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Fixing The Family Glitch

Broker Update | November 2022 | Vol. 17 No. 11

To be eligible for subsidized qualified health plans today, employees must not have "affordable coverage" through their own/spouse's employer. For some, if their employer doesn’t contribute to the cost (or only contributes a small amount) toward the family premium, it may...

Add Preventive Care To Your List Of New Year’s Resolutions

Broker Update | December 2022 | Vol. 17 No. 12

A new year is around the corner and for many, that means evaluating their health status and lifestyle habits. This year, we encourage you and your groups to add preventive care to your list of new year resolutions. Regular preventive care can help reduce the risk or...

The Perks Of Being A Univera Healthcare Member

Broker Update | December 2022 | Vol. 17 No. 12

Are your groups aware of Perks4U, our member discount program that offers exclusive savings on healthy programs, products, and services with vendors throughout Western New York? Perks are always available and constantly being added, and Univera Healthcare members can...

Univera Healthcare Welcomes Dr. Gina Cuyler

Broker Update | December 2021 | Vol. 16 No. 12

In keeping with its mission to ensure access to high quality health care and reduce health disparities, Univera Healthcare announced that Gina Cuyler, MD. has joined the health plan as Vice President Health Equity and Community Investments. In this new role, Dr. Cuyler...

Introducing Rx Update

Broker Update | December 2022 | Vol. 17 No. 12

We’re excited to announce a new section of our Broker Update newsletter called Rx Update that will provide important pharmacy updates for you and your groups. Starting in January, you will see content each month under the heading “Rx Update” that will include information...

Sending Warm Wishes To You, Western New York

Broker Update | December 2022 | Vol. 17 No. 12

In the spirit of the holidays, we’d like to thank you for your partnership over the past year as we’ve worked together to bring high quality, affordable health care and peace of mind to so many in our community. Here's to new opportunities and exceptional client...

Rx Update - Frozen Formulary Mandate - Effective January 1, 2023

Broker News | January 2023 | Vol. 18 No. 1

The Frozen Formulary Mandate is a New York state law that goes into effect January 1, 2023. The mandate prohibits health plans that provide essential benefits from removing a prescription drug from a formulary, or adding additional formulary restrictions, during an...

Rx Update - Pharmacy Concierge Program

Broker Update | January 2023 | Vol. 18 No. 1

The rising price of prescription drugs continues to be a major driver of health care costs. Our innovative approach to pharmacy cost management has produced outstanding savings for our employer groups and their employees while maintaining the highest quality of individual...

Here’s To Heart Health

Broker Update | January 2023 | Vol. 18 No. 1

Did you know your heart is about the size of your fist? Your heart is the engine that runs your circulatory system, which carries blood to and from all areas of your body. Your blood carries oxygen and nutrients to your organs and carbon dioxide to your lungs. If your...

Submission Of Prescription Drug Data Collection Report

Broker Update | January 2023 | Vol. 18 No. 1

On December 23, 2022, we submitted the Prescription Drug Data Collection (RxDC) report as required under Section 204 of Division BB, Title II of the Consolidated Appropriations Act (CAA), 2021. The submission included information for fully insured policies issued and for...

Tax Form 1095-B

Broker Update | January 2023 | Vol. 18 No. 1

Health insurers—including Univera Healthcare—are no longer mailing tax form 1095-B to members. Because taxpayers are not required to include the form when filing their taxes, the IRS no longer requires us to mail the form. Members can still download the form or request it...

Newly Updated Telemedicine Toolkit Is Now Live

Broker Update | January 2023 | Vol. 18 No. 1

The newly updated Univera Healthcare Telemedicine Toolkit is now available for employers to download on UniveraforBusiness.com. With this collection of informational flyers, FAQ and ready-to-send email, employers can encourage their team to activate their telemedicine...

2023 Broker Guide Is Here

Broker Update | January 2023 | Vol. 18 No. 1

The 2023 Broker Guide for Univera Healthcare is now available to help you better serve our clients and grow your brokerage business. The guide is also available in the broker portal on the Univera Healthcare website. 2023 Broker Guide (PDF) Login Required  

Watch: New Experience Rated Formula Video

Broker Update | January 2023 | Vol. 18 No. 1

As we shared earlier this month, Univera Healthcare has filed with NYS DFS and received approval for changes to our insured rating formula, effective July 1, 2023. The changes filed include modifying the credibility and pooling methodology to provide more stable...

