Fiduciary Intermediary Ltd.

Fiduciary Intermediary Ltd. New Location

We are moving to a larger office space to better server our clients needs.

Our New Office Space will have many convenient areas:

• Conference Room
• Work Stations for Brokers to process cases
• Copy Center
• Direct Lines to FILCO representatives

As of the New Year our office will be located at
370 Lexington Ave
16th Floor
New York, NY 10017
Phone: (212) 972 – 1970
Fax: (212) 972 –1126

We look forward to seeing you there!

Many changes are continuing among the carriers as we enter the Third Quarter of 2003. The latest trend in managed care in the metropolitan area is the increase in cost sharing products. Cost sharing products were introduced in New Jersey over two years ago and are now being offered by many carriers in New York, specifically, Oxford, United Healthcare, Guardian / Healthnet, Aetna and Horizon.

Please keep in mind that the cost share products are bringing back the look of the former indemnity plans by applying deductibles and co-insurance to some of the in network services. The main difference in the managed care area is the ability to still see your PCP, Specialist and have certain X-ray and Lab work completed at just a co-pay without having to satisfy this in network deductible or co-insurance.

Each of the carriers have adopted different rules with regard to what is actually covered in the physician’s office by the office visit co-pay. This should be reviewed carefully with your clients.

Cost sharing plans enable the carriers to offer much lower rates that enable your clients to have an entry level Health Plan in the $200 to $220 range for a Single employee.

Cost Sharing Plan Highlights by Carrier

Oxford Direct:
Freedom and Liberty Plan Direct -These are PPO plans combining the popular features found in Oxford’s current non-gated POS plans with in-network deductibles and coinsurance. These plans can be combined with either the Metro or Standard plans to create a unique Point of Enrollment program. In-network deductibles can be either $500 or $1,000 with co-pays of $15/25 or $25/40.

United Healthcare:
United is currently offering their Non Gated cost share plans with single co-pays of either $15, $20 or $25 and in network deductibles of $500 or $1,000. Since United Healthcare has lowered their participation requirements to 60% of the eligible employees after spousal waivers this makes United Healthcare even more competitive. Point of Enrollment plans combining The Traditional Non-Gated Plans with no in network deductibles and their new Cost Share Non-Gated Plans are available when enrolling 7 or more employees.

Aetna:
Aetna has created a portfolio of new Managed Choice Plans that include both referral plans and open access under their PPO network for the New York 2-50 market. Co-pays can be either $20/$30 or $25/$50 and in network deductibles are $0 ($500 Hospital co-pay in lieu of deductible), $1,000 or $2,000. MC plans may be combined with any of Aetna’s HMO or Qpos plans to create a Point of Enrollment product. Please note that Aetna has participation requirements when an MC plan is either sold as a stand alone product or combined with the HMO or Qpos. For 2-9, 100% after spousal waivers and for 10-50, 75% after spousal waivers must be enrolled in an Aetna product.

Guardian / Healthnet:
Guardian / Healthnet is offering two distinct cost share style plans. The Charter Traditions Platinum Plans utilize their main network with co-pays of $20 or $30 and in network deductibles of $500 or $2,000. The Charter Traditions Gold plans utilize a smaller network and offers first dollar coverage of either $500 or $750 rather then a co-pay. After the first dollar coverage a deductible of $2,000 or $4,000 must be satisfied before any additional benefits are paid. All Guardian / Healthnet plans are available as either two or four tier.

Horizon Healthcare:
Horizon Healthcare continues to offer their original cost share plans of 100/90/70 and 90/80/60 which are modeled on their NJ cost share plans. These plans are available on their Standard network. This option is available to downstate NY and NJ residents.

Traditional Plan Highlights

GHI:
GHI’s EPO plan is identical to their PPO product without the out of network benefit portion. Currently the EPO plans have no participation requirements when written as a stand alone plan. GHI has developed a new and unique Rx card for their plans which will lower the single Rx rate to $31.11 downstate. This new Rx card is a 15/25/40 at the retail pharmacy with a maximum benefit of $1,000 and a 30/50/80 mail order 3 months supply with NO maximum benefit. With this Rx card the $20 PPO plan is priced under $300 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 only the EPO plans can be written down to one.

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.