Fall 2023 Insight Employer Newsletter
New national provider network for 2024
Independent Health is pleased to announce our new enhanced national provider network through UnitedHealthcare will be available to you upon your group’s 2024 renewal date. This new network is a nationally recognized, comprehensive network that will:
- Make it easier for our Preferred Provider Organization (PPO) members living or working outside of Western New York to get the care they need.
- Replace the out-of-area network our members utilize when seeking care out-of-area under their Point-of-Service (POS) plan.
We have you covered
When seeking care, our local and national agreements have your employees covered when and where they need it, regardless of where they are located. UnitedHealthcare’s nationwide, participating network includes 1.6 million physicians and health care professionals*, 6,200 hospitals* and 13,500 labs.
Employers will now have a new viable, highly competitive option outside of Western New York that supports their health benefits strategy. Plus, it’s all backed by a dedicated team of RedShirts to support you and your employees every step of the way.
Please note: Due to system enhancements, we will be issuing new member ID numbers and cards, beginning with all groups that renew on January 1, 2024. The UnitedHealthcare logo will be included on the new cards.
If you have any questions, please contact your broker or Independent Health account manager.
*UnitedHealthcare network analysis, March 31, 2023.
Independent Health is one of only two health plans in the nation to receive 5 Stars from NCQA
Independent Health is one of only two health plans in the entire nation to achieve the highest possible rating for clinical quality and member satisfaction, according to the National Committee for Quality Assurance’s (NCQA) Commercial Health Plan Ratings 2023. NCQA is a private, non-profit organization dedicated to improving health care quality.
As part of this year’s NCQA Commercial Health Plan Ratings, 585 health plans from across the country were reviewed and rated based on their combined Healthcare Effectiveness Data and Information Set (HEDIS®), Consumer Assessment of Healthcare Providers and Systems (CAHPS) and NCQA Accreditation scores. Each health plan was rated on a 5-star scale for customer satisfaction, prevention and treatment.
Overall, Independent Health’s HMO/POS (Commercial) plan and Kaiser Foundation Health Plan of the Mid-Atlantic States’ HMO (Commercial) plan were the only plans to earn 5 stars for 2023. This marks the first time a Western New York health plan has achieved this prestigious recognition from NCQA. Previously, Independent Health was a 4.5-star rated Commercial plan from 2015-2022.
“After coming so close over the past eight years, Independent Health is tremendously proud to make it to the top of the NCQA Commercial Health Plan Ratings. In terms of quality coverage and member satisfaction, it’s like winning the Super Bowl,” said Michael W. Cropp, M.D., President and CEO, Independent Health. “Our 5-star status is the latest testament to our unwavering commitment to ensure our members receive the high-quality care they need and the exceptional service they deserve. This year’s ratings reflect the fact that not only are our members pleased with the care and service they are receiving, but they are also benefitting from our many efforts to educate them about the importance of preventive care and improve their overall experience as a patient. It’s just another example of what sets Independent Health apart from other health plans both here in Western New York and nationally.”
In addition to its overall NCQA 5-star rating, Independent Health was one of only two plans nationally to earn 5 stars in the category of member satisfaction and one of three plans to receive 5 stars for preventive care. The complete NCQA 2023 Health Plan Ratings are available at www.ncqa.org.
This year’s 5-star rating from NCQA culminates an impressive year of national recognition that has been bestowed upon Independent Health for all its lines of business:
- Independent Health is once again the only health plan in the nation to earn 5 stars from the Centers for Medicare and Medicaid Services (CMS) for its entire Medicare Advantage product portfolio – Medicare HMO, Medicare PPO and Medicare Prescription Drug plans. This marks this second consecutive year we have achieved this prestigious national designation. In addition, Independent Health is the only Western New York insurer to be recognized as a 5-Star Rated Medicare Advantage Plan for 2024 in the eight county service area.
- Independent Health recently achieved Tier 1 Status in the New York State Department of Health’s (NYSDOH’s) Medicaid Managed Care Incentive Program. This program focuses on the performance in quality and member experiences of health plans. Independent Health’s overall score was the highest among all participating health plans throughout New York state.
“Our deep roots in Western New York are only matched by our deep commitment to this community. Providing our members with the highest quality coverage and customer service is part of our DNA – it’s the RedShirt Treatment®,” said Dr. Cropp. “Combined with the strong relationships we have built with our physician and provider partners, we’ve been able to make it easier for members to receive the coordinated care and services they need to better manage their health and well-being.”
Update about Gag Clause Prohibition requirement
Under the Consolidated Appropriations Act, 2021 (CAA 2021), group health plans and health insurance issuers are required to annually attest they comply with the Gag Clause prohibition. The CAA 2021’s Gag Clause prohibition generally prohibit plans and issuers from entering into certain provider agreements that would:
- prevent the disclosure of cost or quality of care information or data, and certain other information, to active or eligible participants, beneficiaries, enrollees, plan sponsors, or referring providers, or
- restrict the plan or issuer from sharing such information with a business associate, consistent with applicable privacy regulations.
