Another Crisis for Health Republic Insurance of New York

After months of uncertainty surrounding Health Republic Insurance of New York’s liquidation, new court documents released April 22 provide clarity on what creditors can expect to receive. The state Department of Financial Services, now led by Acting Superintendent Maria Vullo, began the liquidation proceeding last week by filing a verified petition and order to show cause in New York State Supreme Court. Vullo declared …

NY to allow anytime enrollment for Domestic Violence Victims

ALBANY, N.Y. (AP) — New York is requiring insurers providing individual coverage through the state health exchange to allow victims of domestic violence or abandonment to enroll at any time. The Department of Financial Services says those enrollments should be available starting Friday for coverage outside the state-operated exchange. Standard enrollments through the exchange, established under the Affordable Care Act, …

Northwell Health Systems sues HealthRepublic

Northwell Health Systems, formerly North Shore/LIJ Hospital Network, is suing HealthRepublic for back claims money owed it, according to an article in Newsday.  An individual attorney on Long Island has joined in with another, much smaller suit for his claims to be reimbursed. This comes after the Federal Government failed to meet its financial obligations under ObamaCare and provide funding …

Update on HealthRepublic Claims

When the Federal Government failed to make the promised payments under ObamaCare to the Coops around the country, more than half of those failed, not having adequate reserves this early in their development. HealthRepublic is one of those Co-ops.  By last published account, they owe somewhere in the range of $200 million in claims to hospitals and other providers.  They …

Are you being forced to use mail order?

We have been hearing some issues pop up on this so we wanted to send it back out again.  Members for NY Oxford groups (small and large) are not required to use Mail Order, they are being gently nudged to do so.   If they want to opt out they can either call the Oxford number on their card or …

Oxford now enforcing drug card rules

As you may be aware, in 2014 Oxford small group NY and Conn went to a mandatory generic Rx card, which they called the “Ancillary charge program”.  If you wanted a name brand drug and there was a generic available you were supposed to pay the difference (the ancillary charge) in cost between the name brand and the generic, even …

NY Medicare Advantage plan closes

Effective Jan. 1, 2016, Touchstone Health HMO, Inc. in New York will no longer be offering coverage of Medicare Advantage benefits in the following service areas: Bronx, Queens, Kings, Richmond, New York, Westchester, and Orange counties. Approximately 10,000 Touchstone Health HMO enrollees have the opportunity to return to Original Medicare and could be in the market for a new Medicare Supplement …

Stonybrook NOT in Oxford Metro

Despite assurances to the contrary, Oxford has now announced that Stonybrook University Medical Center will not participate in the Oxford Metro Network.  This announcement of course, comes far too late for everyone who had to choose their individual plan by 12/15….

Information you should know in NY

It has been a very difficult and challenging enrollment period for many of my clients – for several reasons: The failure of Health Republic has forced clients to change plans twice – once for December 1, and then look at all new plans for January 1. OSCAR Healthplans no longer covers New York Presbyterian, Weill-Cornell Medical Centers, and NY Methodist …