Rx Update - Mona Chitre, PharmD Appointed New Senior Leadership Role

Broker Update | February 2023 | Vol. 18 No. 2

Mona Chitre, PharmD has been named President of Pharmacy Solutions, in addition to her role as Chief Pharmacy Officer. In her expanded role, Dr. Chitre will focus on delivering clinically sound pharmacy solutions to enable growth and diversification and bolster...

Rx Update - Our Patient Assurance Program Enhancement

Broker Update | February 2023 | Vol. 18 No. 2

The Patient Assurance Program was expanded on January 1, 2023, to include certain cardiovascular drugs in a continued commitment to provide affordable medications to members. The program is intended to counteract escalating costs of diabetic and cardiovascular therapy....

Focus On Fiber For Colon Cancer Awareness Month

Broker Update | February 2023 | Vol. 18 No. 2

March is Colorectal Cancer Awareness Month. Colon cancer is the third most diagnosed cancer and the second leading cause of cancer deaths. An estimated 153,020 people will be diagnosed with colorectal cancer in 2023. Colon cancer, however, is largely preventable through...

Safety Net Recertifications Update

Broker Update | February 2023 | Vol. 18 No. 2

During the ongoing COVID-19 public health emergency (PHE), most Safety Net members have not been required by NY State to renew their Medicaid Managed Care, Essential Plan or Child Health Plus eligibility. For most members, coverage has renewed automatically during the...

2023 Healthy New York Resources And Forms Are Here

Broker Update | February 2023 | Vol. 18 No. 2

The Healthy New York maximum wage has been increased to $47,750 and the Healthy New York (HNY) New Business form and HNY Recertification form have been updated. Please use the new forms (linked below) moving forward to reflect the new wages. The cutoff for reviewing the...

UniveraForBusiness.Com: Free Resources To Help Care For Your Team

Broker Update | February 2023 | Vol. 18 No. 2

When was the last time you checked out UniveraForBusiness.com? Univera For Business is your destination for toolkits and content that help businesses and employees enjoy better physical, emotional, and financial health and get the most from their health plan. Resources...

Rx Update - Fully Insured Pharmacy Benefits

Broker Update | March 2023 | Vol. 18 No. 3

Did you know that we offer the nine innovative trend management programs to fully insured groups at no extra charge? All our fully insured employer groups receive fully integrated medical and pharmacy benefits built right into their plan with no hidden costs or additional...

Healthy Vision Is Important To Overall Health

Broker Update | March 2023 | Vol. 18 No. 3

Have you ever heard of “tear film”? Every time you blink, a thin layer of tears called “tear film” spreads across your eyes. Tear film has three layers: an oily outer layer, a watery middle layer, and an inner mucous layer. All three of these layers work together to help...

Small Group Underwriting Healthy NY Form And Annual Group Information Form WebTool Updates

Broker Update | March 2023 | Vol. 18 No. 3

Small Group Underwriting form updates are rolling out as outlined below. Impacted lines of business include Small Group Medical, Dental, Vision and Healthy NY. Healthy NY (HNY) Group Size Information Going forward, Underwriting will begin collecting group size...

2022 Pharmacy Reporting Under The Consolidated Appropriations Act (RxDC)

Broker Update | March 2023 | Vol. 18 No. 3

To comply with the Consolidated Appropriations Act (CAA), we will complete all required pharmacy benefit and prescription drug cost reporting on behalf of fully insured groups (small and large) and self-funded groups with medical and pharmacy coverage with Univera...

NEW! Primary Care Provider Toolkit Now Available

Broker Update | March 2023 | Vol. 18 No. 3

A new Primary Care Provider (PCP) toolkit is now live and can be found on UniveraforBusiness.com. With a ready-to-send email, PCP checklist, find a doctor tool fact sheet and e-book, employers can encourage their team to find a provider and stay ahead of illnesses. Get...