For your reference, the Departments of Labor, Health and Human Services, and the Treasury (“Departments”) jointly issued FAQ guidance (Part 57) addressing the Gag Clause prohibition provisions of CAA 2021.
As part of the CAA, the first Gag Clause Prohibition Compliance Attestation (“GCPCA”), covering the period from December 27, 2020 (or, if later, the effective date of the plan or insurance coverage) through the date of attestation, is due no later than December 31, 2023.
Independent Health will file the attestation on behalf of each fully insured large and small groups who had an Independent Health policy from December 27, 2020 through the submission date this December. There is nothing the groups need to do in order to comply. We will confirm our submission with the groups once we file the attestations in December. Subsequent GCPCA attestations will then be due each December 31.
If you have any questions, please contact your account manager.
Partnering with employers to provide customized workplace wellness programs
Independent Health has a long history of providing employers with the innovative tools, resources, and support they need to create and maintain effective workplace wellness programs. Many of these organizations and companies have been able to improve the overall health and well-being of their employees, which has led to reduced absenteeism and medical costs and increased productivity and morale.
At the same time, we understand that today’s employees are different than they were just a few years ago. Due in large part to the COVID-19 pandemic, a “one-size-fits-all” approach to corporate wellness is no longer viable or sustainable. Organizations, especially those on the larger side, have varying needs depending on their unique circumstances, such as their current work model (e.g., on-site, remote or hybrid), company culture, demographics of the population, and varying geographic locations.
In addition, now more than ever, it’s imperative that employers focus on all the aspects of wellness. Research demonstrates that when a holistic approach is integrated into a corporate wellness program, employees often feel more valued and motivated in the work they do. Here are the five main dimensions of wellness that all employers should now consider:
- Physical – Includes exercise, nutrition, weight management, disease management, sleep, etc.
- Emotional – Includes managing mental health conditions like stress, anxiety and depression.
- Financial – Includes being more informed and secure about personal finances (budgeting wisely, credit score, savings, debt, etc.)
- Work – Includes having purpose and happiness in job, feeling supported and engaged, work/life balance, development and learning opportunities, overall job performance, etc.
- Social – Includes building and sustaining meaningful relationships with co-workers, manager, friends and family, as well as being involved in the community.
Hometown support and solutions
As the only health plan with a team of corporate wellness specialists based here in Western New York, Independent Health can provide employers and their employees with the expert support and personalized experience they deserve.
For instance, we offer a wellness solution for large employer groups that goes beyond the typical workplace wellness program called FitWorks® Prime. Each group that participates in FitWorks® Prime is assigned their own wellness specialist who works one-on-one with them every step of the way. By analyzing the group’s medical and pharmacy claims, biometric screening results, and aggregate health risk assessment data, our wellness specialist will recommend engagement strategies that are tailored to specifically meet the interests and needs of both the organization and its employees.
At the core of FitWorks Prime is our unique FitWorks online wellness tool, which features a variety of prevention and engagement challenges that employees can complete to earn points. Challenges may include getting certain preventive health services, completing a health assessment, exercising for at least 150 minutes a week and taking part in community events, either as a competitor or volunteer. Points earned by employees for completing these activities can always be linked to incentives and rewards. Employers who wish to upload their own challenges to FitWorks can do so. Plus, they have access to a full reporting suite to monitor program outcomes so that they can see the true impact of their workplace wellness efforts.
We’re here for you!
As the local leader in corporate wellness, Independent Health can help keep your employees and your business healthy. If you would like more information about our workplace wellness solutions, contact your Independent Health account manager.
Simple ways to save money on prescription drugs
Prescription medications can help your employees maintain their health and prevent chronic conditions; however, they can also be very expensive. Not surprisingly, three in four American adults think the costs of prescription drugs are unaffordable. However, from using generic drugs to switching to a biosimilar medication, there are several ways your employees may be able to save some money on their medications. Learn more by visiting our “A Healthy Vision” Blog.
Worksite wellness program tax reminder
According to the Internal Revenue Service (IRS), rewards or incentives provided to participants of a worksite wellness program may be considered taxable. This includes any cash or cash equivalents (e.g., wellness cards, gift cards and nutrition benefits) that participants received. Independent health is prepared to provide an accounting of cash and cash equivalent awards received by your employees during the 2023 calendar year so that you may consider them in satisfying any related obligations under the applicable tax rules. If you would like us to provide a report specific to your company and employees who earned an incentive from one of our wellness programs, please contact your account manager. As always, when it comes to federal rules and regulations, we encourage you to speak with your legal consultant, accountant and/or tax advisor for professional advice.