1. Empire Blue Cross Blue Shield

Empire Blue Cross Blue Shield has added a 3rd network – Empire Connections to their 2020 roster. The Downstate Network will be the smallest of the 3 featuring top hospitals & providers. The discounts are are 11% and 20% discount off of #1 Empire EPO/PPO and Blue Access networks respectively. The middle network Blue Access has expanded significantly adding Memorial Sloan Kettering.  Blue Access shares 92% of #1 Empire EPO/PPO network.Empire Blue Cross New Network Trifecta_2019

Additionally, all 3 networks, Empire EPO/PPO, Blue Access, Empire Connections will offers access to the national BlueCard PPO program. As a result of Empire Blue Cross participation in the BlueCard PPO program members enjoy unparalleled national access network to 96% of hospitals and 93% of doctors across the country. This national program will be on 18 of 28 plans below.

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2. 2020 EmblemHealth 

EmblemHealth, formerly GHI and HIP, has recapitalized and reloaded dynamic plan offerings for 2020. They have had stable 3 years of single-digit increases. Emblem has added a new 3rd network,Millennium Network, to their stellar lineup of Hip Prime and Select Care Network. The discounts vary between 8% and 15% discount.

1. Prime Network: Largest Emblem Network. – newly expanded 110,000 Providers Tristate.

3.  2020 Healthfirst Plans

Healthfirst has released affordable new 2020 plans for NY small businesses and not a moment too soon. The only non-profit Health Insurer owned by hospitals has kept market low rates with a 4.7% DECREASE for 2020. By integrating Hospital/Provider medical approach Healthfirst has been successfully delivering value for the 5 boroughs.

Value

• Members have access to a broad network of providers and dozens of industry-leading hospitals.
• Community locations throughout New York City, Long Island and parts of Westchester.
• Dental and vision coverage, 24/7 telemedicine access, acupuncture, exercise reward programs.

All Metal Levels will be included for all size groups including 1-99 market. Referral’s are not needed to visit a Specialist MD but one must select a Primary Care Physician on the enrollment form.

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4. 2020 New Oscar Circle Plus

The Google of health insurance?  Oscar entered the NY market on Jan 1, 2014 and had around 16,000 members. In 2015, it expanded coverage to New Jersey and grew to about 40,000 members. In 2016, Oscar had 145,000 members in New York, New Jersey, California, and Texas. Oscar’s cutting edge technology and pioneering benefits have simplified the consumer health insurance experience propelled easier access and understanding of health plans.  Examples of success have been ease of physician locator, online appointment setting and no cost telemedicine 24/7.  Additionally, some plans have $0 Copay generics and annual 3 free office visits

The Numbers:

• NY based with 900+ employees
• 260,000 members across 6 states
• $890M raised from top investors (Fidelity, Goldman Sachs, Google, etc.)
• $375M investment from Alphabet Inc. (Google parent company)
• For more details, check out our CEO Mario’s interview in the Wired story: Health Care is Broken. Google Thinks Oscar Health Can Fix It)
• Delivered an underwriting profit in 2017
• Expecting $1B in revenues in 2019
• After doubling footprint for 2019, Oscar is on-track for 2x growth.

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5.   2020 Oxford Metro Network NY

Oxford has expanded on their successful Oxford Metro Network plan released in 2016. For 2020 the network has expanded 15% in NY and added NJ network last year.  In 2019 most Metro plans stayed flat and  for 2020 increasing single digits.

Oxford Metro Network:

The NY network has grown to approx. 13,000 Primary Care Providers, 32,000 Specialists and 85 hospitals.  Furthermore, the Oxford Garden State network has been added as well onto the Metro Network.  The Garden State network alone has access to 24,900 physicians and 67 hospitals.

All Metal Levels will be included for all size groups including 1-99 & 100+. The new Oxford Metro plan will be limited to NY and NJ Garden State Network Providers. Referrals will be needed to see Specialists.  Importantly, most NY Hospitals will be participating with the EXCEPTION of NYU Health System, North Shore LIJ Health System (NorthWell Health) and Maimonides Medical Center. In addition, certain key medical IPA Groups such as Caremount, formerly Mt Kisko Medical Group,  are NOT in the network.

Value:

Today’s largest networks with  in-network only GOLD  are  priced at  $12,000 /single annually. They typically are accompanied with $50 copays and  non-office exposures of $1,000 deductibles and coinsurance percent in network. By comparison, the new Metro network is approximately 25% smaller than NY Liberty network with up to 16% IN SAVINGS. For example, a popular Oxford Liberty HMO Gold  is $910 vs.Oxford Metro Gold $770.

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