After conducting a review of their entire portfolio, the decision was made that Oxford Health Plans (NY) will exit the commercial market and not renew the OHP license in 2017.
Not renewing the license means that Oxford Health Plans (NY) will not offer individual plans, small group OHP New York plans, or OHP New York POS products.
*All changes will begin at the clients' renewal date in 2017.
While Oxford Health Plans (NY) is withdrawing, Oxford Health Insurance (OHI) is not. OHI will still offer a wide selection of insurance offerings in New York. The OHI portfolio will still offer an extensive range of insurance coverage options for any and every employer regardless of size.
What the Changes Mean
You should have the opportunity to select a new OHI group plan before any current coverage runs out.
All groups and individuals who may be affected by this change will receive notice of the changes at least 180 days before the end of their 2017 coverage date. Notices will clarify all action that needs to be taken to ensure future coverage, along with different options.
How You Could Be Impacted
A few large group employers will end up needing to select new OHI plans for any and every affected employee. Most large group employers won't have to worry about the change, as only a small number of these clients will be affected.
Small group employers are more likely to be impacted. Many offer both OHP and OHI plans. These clients will find their plans automatically moved from the OHP HMO plan to an OHI program. Information on this change will be sent to affected customers. There will be no changes to the current OHI plans.
If a small group employer was only offering an OHP plan, then they will need to take action and potentially purchase a new OHI plan, as OHP plans will not be renewing. Groups like these will need to reapply as a new group with OHI to get coverage again.
Groups that qualify for Healthy NY group coverage will be offered a similar plan from OHI. These groups will not need to apply again; they only have to use the Healthy NY Recertification Form. The key requirement for any groups using this coverage is that they meet Healthy NY's requirements.
Individuals who have OHP will need to find new coverage. Working with your individual clients, you'll want to encourage them to seek coverage through "The Marketplace" from the New York State of Health.
How SKYLINE Can Help
Ultimately, this change may be confusing for many groups and individuals. Many will need to work with insurance consultants and/or agents to find the proper coverage options from OHI moving forward.