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Online plan linchpin for Oscar’s NJ return

By , - Last modified: December 12, 2017 at 1:46 PM

After a yearlong hiatus from the New Jersey market, Oscar Health has returned with a plan that will enable small business owners and insurance brokers to enroll online, thereby significantly cutting down on the time it takes to enroll in through the typical paper process.

The New York-based company is hoping the convenience of its new Oscar for Business product, along with competitive pricing and a heightened focus on customer service, will help give it an edge in the coming year as it tries to once again penetrate New Jersey’s crowded small business health insurance market.

The 4-year-old company withdrew from New Jersey and other markets in 2017 due to uncertainty over whether Congress would repeal the Affordable Care Act; losses on its balance sheet in 2016; and the reality that the state’s health insurance landscape is already dominated by Horizon Blue Cross Blue Shield of New Jersey and, to a lesser extent, AmeriHealth New Jersey and UnitedHealthcare.

When Oscar left New Jersey at the end of last year, it was available in 14 counties and owned an 8.4 percent share of the health insurance plans formed under the ACA, covering more than 21,000 people, according to the state’s Department of Banking and Insurance.

Louis DeStefano, vice president of sales and head of the New Jersey market for Oscar, told NJBIZ that with the threat of repealing the ACA having been tempered and the health insurance market somewhat stabilized, he is optimistic that the company can gain a significant foothold in the state in 2018.

“What we saw last year [around the country] was attrition and market shrinking in the U.S., but we didn’t see that in New Jersey,” he said. “The small business and individual marketplace in New Jersey is still robust, and we think there is the opportunity to have another carrier here.”

Oscar has its sights set on businesses with up to 50 employees, and what will differentiate it this time, the company said, is the convenience of online enrollment, plus its “concierge” approach to customer service, in which each consumer will be assigned three different service agents and a nurse to help them navigate the system.

Oscar also will offer free, unlimited telehealth services, in which customers can be connected to a doctor in its network within eight minutes, and be able to send them a picture of their condition and get a prescription sent to a pharmacy of their choice, DeStefano said.

“Every time a customer calls, texts or emails, they will speak to the same four people who will know their medical history,” said DeStefano. “That makes us completely different from any other company here. These tools are fully integrated into our service.”

The company said it believes its insurance products are competitively priced and plans to sell to both brokers and benefit administrators during the remainder of the open enrollment period and beyond. Open enrollment ends Dec. 15.

“I’ve been speaking with employers throughout the state over the last few months, and they’ve been enamored with the concierge approach, online enrollment and other features, such as allowing members to book doctor appointments online,” said DeStefano.

According to figures released by the state’s Individual Health Coverage Program, Oscar Health’s Silver Saver plan will cost an average of $349.30 per month, making it comparable, middle-of-the-road Silver plans – AmeriHealth New Jersey’s IHC Silver EPO Advantage plan will cost an average of $311.86 per month, and Horizon BCBSNJ’s Omnia Silver HAS plan will average $346.72 per month. 

Oscar will once again partner with health insurance agency QualCare to offer a network of roughly 65 hospitals across the state, as well as hospitals and doctors in the New York City area. It also will offer its insurance products in the same 14 counties it did in 2015 and 2016: Essex, Hudson, Union, Bergen, Passaic, Monmouth, Morris, Sussex, Warren, Middlesex, Somerset, Hunterdon, Mercer and Ocean.

“We’re in growth mode right now,” said DeStefano. “What I can tell you is that these next two weeks are critical, as members are still in open enrollment.” 

The company is also re-entering markets in California, Ohio, Tennessee and Texas, and will continue serving the New York region.

“We feel confident that we can offer seamless, guided health insurance plans for both small businesses and individuals in this area,” said Oscar co-founder and CEO Mario Schlosser in a statement. “Our new Oscar for Business plans would be an especially attractive product for New Jersey businesses and include regional coverage with our optimized New York network.”

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Vince Calio

Vince Calio

Vince Calio covers healthcare and manufacturing for NJBIZ. You can contact him at vcalio@njbiz.com.

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