Oxford Health Plans Exits NY Insurance Market

 In Blog, latest news

Okay, so I was just as confused as maybe you were when I got the news about Oxford exiting the NY insurance market. The announcement or letter that came across my desk read as follows: Oxford Health Plans (OHP) is withdrawing their individual and group health plans from New York but Oxford Health Insurance (OHI) will still offer health insurance plans. Huh?

It seems that Oxford offers health insurance plans under 2 companies; Oxford Health Plans (OHP) which serves the individual, small and large group market and Oxford Health Insurance (OHI) which serves only the small and large group marketplace.

OHP products include their individual, small group HMO (Health Maintenance Organization) products and large group POS (Point of Service) products. These health plans will be gone effective January 1, 2017. They will be replaced with OHI insurance products such as EPO’s, PPO’s and HSA’s for small and large groups. Oxford individual plans are gone period.

So what this means to New York small business (1-100 employees) is that if you offer an Oxford HMO plan, you will be dropped and need to re-apply for another Oxford Plan that is available through OHI. If you are a large business owner (100+ employees) and offer their POS plan, you need to apply for a new OHI health plan.

A bit confusing right? Here’s the announcement from Oxford:

“We have conducted a review of our entire portfolio, which has led us to the decision to exit the commercial market on our Oxford Health Plans (NY), Inc. (OHP) license in 2017. This change will result in withdrawal of our individual and small group OHP New York HMO products and our large group OHP New York POS product. This change will occur on your clients’ 2017 renewal date, beginning January 1, 2017.”

Small group employers offering OHP plan

These employers will need to take action to purchase a new policy before the end date of their current OHP plan. Since their current OHP plan is not renewing, the groups will not receive a renewal package from Oxford. These groups will need to apply as a new group. Information about a similar plan replacement option will be viewable in the Idea Management System (IDEA), where groups can enroll in new coverage and upload supporting required documentation, such as tax documents and waivers. If you are not able to access IDEA, you can also call your broker or send a paper application.

Large group employers  offering OHP Plan

Large employers will need to select a new OHI plan for their affected members. This change will not impact most groups since only a small number of large group customers continue to offer this product. If your company offers an OHP plan to employees, Oxford representatives will reach out to you and are prepared to work with you to help simplify this transition and minimize disruption to affected members.

Oxford Individual plan members

Individual plan members will need to take action and must enroll in a new plan to have health insurance in 2017. The last day of coverage for these members, under their current plan, is December 31, 2016. You are encouraged to work with your through the New York State of Health, the Official Health Plan Marketplace (“the Marketplace”). The Marketplace offers a variety of coverage options from a number of insurers and premium assistance is available for those who qualify.

Need Help Making Sense Of It All?

We can help you find an alternate health plan for your small business or review your current plan and suggest improvements. Just call Jay or Bill at: 914-633-1717

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