Cigna, Oscar Health Form New Brand for Small Business Plans

Cigna and Oscar Health will be partnering to provide a health plan designed for small businesses that struggle to afford healthcare coverage for their employees, the companies announced.

"Small businesses are the backbone of the American economy and through this partnership, we can take a disciplined approach to offering differentiated health care solutions that help small businesses save money, expand network and product choice and keep employees healthy," said Julie McCarter, vice president of product solutions at Cigna.

Seventy percent of uninsured workers do not have access to employer-sponsored health plans, a KFF report revealed in December. 

A small business’s ability to offer health insurance can impact its performance as a whole. Fifty percent of Americans make job decisions based on healthcare coverage benefits, so a small business that cannot afford health insurance will likely fail to attract qualified workers it needs in order to grow. 

The Cigna + Oscar brand has tailored its small group market offering for this demographic. The combined payer option is using a reinsurance agreement to share the risk.

The plan’s services will encompass integrated medical, behavioral, and pharmacy services.

The plan’s concierge team gives members constant access to healthcare navigators to help them understand their health benefits.

A telehealth platform also provides benefits navigation assistance. Through it, employees can access copay information, benefits details, and track their deductibles.

Apart from technical services for benefit support, the plan also offers telemedicine health support options. Employees can retrieve health history information and see lab results. They can also find help for physical conditions through the telemedicine service.

To connect with a healthcare provider, the plan offers search tools through which members can book appointments, review providers, locate their healthcare facility, and track their prescriptions.

Finally, a portal serves brokers, business managers, and providers, helping each entity with enrollment and manage their accounts.

"Together, we are giving small business owners an affordable, simple-to-use option that makes it easier for their employees to get appropriate care quickly and stay healthy," said Joel Klein, chief policy and strategy officer at Oscar. "Cigna + Oscar will give these business owners and their employees consumer-centric health care coverage and physician networks that provide personalized care.”

Small businesses were at the center of some health insurance controversy in 2019. 

The Administration took a threefold approach to resolving small businesses’ difficulty in securing health insurance. It promoted association health plans, short-term health plans, and health reimbursement arrangements (HRAs).

With HRAs specifically, employers can support employee health coverage without being responsible for providing health insurance. Employers provide a certain amount to defray health insurance costs, employees purchase an individual plan that makes sense for their needs, and the business reimburses them.

Opponents call short-term health plans “junk plans” because they often do not provide very comprehensive coverage.

Cigna and Oscar are taking the matter into their own hands. Their plan is fully insured and serves a market that grows by 500,000 businesses every month. The payers also say their plan will be affordable, though pricing details have not yet been disclosed.

The companies plan to launch the plan in 2020. First, however, the plan must pass through regulatory approvals.

This is not the first time that Oscar Health has partnered with a larger payer to offer small business healthcare coverage solutions.  Oscar Businesses partnered with Humana in 2017 and sold a small business plan in the Nashville, Tennessee area. That partnership is no longer active.

“Taking into account the learnings from the Humana partnership, we tried to be really thoughtful about how we structured this relationship with Cigna. We think the partnership alignment here is optimal, with Cigna having the network depth and employer market experience to match with our strong consumer-facing, technology-driven member experience. We aligned on a number of key principles upfront to set ourselves up for success,” said an Oscar spokesperson.