Broker News

  • COVID Cost Sharing Waivers Extended

    August 16, 2021
    The National Public Health Emergency has been extended through October 17, 2021. The waiver of cost-sharing for COVID-19 Vaccines, Testing, and Diagnostic Visits is part of the Emergency, and will continue through October 17th. EmblemHealth has released a helpful FAQ regarding procedures, vaccines, and testing under this arrangement, please click here to read their guidance.

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  • EmblemHealth SG July Submission Deadline Extended

    June 17, 2021

    The EmblemHealth small group submission deadline has been extended until 7/6/2021 for a 7/1/2021 effective date.
    Please ensure that cases submitted during this extension period are complete, and include a Late Submission Form, as ID cards may not be available on the effective date.
    Individual Open Enrollment is continuing through the end of the year. Cases must be submitted by the 15th of the prior month.
    Please be advised that EmblemHealth has maintained their long standing relationship with Montefiore for 2021. If any of your small or large group clients have recently lost access to Montefiore through another carrier, EmblemHealth is an option for you. Please feel free to call in to our offices to discuss your client's situation and how EmblemHealth can help.

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  • CAI is now a GA for Healthfirst!

    June 3, 2021

    We are excited to announce our new GA relationship with Healthfirst for Small Group product!
    Healthfirst offers some of the most affordable plan options on the marketplace, a simple enrollment process (including ACH for binder payment), an extensive hospital list (including MSK, NYU, and LIJ hospitals), and generous 4% commissions.
    Our website has been updated with all the information and sales materials you will need, please click here to view our Broker Resources. Healthfirst Small Group product is also now available for quoting on HealthConnect.
    Brokers must be appointed with Healthfirst prior to marketing or selling their plans. Appointment is handled online, and we have created this handy guide to walk you through the entire process.
    CAI and Healthfirst will be hosting a webinar in the near future to explain the products and procedures in more detail. Keep an eye out for an invite coming soon.

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  • Exclusive Group Medical Bridge Plans Through NYSBG

    May 6, 2021

    The Group Medical Bridge plans are a hospital indemnity product designed to reimburse members for incurred expenses.
    The benefits are tailored to address the high cost-sharing procedures under existing health plans, such as hospital admission or outpatient surgery. This enables clients to save on premium by stepping down a metal tier, while protecting themselves from the increased expenses.
    These plans do not coordinate with health insurance; the benefit pays out according to the schedule as long as an eligible service was performed.
    Our most popular plan provides a $2,500 reimbursement for Hospital Admission, up to $3,000 for surgery, $1,000 for diagnostic services, plus $165/day of hospital confinement (up to 60 days), greatly reducing the out of pocket responsibility on a Bronze or Silver tier plan.
    These plans are offered through the New York State Business group, allowing us to secure exclusive rates and tailor the plan designs. Monthly dues are $5, and include a $10,000 Life and AD&D Policy issued through The Standard Life Insurance Company of NY (*Must be under the age of 65 at time of issuance).
    Information on these products can be found in the broker section of our website under "Hospital Indemnity", and here's some quick links for your convenience:

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  • COVID Vaccine Eligibility Expanded

    March 31, 2021

    Governor Cuomo announced that effective 3/30/21, New Yorkers age 30 or older are now eligible to be vaccinated. This will expand again on 4/6/21 to age 16 or older.
    Appointments are required, and can be obtained online through the NY.gov website by clicking this link: https://am-i-eligible.covid19vaccine.health.ny.gov/
    Appointments are issued on a rolling basis, and may be a few weeks out.
    Those who are under the age limit are still eligible for a vaccine if they have certain health issues or comorbidities. A Doctor's letter, signed certification, or official medical documentation is required. The eligibility tool has been updated to reflect this.

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  • Form 1095 Information

    March 22, 2021

    We've received quite a few questions regarding 1095 forms during this tax season, and we're sure you have too. So you can better serve your clients, here's an overview of what it all means:
    Under PPACA, an Individual Penalty was established to incentivize Americans to obtain health insurance coverage. The 1095 form was introduced as a standardized document to report enrollment in a Qualified Health Plan.
    The 2017 Tax Cuts and Jobs Act reduced the individual penalty to $0, effectively eliminating it, effective 1/1/2019. Due to this, beginning with the 2019 tax year, IRS tax forms like the 1040 no longer include the question about health coverage.
    1095-A comes from the Exchange in mid-February (also available by logging in to the member's exchange account) and reports any Advanced Premium Tax Credit the member received. This is used to complete Form 8962 and reconcile the subsidy. Accountants will request this, including from clients who aren't on-exchange.
    1095-B comes from the Carrier (usually available in the member portal as well). Now that the individual penalty is gone, it no longer serves any real purpose. It's basically just a "receipt" for the member's records and isn't needed to file taxes.
    1095-C comes from a Self-Insured Large Employer, and is generally handled the same as a 1095-B for tax purposes (it's just a receipt). Because this form confirms the coverage offered by an employer, it can also serve to prove/disprove eligibility for a premium tax credit.
    If you'd like to read more on this subject, or would like to refer clients/accountants to the official guidance, the IRS has posted a helpful Q&A on their website.

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  • Open Enrollment Extended Through End Of Year

    March 22, 2021

    Yesterday, Governor Cuomo announced that Individual Open Enrollment is being extended through the end of the year due to the COVID-19 pandemic, both on and off exchange.
    In addition, through the American Rescue Plan, increased tax credits may be available to consumers who have already enrolled in coverage.
    The same effective date guidelines still apply, remember to submit by the 15th of the month for the 1st of next month.

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    All health plan, insurance coverage information, or otherwise is subject to carrier approval and/or NYSID approval. For complete coverage information, always refer to the certificate of insurance. Neither Conference Associates, Inc. (CAI)/ELITE Programs Inc. (ELITE), nor its web administrators may be held liable for typographical errors.