Beginning 3/1/2012, Oxford will be making changes to small group health insurance participation requirements in New York for new business. For existing small businesses in New York, these changes will likely take effect in late 2012 or early 2013.
-Triple plan options (three concurrent plans with a single employer) for new business will be on an approval basis, will require at least 15 enrolled employees, and will require a Liberty HMO as one of the options
-Dual options (two concurrent plans with a single employer) with fewer than 15 enrolled employees must include a Liberty HMO or an HMO-based product
-The new participation requirement is 51% after valid waivers (another health plan is not a valid waiver)
-Liberty HMO only groups, because they are an HMO, are not subject to participation requirements
Full details of Oxford’s participation requirement changes can be found in the attached document:
Oxford Underwriting Guidelines For New York.pdf
For more information on how this can impact health insurance for your business, contact a New York health insurance broker.