now eligible.
|
Aetna:
Aetna has created two new plans for the New
York 2-50 market. These plans are Managed
Choice Plans utilizing Aetna’s PPO network.
They have In Network co-pays and coinsurance
and have participation requirements. Rates
for the MC#1 plan (the least expensive plan)
is $268.67 per single. The new plans pay a
5% agent commission which requires a new agent
agreement to be completed to cover all lines
of business.
|
GHI:
GHI’s new EPO plan is now available.
This plan is identical to their PPO product
but without the out of network benefit portion.
Currently the EPO plans have no participation
requirements when written as a stand alone
plan. GHI’s PPO and EPO plans with a
10/25/40 Rx start as low as $281 per single.
Remember, GHI is one of the few quality carriers
left that allow either TWO or Four Tier pricing
in the community rated market. Please note
that these GHI plans cannot be written down
to one.
|
Guardian
/ Healthnet:
Guardian / Healthnet (formally PHS) is another
quality carrier that allows either TWO or
Four Tier pricing in the community rated market
and all plans are Open Access. The NYC 91
HMO with a 10/20/35 Rx card is priced at only
$286.37 Single and $740.27 Family on a two
tier basis.
|
Oxford:
Oxford’s new Freedom Metro plan with
a $25/$40 Co-pay is an excellent entry level
plan for those wanting the Freedom Network
and reasonable rates. Also, please do not
overlook the older Adult/Child Freedom Metro
plans with co-pays of $30 for adults and $15
for children under the age of 19. As co-pays
continue to rise, the Adult/Child combination
offers you a good option to keep a lower co-pay
for children. These plans start as low as
$229.73 per single without an Rx card.
|
Healthsearch Program:
FILCO is 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.
|
