Tag Archives: NY

Major Changes to NY Empire and Oxford plans for 2017

logos for blue cross and oxford

Empire Blue Cross Network Changes-

  1. EPO/PPO (i.e. “BlueCard”) –this is Empire’s best-in-class legacy BlueCard network
  2. Blue Priority – full BlueCard hospital network with a narrowed practitioner (doctor) network when in Empire’s 28-county service area. Plans are non-gated with National BlueCard access for folks living and traveling outside of NY.  Most of Northwell doctors now are non-participating in the Blue Priority Network.  Doctors were just notified in November. The change does not impact BlueCard and/or Pathway networks – Northwell doctors and hospitals still participate in both of those.
  3. Pathway – narrowed hospital and practitioner network limited to Empire’s 28-county service area (though this network has grown to be fairly comprehensive, missing really only Memorial Sloan Kettering & SUNY Stonybrook)

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NY individual Plans get 20%+ increases, smaller networks

The New York State insurance Department has released average increases that they have approved, effective January 1.  CareConnect is going up 29.2%, Oscar 19.6% and United Healthcare 28%.

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Oxford pulling HMO and POS from NY Market

Beginning with January renewals, Oxford will no longer make the Oxford HMO and POS plans available.  the PPO and EPO plans will continue to be available.  This impacts a lot of groups, as the LIberty HMO was the “affordable” alternative for a company that wanted to keep Oxford.

The company also has indicated it is leaving the individual off-exchange market in NY as well.




Oxford Health Plans (NY), Inc. (OHP) License Withdrawal,
Effective January 1, 2017, Upon Renewal

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. Please work with your affected clients to ensure they have selected a new OHI group plan before their current coverage ends.

This change does not affect our Oxford Health Insurance, Inc. (OHI) plans. Our OHI portfolio in New York offers a wide range of coverage options for employers of all sizes.

Impacted groups and members will receive a notice from us approximately 180-days prior to their 2017 coverage end date. The notice will outline the actions they need to take and other available coverage options. Samples of the 180-day communications are enclosed. The first mail drop to January 2017 renewing groups, their members, and individual policy holders will be postmarked by July 1, 2016, with subsequent mailings issued monthly thereafter to renewing groups and their members through June 2017.

What this means for your clients

Summary of New York Rate Increase Filings


Company Name 2017 Requested Rate Change
Aetna Life Insurance Company 19.4%
Affinity Health Plan, Inc.* 20.7%
Capital District Physicians’ Health Plan* 11.2%
Crystal Run Health Plan, LLC 89.1%
Empire HealthChoice HMO, Inc.* 24.0%
Excellus Health Plan, Inc.* 15.9%
Health Insurance Plan of Greater New York* 14.0%
Healthfirst PHSP, Inc.* 6.6%
HealthNow New York Inc.* 6.1%
Independent Health Benefits Corporation* 19.2%
MetroPlus Health Plan, Inc.* 20.3%
MVP Health Plan, Inc.* 6.1%
New York State Catholic Health Plan, Inc. dba Fidelis Care New York* 8.1%
North Shore-LIJ CareConnect Insurance Company, Inc.* 29.2%
Oscar Insurance Corporation* 18.4%
UnitedHealthcare of New York, Inc.* 45.6%
Weighted Average Requested Rate Change – Individual Market 17.3%

*Indicates that the company makes products available on the “New York State of Health” marketplace.


Company Name 2017 Requested Rate Change
Aetna Life Insurance Company 12.0%
Capital District Physicians’ Health Plan, Inc. 9.6%
CDPHP, Universal Benefits Inc.* 11.6%
Crystal Run Health Insurance Company, Inc. 61.9%
Crystal Run Health Plan, LLC 66.6%
Empire Healthchoice Assur Inc 10.0%
Empire HealthChoice HMO, Inc. 12.6%
Excellus Health Plan, Inc.* 12.3%
Health Insurance Plan of Greater New York* 10.6%
Healthfirst Health Plan (Managed Health) 5.0%
HealthNow New York Inc.* 5.8%
Independent Health Benefits Corporation* 11.2%
MetroPlus Health Plan, Inc.* 13.1%
MVP Health Plan, Inc.* 5.4%
MVP Health Services Corp. 6.8%
North Shore-LIJ CareConnect Insurance Company, Inc.* 16.8%
Oxford Health Insurance, Inc. 12.9%
UnitedHealthcare Insurance Company of New York 12.8%
Weighted Average Requested Rate Change – Small Group Market 12.0%

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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.
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