Safety Net Recertifications Update

Broker Update | March 2023 | Vol. 18 No. 3

During the ongoing COVID-19 public health emergency (PHE), NY State has not required most Safety Net members to renew their Medicaid Managed Care, Essential Plan or Child Health Plus eligibility. For most group members, coverage has been auto renewed during the PHE. ...

Rx Update - 2022 Results For Pharmacy Concierge

Broker Update | April 2023 | Vol. 18 No. 4

Higher prescription costs affect everyone. We know that escalating drug prices are a problem for more and more Americans. And we understand that employers want to offer their employees the best possible health care but need to keep costs in check. Pharmacy Concierge is...

May Is Mental Health Awareness Month

Broker Update | April 2023 | Vol. 18 No. 4

According to the Centers for Disease Control and Prevention (CDC), mental health is an important part of overall health and wellbeing. Mental health includes our emotional, psychological and social wellbeing. It affects how we think, feel and act. It also helps determine...

MDLIVE Claims Cost Increase

Broker Update | April 2023 | Vol. 18 No. 4

Effective April 1, 2023, the MDLIVE claim cost for medical consults increased. The medical claim cost increased from $40.00 to $50.00 per MDLIVE visit, which is still 39% below the non-MDLIVE member price. This cost is also significantly below a telehealth visit with a...

COVID-19 National Emergency And Federal Public Health Emergency To End May 11, 2023

Broker Update | April 2023 | Vol. 18 No. 4

The federal government announced the COVID-19 National Emergency and Federal Public Health Emergency (PHE) will end on May 11, 2023. Univera Healthcare has been reviewing the guidelines surrounding COVID-19 related vaccines, testing and telehealth services and is sharing...

June Is Men’s Health Month

Broker Update | May 2023 | Vol. 18 No. 5

Men's health is a critical issue. Unfortunately, many men tend to neglect their health until they experience a severe illness or injury. This leads to a higher risk of chronic diseases, disability, and premature death. Additionally, men also tend to engage in riskier...

Contract Renewals Underway For Lifetime Benefit Solutions Clients

Broker Update | May 2023 | Vol. 18 No. 5

We’re reminding brokers that Lifetime Benefit Solutions will begin a phased approach to update client contracts. We will communicate with your Lifetime Benefit Solutions clients based on their contract effective date. These clients will receive contract documents to...

How Safety Net Plan Renewals Impact Your Business And Groups

Broker Update | May 2023 | Vol. 18 No. 5

As we’ve been sharing for the past few months, Safety Net recertifications resumed in April, with the first of our members receiving notifications in May. We understand that not all brokers typically engage with our Safety Net population, but it’s important to understand...

What Happens With Claims, COBRA And Special Enrollments Once The National Emergency Ends?

Broker Update | May 2023 | Vol. 18 No. 5

As you may recall, due to the COVID-19 National Emergency, the Department of Labor provided relief via extensions for filing and appealing claims, electing and paying for COBRA, and notifying administrators of disability notices and special enrollments. The extensions...

Individual & Small Group – NYS Prior Approval Of Rate Changes

Broker Update | June 2023 | Vol. 18 No. 6 - Special Issue

On May 10, 2023, an application was submitted requesting 2024 premium rate changes in accordance with New York state prior approval law. This rate application applies to Community Rated Individual and Small Group products. The following products are included in this 2024...

Looking For Something?

Broker Update | June 2023 | Vol. 18 No. 6

Ever found yourself looking for a certain broker blast article or announcement? You know you read it and filed it away but now can’t locate it! Don’t worry, we’ve got you covered. We archive all our broker blast articles and announcements chronologically on the broker...

Rx Update - Pharmacy Concierge Delivers Value

Broker Update | June 2023 | Vol. 18 No. 6

We understand that employers want to offer their employees the best possible health care but need to keep costs in check. In 2020 Univera Healthcare launched a pharmacy benefits management program called Pharmacy Concierge. We first offered Pharmacy Concierge to our...

