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Cigna, Oscar to offer small business plans in Philadelphia

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Dive Temporary:

  • Cigna and Oscar Well being mentioned Monday they may supply medical health insurance plans to small companies within the Philadelphia market in an growth of a partnership between the standard payer and the insurtech.
  • The announcement comes days after Oscar Well being CEO Mario Schlosser mentioned the startup would cease pursuing full-service offers for its +Oscar data platform expertise for 18 months, after operating into difficulties implementing a partnership with Florida-based Well being First Well being Plans.
  • Within the new Cigna + Oscar small enterprise deal protecting Bucks, Chester, Delaware, Montgomery and Philadelphia counties, the 2 payers mentioned they may share threat equally beneath a reinsurance settlement and plan to broaden the association over time.

Dive Perception:

Cigna started collaborating with Oscar in 2020 to promote business well being plans to small employers, anticipating development within the small group market as extra companies look to supply complete advantages as a strategy to entice and retain expertise. The small enterprise plans are actually accessible in markets throughout seven states.

The co-branded plans had a robust first half of the yr, surpassing the 50,000-member mark in enrollment, Louis DeStefano, Oscar’s head of small enterprise, mentioned in asserting the Philadelphia growth.

Within the Philadelphia market, the Cigna + Oscar plans for companies with fewer than 50 staff will embrace low-cost prescription drug protection, behavioral well being assist and Cigna’s networks of docs, specialists and hospitals, the businesses mentioned. Entry to suppliers nationwide is out there with out the necessity for referrals, by way of the Cigna Open Entry Plus community. The merchandise will change into accessible Jan. 1, pending regulatory approval.

Oscar, which was based in 2012 and went public in March 2021, is refocusing its technique in a bid change into worthwhile in its insurance coverage operations subsequent yr and general by 2025. In Might, the New York-based insurer mentioned it will exit the Arkansas and Colorado markets subsequent yr whereas remaining in 20 states as a part of a reallocation of assets.

The choice to pause new full-service offers for the +Oscar data expertise platform will enable extra time to assist the combination of the Well being First partnership, firm executives mentioned final week. The tech platform helps organizations transition to risk-based fee fashions, interact with sufferers and management medical spending.

Oscar’s quick development within the particular person and small group markets has boosted its general membership to greater than 1 million enrollees. The corporate affords particular person plans each on and off the Inexpensive Care Act medical health insurance market, in addition to Medicare Benefit plans.

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