small group market Archives

Cigna Links Up With Upstart Oscar For Small Business Health Insurance

Cigna, and small startup insurance company Oscar are teaming to begin offering small business health insurance options that are fully insured. The plans will be branded as Cigna + Oscar, and both companies will share risk equally. The plans are set to begin selling in 2020.

chains connected together by one red link — *Cigna and Oscar Health link up to provide better small business health insurance plans.*

Oscar’s Start-up

New York based Oscar Health started out small in 2012, and has slowly expanded to different states. They offer individual market plans, and expanded to offering small group and Medicare Advantage plans. Just this past August, the company has expanded to 6 new states in the US, and grew to 400,000 members this year.

Unfortunately, Oscar does not provide vision or dental insurance. However, the company is hoping that partnering with Cigna will change this.

empty dentist patient room — *Small business health insurance does not generally cover dental and vision. Hopeful the merge provides these benefits.*

“Small businesses are the backbone of the American economy and through this partnership, we can take a disciplined approach to offering differentiated healthcare solutions that help small businesses save money, expand network and product choice and keep employees healthy,” Julie McCarter, vice president of product solutions at Cigna, said in a statement.

How Small Businesses Can Save

Small businesses do not necessarily have to offer health insurance to their employees. It can become too expensive for the business. However, with this new merge, this will open the door to small businesses being able to afford healthcare coverage for their employees.

silhouette of a group of people with a huge red heart behind them in the background. — *“Together, we are giving small business owners an affordable, simple-to-use option.”*

“Together, we are giving small business owners an affordable, simple-to-use option that makes it easier for their employees to get appropriate care quickly and stay healthy,” Oscar Chief Policy and Strategy Officer Joel Klein said in a news release. “Cigna + Oscar will give these business owners and their employees consumer-centric health care coverage and physician networks that provide personalized care.”

The plans will include medical, behavioral health, and pharmacy services. Telemedicine will also be provided at no cost 24/7. This will help employees with the ability to call and speak with a doctor. They will also get their medicine quicker than going into the doctor’s office.

Although Cigna is not one of the largest 3 insurers in the small group market, they do offer group insurance to employers with 50 or more employees. The company is hoping tha partnering up with Oscar will help the company grow more and bring in more revenue. Together, the companies can do more in smaller markets than they would have been able to do alone. Let’s hope the future is bright for small businesses, and more importantly their employees receiving health insurance!

Get Ready For The 2020 Health Insurance Tax

Insurers were given a pass in 2019 by Congress regarding their annual health insurance tax. The reason was that the government was concerned about consumers’ out-of-pocket costs. However, if the ACA’s health insurance tax resumes as planned, this ‘free pass’ might be over and insurers will face a $15.5 billion tax bill in 2020. The health insurance tax

Silhouette of a man holding another man upside down with money falling out. — *Insurers might face a $15.5 billion tax bill in 2020, meaning health insurance premium costs will go up at least 2% next year.*

was created to fund the implementation of the ACA’s marketplace exchanges. For consumers, this means that insurers will raise premiums by more than 2% if the tax is implemented by the IRS.

Health Insurance Tax Over The Years

Oliver Wyman Actuarial Consulting recently analyzed the projected impact of the health insurance tax on health insurer premiums over the next 10 years. They found that premiums are likely to increase by 2.2% in 2020.

The tax started at $8 billion in 2014, increased to $11.3 billion for 2015-2016, and had a suspension in 2017. The tax was then reinstated at $14.3 billion in 2018, and then given another suspension for the year of 2019.

Who It Applies To

A fully-insured health plan is the more traditional way to structure an employer-sponsored health plan. With a fully-insured health plan: The company pays a premium to the insurance carrier. The health insurance tax applies to all insurers offering fully-insured coverage. This goes for :

on-exchange and off-exchange individual markets
large and small group markets
insured public programs such as Medicare and Medicaid.

The Rise In Premiums

Premium increases will vary by state. However, premiums are expected to increase annually anywhere from $154 to $479. A person in the individual market can face a $196 increase. A person in the small group market can expect a $154 increase, while a family of 4 faces a $479 increase. As for families in the large group market, the increase for an individual will be about $158, while a family faces a $458 increase.

Two arrow signs in yellow. The top one says health and points right, the bottom one says illness and points left. — *The rise in premium costs might cause a lot of people to opt out of insurance, throwing off the risk pool.*

The Outcome Following The Tax

If the tax is implemented and is as high as almost $16 billion, then increased tax burdens on small employers will follow. Fully-insured small employers will face the repercussions, while private and self-insured public employers will not. Employers are not the only ones who will have to pay for the tax increase. State taxes will go up for everyone in order to cover the increased tax on Medicaid.

More importantly, many people might opt out of insurance due to the increase in premium costs. Healthier individuals opting-out will cause an imbalance in the risk pool, meaning higher premiums for the (less healthy) people who are insured.

As of now, there is no definitive answer if the tax will be implemented in 2020. Congress is considering bipartisan legislation that would suspend the tax through 2021, but it is not a guarantee. If the health insurance tax is implemented, insurance rates and premiums will be more expensive than it already is.