2020 Oxford Health NY Small Group plan updates
Oxford Health NY small group plans are being updated for 2020. In order to keep you apprised on new trends and news for the new year, below is our rundown for Oxford in 2020.
As we reported last month, in 2020 Oxford received an aggregate 9.6% increase on their rates. As a reminder, this year the HIT (Health Insurer Tax) is back after a 1-year holiday in 2019, Oxford like most other carriers equates this to a 2.5-3% increase in rates, just for this tax. It is important to note this fact as it accounts for a good chunk of this years increase in premium.
In 2020 Oxford will be offering 42 plans in the small group health insurance market.
There were a few products they decided to pull this year, most notably the Primary Advantage and the Gated Liberty Advantage products. Neither of these products had much traction in the market. As in most years, there have been some changes to the existing benefits due to the constantly moving Actuarily Value (AV) dartboard the carriers are trying to hit. The most notable change is in the MOOP (maximum out of pocket). 18 of their 42 plans have no changes in benefits, and all of the remaining Platinum plans have no benefit changes.
Oxford has introduced 4 new plans in 2020: Oxford 411 and Oxford Zero Deductible (AKA Oxford ZD).
Oxford 411(Platinum & Gold): These are new Liberty only non-gated options which offer national network access that offer discounted copays on certain services that are most utilized. Under these new plans, members will get 4 PCP visits at a $5 copay, 1 specialist copay at $25, 1 Urgent care copay at $25 and finally Unlimited $5 Tier 1 meds. These benefits are per person NOT per family. While these plans are very innovative and attractive to employer groups, we foresee there being a challenge when it comes to communicating this information to providers offices since all materials including the members ID card will reflect the higher cost share ONLY.
Oxford Zero Deductible (ZD) (Gold & Silver): The deductibles have been removed and the coinsurance will be 100%. Since there are no deductibles, there will be slightly higher copays for all services which will go towards their OOP max. We expect these plans to be very popular, especially for the Silver level plan.
Oxford is looking to continue to grow their Metro network.
The Oxford Metro Network now has over 50,000 members in New York. Keep in mind the Metro Network does not include NYU, Northwell, Stonybrook and no CVS for RX. Winthrop is still in network even though they were acquired by NYU, however come 2021 this could change.
A new enhanced Gym Benefit has been rolled out called Sweat Equity, new business and renewing groups in 2020 will receive the enhanced benefit. The benefit will now be available for dependent children 13 or older. The dependent will be reimbursed the spousal reimbursement of up to $100 every 6 months.
Federal open enrollment is upon us and Oxford will be waiving participation for groups submitted between 11/15 through 12/15 for the following effective dates: 11/15, 12/1, 12/15 and 1/1, so be sure and work on those groups needing the FOE option earlier in the season.
Click here for more information on Oxford Health Plans. You can also compare all carrier networks and search for providers with this link as well.
Peak Advisors is a NY health insurance broker serving NY, Long Island, and NYC for over 29 years. For quotes and information please complete our small group information form to get rates and to discuss options for your small business.