Private Payers News

Cigna + Oscar Extend Small Business Health Plan Footprint

The Cigna + Oscar brand’s small business health plan will be available to employers in California as businesses flounder due to the coronavirus pandemic.

coronavirus, access to care, telehealth, small business

Source: Cigna and Oscar Logos

By Kelsey Waddill

- Cigna and Oscar Health are extending the footprint of their small business health plan into California, partially in response to the economic fallout of the coronavirus pandemic, the companies announced.

“Cigna + Oscar brings together Cigna's nationwide and local provider networks, and Oscar’s member-focused experience, to deliver small group health insurance for the unique needs of small businesses,” said Bruce Grimm, Cigna's senior vice president of segments.

“We are excited to bring this innovative partnership to California to help small businesses prioritize their employees’ health needs.”

Cigna + Oscar plan enrollees can leverage both local and national provider networks through Cigna LocalPlus, which offers access to local providers, and Cigna Open Access Plus, the national network.

The plans also incorporate care teams that can help with health plan navigation. Behavioral healthcare support is also available.

By design, the partnership enables the payers to share the risk between them due to their reinsurance agreement.

“Cigna + Oscar provides a solution for the unique challenges that small businesses face by offering a variety of services that meet their employees’ health needs, and at a cost that helps make it possible to keep their doors open,” said Louis DeStefano, head of the small group business and senior vice president of growth at Oscar.

When it comes to cost, the payers have projected that businesses and employees will save each month by leveraging the Cigna + Oscar plan. Employees can choose from a diverse set of price points for various services. The plans also offer constant access to virtual care at no cost to the employee.

Employees can utilize pharmacy services through Cigna’s Express Scripts, which could result in cost savings.

From the beginning, the payers have touted that the plan will leverage Oscar Health’s full-stack technology platform, which allows employees to see their copay and deductible information and navigate their health benefits.

The plan will be available in the Bay Area, Central Coast, Greater Sacramento, Inland Empire, Los Angeles, Orange County, North Bay, and San Diego.

The expansion has been timed intentionally in response to the economic impacts of the coronavirus pandemic.

“Small businesses are the heart of the economy, and of their local communities. Now more than ever, they need affordable health insurance that works for them and their employees,” said Grimm.

“The COVID-19 pandemic has impacted us all, especially small businesses, in ways that no one could have imagined,” DeStefano agreed.

Although the pandemic has left many states scrambling to support their small businesses, perhaps no state’s scramble was as dramatic as California’s.

California is one of three states with the highest rates of both business closures unemployment, according to a 2020 Yelp report.

“California’s small business owners have been so heavily impacted by this pandemic and the subsequent closures, as they’ve worked hard to serve their communities and keep their customers and their employees safe,” Dee Dee Myers, director of the Governor’s Office of Business and Economic Development, said in response to a recent coronavirus relief grant program.

The state’s two lockdowns provoked many small business owners, who blamed the severity of the lockdown for their plummeting businesses. As a result, California is heading towards a recall election for its governor, Gavin Newsom.

As Cigna and Oscar Health seek to support California businesses, they may fall back on results from a survey that they conducted in 2020 which identified small businesses’ healthcare priorities.

The survey uncovered that small businesses—with 11 to 50 employees—were most focus on employee health and wellbeing.

The small business decision-makers had a broad range of interests, such as seeking flexible support recovery options, coverage for dependents, and personalized member engagement.

Small businesses are also focused on lowering healthcare costs, particularly premiums and deductibles, and telehealth.

With these elements in mind, Cigna and Oscar Health will pursue expanding their combined footprint, though they did not reveal when employers in California can expect to be able to access the Cigna + Oscar plan.