Health Insurance Update & New Plans
August 19th, 2010 // 3:54 pm @
Good Afternoon Everyone:
As you know, I occasionally send blast e-mails to all of my group clients when any major happens in the health insurance world. This is one such time. While national health reform continues to mosey along without much direction, New Jersey is moving forward with its own reform plans.
Beginning September 1st, 2010 New Jersey set forth new underwriting guidelines for the small group market. Many carriers took this opportunity to make some additional changes in the way they do business and what plans they offer. Below is a summary of the changes each carrier is making effective September 1st for new business and October 1st for renewal business.
Horizon Blue Cross Blue Shield:
- Horizon has significantly reduced their product portfolio by almost two thirds and has dramatically limited the number of prescription options offered as well.
- If you received a letter from Horizon saying that they are terminating your plan, you might have one of the options (either Health or Rx) that they will no longer offer. If you have one of these plans, you don’t have to worry about making changes until your renewal or October 1st, whichever is later. Don’t worry; we will contact you in plenty of time to review the options available to you.
- You must move your plan on Anniversary, or Horizon will arbitrarily choose one for you.
- You can keep any number of “preferred plans” you may have now (many of the plans we recommend and many of you have are already “preferred”) as long as you don’t make any changes. We have the list of “preferred plans” and will go over them with you upon renewal.
- Horizon will not offer coverage as a second carrier. What this means is that a business can only have Horizon coverage and not a second carrier (i.e. you can’t have half of your employees with Horizon and the other half with AmeriHealth). In fact, no carrier will allow a second carrier going forward.
- Horizon will limit the number of options you can offer your employees to a maximum of 2 plans regardless of the number of employees you have. They will allow a third option if and only if the third plan is a HSA. In addition, these plan options can not be alike…in other words you can’t have 3 variations of HMO plans with different Rx cards.
- Horizon is talking about adding additional restrictions on the Rx options, but nothing is official yet.
Oxford
- Oxford, at this point, is not reducing their product portfolio
- Oxford will not offer coverage as a second carrier
- Oxford will allow up to 3 plan options with no limits on design or prescriptions
AmeriHealth
- AmeriHealth will not offer coverage as a second carrier
- AmeriHealth, at this point, is not limiting their product portfolio
- AmeriHealth will allow up to 4 plans but the Rx can not be the differentiator between the 4 plans allowed.
Aetna
- Aetna has limited their portfolio…although they are rarely competitive so I don’t think it matters much
- Aetna will not offer coverage as a second carrier
- Aetna, like Horizon, will offer a max of 2 medical plans and they must be different. A third option is allowed if and only if the third option is a HSA plan.
Please remember that we will be there to help with any transition we may have to make well before your renewal. We are ready to answer whatever questions you may have.
NEW CARRIERS IN NJ!!!!
Last but not least, there are two new carriers offering coverage in New Jersey. Assurant Health and Trustmark are two self insured options that may or may not work for your business. Both carriers do medical underwriting (so your health will affect rates) and are not subject to NJ mandates. These plans may be a way to save money, or they may end up not being good options at all. We will begin to obtain quotes from these carriers for renewals beginning with September 1st, 2010. I’m sure no one is interested in being the proverbial “guinea pig” but it is better to know what is out there and then make an educated decision.
As always, all of our producers and I will actively seek any and all available quotes to assure that your company has the best benefits possible for the lowest possible price.
We appreciate your business and look forward to continuing to earn your trust going forward in these challenging times.
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