Rx Update - Offering Members Cost-Effective, Convenient Options

Broker Update | June 2023 | Vol. 18 No. 6

Site of Care is an Univera Healthcare program that provides valuable options to members who are currently receiving infusion drugs at high-cost facilities. Our program provides cost savings by transitioning members from receiving their treatment at a hospital or infusion...

The Benefits Of Getting Outdoors

Broker Update | June 2023 | Vol. 18 No. 6

According to the Environmental Protection Agency, Americans spend 90% of their time indoors. But going outside actually has lots of benefits to our mental and physical wellbeing. Summer is a wonderful time to enjoy the benefits of getting outdoors in nature, whether...

Healthy NY Group Recertification Forms

Broker Update | June 2023 | Vol. 18 No. 6

Univera Healthcare was set to begin requiring the Healthy NY (HNY) Recertification form and Supplemental form from all HNY groups upon renewal starting July 1, 2023. We are postponing the requirement of the HNY Supplemental form at this time; however, all HNY groups will...

2024 Small Group Package Update

Broker Update | June 2023 | Vol. 18 No. 6

The following Univera Access package will no longer be offered directly through Univera Healthcare or on the New York State of Health (SHOP) Marketplace beginning January 1, 2024: Univera On Demand will be updated for package comparisons. The package that will no...

Creating A Clearer Path To Better Health

Broker Update | June 2023 | Vol. 18 No. 6

Advancing health equity is central to our mission and is woven throughout the work we do day in and day out. It’s good for our members, as well as businesses and the Western New York community. With this, it’s important to recognize the diversity of employees and how...

New And Improved Agent Onboarding!

Broker Update | June 2023 | Vol. 18 No. 6

We are excited to announce a new way Univera Healthcare will be managing your agents' data. This summer we will begin using the Miramar:Agent System to onboard agents, perform background checks, and more. Miramar:Agent is a web-based software solution that will help...

Prescription Drug Data Collection (RxDC) Report Submitted

Broker Update | June 2023 | Vol. 18 No. 6

On June 1, 2023, we submitted the Prescription Drug Data Collection (RxDC) report as required under Section 204 of Division BB, Title II of the Consolidated Appropriations Act (CAA), 2021. The submission included information for fully insured policies issued and for...

2024 Large Group Product Updates

Broker Update | July 2023 | Vol. 18 No. 7 - Special Issue

We’ve got exciting changes planned that will help groups and their employees enjoy even better health and wellbeing in 2024. Let’s look at what’s in store. Here’s What’s New for 2024*: Vitalize℠ ** Introducing Vitalize, a digital homebase dedicated to engaging teams...

Rx News - An Innovative Way To Reduce Spend On Specialty Drugs

Broker Update | July 2023 | Vol. 18 No. 7

Learn about Specialty Drug Benefit Optimization, an innovative program aimed at reducing spend on specialty drugs. When medical and pharmacy benefits are integrated, this program allows us to target specialty drugs that can be covered at a lower cost under the pharmacy...

Vaccines Are Important For Adults Too

Broker Update | July 2023 | Vol. 18 No. 7

Vaccinations are not just for children – adults need vaccinations, too. Immunity from some childhood vaccines can wear off over time and adults are at risk for different diseases (shingles, for example) than children. Vaccines are important during pregnancy too. According...

Preparing Children For Peak Asthma Season

Broker Update | July 2023 | Vol. 18 No. 7

If you have a child with asthma, now is the time to revisit their asthma action plan so you are prepared for the annual increase in asthma attacks that occurs each year as kids return to the classroom. A dramatic rise in the number of asthma flare-ups occurs each year...

Looking For Something?

Broker Update | July 2023 | Vol. 18 No. 7

Ever found yourself looking for a certain broker blast article or announcement? You know you read it and filed it away but now can’t locate it! Don’t worry, we’ve got you covered. We archive all our broker blast articles and announcements chronologically on the broker...

Making It Easier To Reinstate & Update

Broker Update | July 2023 | Vol. 18 No. 7

With the click of a button, we’re making it easier for groups to track and view requests to reinstate health plan policies for their members. Today on UniveraHealthcare.com, employers can go to the View/Update Policy tool to view or reinstate their members’ cancelled...

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