Oscar Small Business Health Insurance – Oscar Health, a startup reimagining health insurance for the digital age, is launching a new product for small businesses called Oscar for Business.
The launch comes as Oscar struggles with its initial push for individual insurance through the Affordable Care Act. That move propelled the company, now valued at $2.7 billion, to its initial success. Oscar was the only startup allowed to sell scholarships under Obamacare when it launched in 2013, just before the ACA went into effect. It proved to be a catalyst for the company and still owes most of its pipeline to the program.
Oscar Small Business Health Insurance
But individual markets are not as profitable as hoped in some areas of the country. Despite the high valuation, Oscar lost $128 million in the first three quarters of last year and $105 million less in 2015. Since then, the company has scaled back operations, tightened prices and closed ACA sales in Dallas and New Jersey to run the business.
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There is also a lot of uncertainty surrounding Obamacare. Although Republicans have been unable to reach a consensus on repealing President Obama’s legislative legacy, our current administration has vowed to continue to strike a deal to repeal the law.
It seems like the right time to introduce a new plan, given the past losses, combined with the current precarious position of the ACA, the threat of an overhaul lingers. But Oscar for Business is not a new response to a failed model, according to CEO Mario Schlosser. He says the new product has been in the planning all along.
“Most Americans get health insurance through their employers,” he noted. “Very early on, we thought we should build software for existing employers, for existing insurance companies.”
The ACA covers about 20 million Americans who would otherwise not have insurance. However, the same measure requires companies with at least 50 employees to also have employee health insurance. Oscar for Business takes advantage of this demand, which covers approximately 56% of the US population. Since Obamacare gutting entrepreneurs aren’t biting that part of the bill, it easily provides another opportunity for startup growth and could ultimately lead to bigger Oscar corporate deals.
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Oscar for Business officially launches today in New York State, where it has already launched and worked with a few companies over the past two months. The new product is aimed at small businesses with up to 100 employees and offers the same services as the individual plans. Oscar will eventually offer the same service in other states as it operates through regulatory hurdles. Oscar Health Insurance sells individual and small business health plans in limited areas of the United States. Oscar has some great membership benefits and a great mobile app that customers can use for virtual use. doctor visits, some free. But the company’s individual plans cost more than some of the competition’s plans, and customer satisfaction ratings are average.
Oscar plans are good for consumers who want to use a premium mobile app that includes useful features like virtual health visits. And the company’s dedicated care teams are perfect for members who want personalized services geared toward their health needs and insurance plan.
While customers are happy with Oscar’s mobile app and care teams, some have reported problems reaching a care team member and an overall poor customer experience.
You can purchase an individual Oscar health insurance plan through HealthCare.gov or a state health insurance marketplace, and the company sells small business health insurance plans in limited areas.
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Shoppers can also browse Oscar’s health insurance plans and network on the company’s website. The service provider search includes interactive maps, reviews and ratings to help you choose. Once you are a member, you can interact directly with providers online to schedule healthcare visits.
Plans are offered statewide in some states and limited areas in others. For example, Oscar plans are sold throughout Nebraska, but only in two counties in Arizona.
Individual Oscar plans come in all five plan tiers: Catastrophic, Bronze, Silver, Gold and Platinum, depending on where you live. All plans cover essential benefits required by the Affordable Care Act (ACA).
Monthly prices are generally the lowest of the catastrophe plans and increase with each metal level, with the platinum plans being the most expensive. But while you’ll pay more per month for the Gold and Platinum plans, you’ll pay lower deductibles and copays when you get medical care, making these plans best for people who need medical care often.
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Average Oscar metal package prices in Texas range from $312 to $1,103 per month, depending on your age and the metal package you choose.
Oscar does not sell Platinum plans in the Texas health insurance market, but does offer them through the company’s website.
In Texas and other states, silver plans may cost more than gold plans. That’s because Silver plans offer income-based subsidies to help lower out-of-pocket insurance costs, and some of those costs can be offset by higher premiums. Compare plans carefully, including any subsidies, to make sure you get the best deal.
Under the Affordable Care Act plan, Oscar may offer one or more of its own plans based on location: Simple Saver, Simple, Classic or Elite.
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The Simple Saver plan works well for those with fewer medical needs because you pay a small, flat fee for primary care visits, but higher costs for specialty care and other services. Although the Simple Saver plan has a lower price and a fairly low deductible, you pay 100% of the cost for much of your care, including specialty visits and physical therapy, until you reach your deductible. After that, you pay a smaller percentage for these services, but it’s still a percentage of the flat fee.
A simple plan is suitable for people with moderate health care needs. It has a lower deductible than the Simple Saver plan, which you can top up quickly if you have more frequent medical needs. Simple plans charge a higher percentage of your medical expenses than Simple Saver plans.
These plans may be best for those with frequent healthcare needs. With the classic package, you pay the highest fees of the four plan types. For those with the most common health needs, we recommend the Elite plans over the Classic plans. Once you reach the deductible, premiums for the Elite plan are lower than those for the Classic plan.
Elite plans are best for those with higher health care needs because frequent use means you can meet your deductible more quickly. You’ll only pay about $7 more per month for the Elite plan than the Classic plan, and once you reach your deductible, your payments will be slightly lower than the Classic plan. But some Elite plans have separate drug deductibles, so you may want to avoid those options if you need help with prescription costs.
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Oscar plans cover preventive lab tests and pay less if you use one of Oscar’s most popular labs: BioReference, LabCorp or Quest Diagnostics. If you have or purchase Oscar insurance, be sure to ask your doctor to send all lab work to your preferred provider.
The chart below compares Oscar’s silver prices to its main competitors in Texas. Oscar is more expensive than Molina, but cheaper than Celtic/Ambetter and BlueCross BlueShield of Texas.
Oscar partners with Cigna to offer small business groups health plans based on the number of employees. Oscar Business Plans are only available in certain regions:
Plans are EPO or PPO, depending on location, and are available for businesses with 1 to 50 employees.
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If you are eligible for Medicare, Oscar has Medicare Advantage plans available in limited areas. All plans are HMOs with Medicare and cost an average of $3 per month.
Only the plans in New York have been evaluated by Medicare, and each received 3 out of 5 stars for customer satisfaction, which is lower than the plans of most major competitors.
Broward County Medicare Advantage plans are available to patients receiving healthcare through Holy Cross and Memorial Health providers.
Oscar has many of the standard health care resources, but also offers unique policyholder benefits compared to other health insurance providers. All of these resources are available through the Oscar smartphone app or website.
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The app and website allow you to track progress towards self-responsibility and review health-related topics such as managing mental health. You can track your steps in the app and be rewarded with up to $100 in Amazon gift cards per year if you hit your step goal.
When you purchase an Oscar health plan, you will receive a welcome packet that includes your plan ID cards, a summary of insurance benefits, and a list of all benefits and extra benefits.
Oscar assigns you a dedicated care team to help you with your insurance and health care needs. This is a group of professionals, including health guides and nurses, who will give you advice about your health when you need it. Your care team can help you with billing and policy questions and help you find an available doctor or