Category Archives: Uncategorized

NY Essential Health Plan Future threatened?

From HealthAffairs 12/8/17.  For the full article, click here.

“The Basic Health Program (BHP) is an alternative that the Affordable Care Act offers states to provide health care coverage to their low-income uninsured population. States that choose to participate in the BHP offer “standard plans” to their residents with incomes between the Medicaid expansion level and 200 percent of the federal poverty level who are not eligible for employer coverage or other government programs. BHP coverage may be more affordable for enrollees than exchange coverage and can smooth transitions between Medicaid coverage and the private market.

To fund BHPs, the ACA requires the federal government to transfer to states funding “equal to 95 percent of the premium tax credits under section 36B of the Internal Revenue Code of 1986, and the cost-sharing reductions under section 1402, that would have been provided for the fiscal year to eligible individuals enrolled in standard health plans in the State if such eligible individuals were allowed to enroll in qualified health plans.” New York and Minnesota are the only states that have to date created BHP programs.”

So if the federal government doesn’t fund the “cost-sharing reduction payments” (based on President Trumps executive order not to make those payments) by the end of the year, NY will lose what is claimed to be $1 billion in funding.

New York releases Paid Family Leave Claim Forms

New York State has released generic claim forms for the Paid Family Leave Act.  There are different claim forms for bonding, care-giving, and military.  Call your DBL carrier or our office with any questions.


Download Generic PFL claim forms from the State of New York here:

PFL Claim Form  – Bonding

PFL Claim Form – Providing Care

PFL Claim Form – Military Exigencies

CVS Agrees To Buy Health Insurance Giant Aetna

The pharmacy chain CVS Health has agreed to buy Aetna in a $69 billion deal that could transform the health care industry. If the deal, which was announced by the two companies on Sunday, is approved by regulators, it would bring a large health insurance company and pharmacy provider under one umbrella.

The agreement is expected to close in the second half of 2018. The terms of the merger agreement were approved by the board of directors of both companies on Sunday.

“This transaction fills an unmet need in the current health care system and presents a unique opportunity to redefine access to high-quality care in lower cost, local settings whether in the community, at home, or through digital tools,” the two companies said in a joint announcement.

In the statement, the companies said they will become a trusted community partner who will help consumers better manage the cost of the health care they need.

As part of the deal, CVS plans to use its pharmacy locations to provide consumers with “community health-hubs” where patients can get answers to questions about their health, prescription drugs and health coverage. Pharmacy locations will also includes space for wellness, clinical and pharmacy services, vision, hearing, nutrition, beauty, and medical equipment.

The two companies touted the merger as a better opportunity to utilize local care solutions by connecting Aetna with greater consumer access through CVS’ 9,700 pharmacies and 1,100 MinuteClinic walk-in clinics. By connecting patients with community health-hubs, the companies say it will help them reduce hospital readmission costs as patients can stop at these local facilities to assess their needs.

Several news reports on the deal note that a big driving factor in the acquisition is potential competition from Amazon as it seeks to enter the pharmacy market. Corporations from all industries are dealing with the threat of Amazon and most recently the e-commerce giant entered the grocery business with its acquisition of Whole Foods.

Oxford expands the Garden State Network

We’re pleased to announce that we will be expanding the Oxford Garden State Network to include access to physicians and hospitals that participate with the Oxford Metro NetworkSM in New York.


New and existing Garden State Network members will be able to receive in-network care from Metro Network physicians on Jan. 1, 2018.

More than double the provider access.

The Garden State Network offers easy, no-tiered access to more than 22,000 doctors and 62 hospitals throughout New Jersey. Enhancing the Garden State Network with the Metro Network allows members to receive care from an additional 28,000 physicians and 76 hospitals in the Oxford New York service area.

How to find a participating provider.

To help provide easier access to available New York doctors and hospitals, current or prospective Garden State Network members can find a participating New York physician or hospital within the Garden State Network online search tool. The steps to locate a provider are below.

  1. Go to and select “Members.”
  2. Under Links and Tools, select “Find a Physician or Facility.”
  3. On the next screen, select “Garden State.”
  4. Enter the search location.
  5. Complete the search criteria on the next page and select “Search.” Or, use the supplied categories to narrow the search.

$200,000 to sign up on person on ObamaCare

From CNBC 11/22/17.  For the full article click here.


A group that is supposed to help Native Americans sign up for Affordable Care Act coverage in South Dakota received $200,000 in federal funds to support its efforts — and managed to sign up just one person in an Obamacare plan, the Trump administration said Wednesday.

The group, the Great Plains Tribal Chairmen’s Health Board, had better luck in North Dakota — where it assisted 67 people in shopping for and enrolling in an Obamacare plan that went into effect in 2017.

But in that state, the board received another $154,000 in federal cash for its efforts.

That works out to nearly $2,300 per enrollee in North Dakota.


COMMENTARY:  Compare this to the fact that I get $14 a month for renewing someone in South Carolina, and only 1 carrier in New York even pays commissions for our work.  Where do I sign up for this deal?!? – Reeve

March 2018
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Reeve Conover is a Registered Representative. Securities offered through Cambridge Investment Research, Inc., a Broker/dealer member FINRA/SPIC. Cambridge and Conover Consulting are not affiliated. Licensed in SC, NC, NY, CT, NJ, and CA. - SIPC - Brokercheck