Perhaps an unlikely partnership, Cigna and Oscar Health teamed up to jointly launch small business health plans. On Tuesday, they named the first markets where they plan to offer the new service.
The new plans, dubbed “Cigna + Oscar,” will be offered in Atlanta, the San Francisco Bay Area, and across Tennessee. All of the plans are still pending regulatory approval, but the companies hope to make them available in the fourth quarter.
Both Cigna and Oscar have been looking to expand their footprint for small group plans, which apply to businesses with 100 employees or fewer. Oscar, a New York-based insurance startup known for its tech-savvy approach, could also benefit from Cigna’s footprint. The startup initially began offering ACA marketplace plans, but has since expanded to small group and Medicare Advantage plans.
The new plans will give members access to Cigna’s network of providers and hospitals. They will also include access to 24/7 virtual urgent care visits at no out-of-pocket cost, and in some states, access to Oscar’s $3 prescription drug formulary.
Members will also have access to Cigna’s behavioral health coaching programs and crisis helpline.
A Deep-dive Into Specialty Pharma
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
The health plans will not cover dental and vision services for adults, though they will cover pediatric services. In an email, Cigna confirmed that its subsidiary, Express Scripts would administer pharmacy benefits for the new plans.
The companies have not yet disclosed pricing. They will split the risk equally through a reinsurance agreement.
Both Cigna and Oscar have indicated that they plan to expand the partnership in the future. In light of the ongoing Covid-19 pandemic, they expect to see increased interest from small businesses.
“Small businesses are the lifeblood of the U.S. economy and have been significantly challenged by the COVID-19 pandemic,” Chelsea Cooper, senior vice president of small group business at Oscar, said in a news release. “Cigna + Oscar was created with the purpose of addressing small businesses’ unique challenges through solutions tailored to their budgets and care designed to prioritize their employees’ health needs.”
Photo credit: JungleOutThere, Getty Images
