Oct 23, 2018
Oscar Health has a consistent overall rate decrease for Q1 2019. Exclusive Provider Organization (EPO) HSAs are showing a big decrease across the board. Quoting is expected to be available soon.
| Region | EPO | EPO HSA |
| Statewide (Regions 15, 16, 18) | -6.8% | -11.2% |
Portfolio Changes Oscar Health will offer 16 plans with the option of infertility coverage in each. The portfolio for 2019 will include:
| Metal Tier | EPO | EPO HSA |
| Platinum | 3 | - |
| Gold | 5 | - |
| Silver | 3 | 1 |
| Bronze | 2 | 2 |
Materials Update The 2019 benefit summaries and forms are not yet available. We will update you when they are posted. Remember, the Oscar submission process is paperless. So don’t let the lack of paper applications hold up your group. Promos Oscar Health has extended their underwriting promo through January (both 1st and 15th effective dates). Relaxed Underwriting
- Relaxed participation rules — As long as the number of employees in all locations is under 100, only employees in Oscar Health’s service area are counted towards participation (Los Angeles and Orange Counties: rating regions 15, 16, and 18).
- Employees with individual coverage are considered a valid waiver — with or without a subsidy (APTC).
- No DE 9C is required for groups with 5+ enrolling — A copy of the prior carrier bill is required. Eighty percent of employees on the bill must match the enrollment
Why Oscar Health Oscar Health’s new Bronze $6,650 HSA/HDHP/EPO meets the deductible and out-of-pocket maximum at the same number – $6,650. Combine that with the 11% rate drop. Twenty-eight percent of Oscar Health members use telemedicine versus less than 3% of other carriers. And it’s always free and unlimited, even for HSA plans. Telemedicine cuts down on absenteeism, which is great for employers and employees, especially those with children:
- Newborns – It can take only 15 minutes or less for new parents to get all of their questions answered.
- Toddlers and school-age children – There is less time from symptom onset to treatment, and there's no waiting in doctor’s offices with other ill children.
- Dependent students who live out of the service area –They need to return home for annual physicals and major care. But telehealth covers just about everything else, so they can get that prescription filled or their cold addressed over the phone.
Oscar Health is easy to write alongside other carriers. If you offer Oscar Health alongside another carrier, the group only needs enrollment from 25% of all eligible employees, or 5 eligible employees. Contact your LISI Regional Sales Manager for Oscar Health selling strategies.
