The first major insurer is the North Shore-Long Island Jewish Health System, Oscar, which is founded by 3 tech-savvy Harvard Business School graduates and Health Republic, which is a new type of nonprofit health insurer created by the Affordable Care Act.
The Exchange - being the marketplace where individuals and small businesses can, with the help of navigators, buy their health insurance. "Long Island is one of the markets around the country that is showing a true increase in choice," said Joseph Berardo, chief executive of MagnaCare, which manages plans for self-insured organizations in New York and New Jersey. "I think this is one of the most exciting and most competitive times in my 20-plus years in New York health care." MagnaCare isn't participating directly, but is leasing parts of its network of 81,000 doctors and other health care providers to two of the newcomers: Oscar and Health Republic.
The third, North Shore-LIJ Care Connect, will use its own 15 hospitals and 400 doctor and ambulatory care practices. All three insurance companies are claiming cost effective care though they can offer ore clarity once the exchange is operative. "Not all insurance is equal," said Janine Logan, spokeswoman for the Nassau-Suffolk Hospital Council, which the state has appointed to provide trained navigators at sites throughout Long Island. "It depends on what premiums you're willing to pay each month, how much coverage you want, and the provider networks the plan offers. Like anything else, you should comparison shop." Alan Murray, hired from United Health Care as chief executive of North Shore-LIJ CareConnect, said that the insurance exchange "really changes the landscape. It's a fundamental shift."
Now, he said, customers will have "a direct portal of entry" to compare health plans. And, he said, he knows that if their experience with North Shore-LIJ Connect is not good, "next year they can use their dollars and go elsewhere."
Health Republic, which will be offered in New York City, Long Island, Westchester, Albany, Buffalo, Syracuse and Rochester, is the only CO-OP in New York and although a separate entity from Freelancers, uses the same model, said Health Republic chief executive Debra Friedman. "We're happy to provide alternative to traditional insurance models," she said. It's the only insurance company in the exchange that is member owned. Because the majority of board members will be health plan members, the company will have fewer administrative costs. "Because we don't have public profit margins, members profit from lower premium prices," Friedman said. "We're able to be highly effective and efficient." Oscar is started by three Harvard Business School graduates, the founder of which is Joshua Kushner, 28, who felt that the relationship of the insurer with the customer was very strange as, "They do everything to acquire customers and then do everything to avoid dealing with them," he said. "What if you took that relationship that is broken and made it simple and transparent?" Kushner and two friends - Kevin Nazemi from Harvard Kennedy School and Mario Schlosser a graduate of the Stanford University together want to make the company seem like a person.
The trio aspires to make something as complex as health care simple and affordable, and as Kushner said: "Young people want to work on big problems."
Hannah Punitha (IRDA Licence Number: 2710062)
Ridgely Ochs September 2013