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Small Business Predictions for 2022

A Q&A with Oscar’s Troy Parant BY PHIL CALHOUN

I RECENTLY CAUGHT up with Troy Parant, the senior director of Sales
(West) for Cigna + Oscar, to talk about Oscar group plans. I learned a great deal worth sharing with you here.

Phil: We’re thrilled to have more options for our California small group employers. Would you introduce yourself and tell us a little bit about Oscar and what you see for 2022?
Troy: I’ve been in the benefits space for over 10 years, helping businesses offer better benefits and spend their health care dollars more efficiently. There are so many different strategies and solutions in health insurance. Unfortunately a lot of them are geared toward large group employers. When someone is accessing health care, it is a very personal thing. That puts employers in a position where they need to choose the entry point to the healthcare ecosystem for their employees by picking an insurance carrier.

Historically, all carriers have been created somewhat equally. Oscar is doing things differently by putting the member at the center of everything that we do. We set out to create a health insurance company that behaves more like a doctor in the family. We give you a personal advocate to help navigate care, get questions answered without getting bounced around or waiting
on hold. Having a personal advocate has never been a thing in small group insurance. We’re happy to be bringing it to a new market segment and setting that new standard.

Phil: You launched Cigna+Oscar in the Bay Area in California on January 1, 2021, then in Southern California on April 1, 2021. Launching a health plan in such a complex market is no simple feat, let alone during a pandemic. How is Oscar doing in this regard?
Troy: Oscar was a pretty remote (virtual) company prior to everyone needing to work from home, so that adjustment was relatively easy. That said, this is the first time we, like many organizations, have interviewed, hired and managed teams in a fully virtual environment.

Cigna + Oscar, a fully insured small group product, is in nine markets across eight states and we are growing quickly. We’ve learned a lot in the last year and a half and are using those learnings as we launch new markets. There are certainly some challenges that are unique to California, where each region operates like its own market. Likewise, launching a health plan would typically be complemented by a series of general agent/broker meetings. Now that’s all gone virtual. The reduction in social events where you would typically build buzz about your product has its own challenges, with only limited in-person interactions. We are a relationship business and we’ve had fun finding ways to interact with our distribution channels. While we’re all craving the big industry events to interact with each other, our partners and clients are all dealing with the same issues within their own day-to-day businesses.
Those small businesses need solutions that will keep their employees focused on their jobs.

Phil: You mentioned Cigna + Oscar. Can you tell us more about how your organizations came together? And how they are set up?
Troy: This is a partnership where the companies share risk equally under
a reinsurance agreement. As for how we came together, Cigna and Oscar leadership teams were eager to grow within the fully insured small group market, believing it’s an important segment of the market. For Cigna, many of the existing solutions in the market tend to center on similar networks and pricing, making it difficult to take share from existing carriers. Meanwhile, the Oscar team was eager to find a network solution that could complement our differentiated member and broker experience. It’s a great partnership allowing both companies to leverage our strategic advantages to bring a truly differentiated product to market, and we’re extremely encouraged by the early market response to the partnership and product.

2022 promises to be in some ways, even more challenging.

Phil: So, you’re bringing Cigna’s large group networks to small group. That’s great for such a dynamic market like California. What unique challenges do you see for the small group segment?
Troy: 2022 promises to be in some ways, even more challenging. As businesses look to reopen and navigate a hybrid world, benefits will become even more important. Some businesses may be adding remote flexibility, allowing employees to move out-of-state. With this dynamic, small businesses have a challenge that is different from their larger employer counterparts. For example, California state law requires 51% of enrolling employees to live in the state. There could be some regulatory changes needed to relax this requirement or allow carriers to apply some discretion, even if just temporarily. We’re lucky to be able to offer a national network option to small businesses to meet this need.

There’s also the need to recruit and maintain great talent, which has become increasingly challenging in today’s climate. Employers are reevaluating their benefits offering — looking for ways to manage their budget and take care of their employees.

And right now, taking care of their employees also means taking care of their mental health. We’ll continue to see increased demand for affordable plans that also offer mental health coverage. Cigna + Oscar offers access to Cigna’s behavioral health network as well as to Talkspace for virtual behavioral access. Employees need to have access to coverage in-person or virtual and we’ll continue to meet those needs. Phil: What does this mean for brokers?

Troy: What this means for brokers is offering a traditional local provider-based plan as the only option may no longer work for many employers. The 30-mile radius that an HMO requires had some employees questioning how they were going to take advantage of their new flexible work arrangement. I don’t see that changing. More employers require access to plans with multi-state networks and greater flexibility around pairing or slicing with another carrier.

Oscar is doing things differently by putting the member at the center of everything that we do.

At Oscar, our mission has always been focused on refactoring healthcare to make high-quality care affordable and accessible. We are working with Cigna and their national networks but still have to comply with state rules that require more than half the group to be in California. So, we’re watching this closely, and you should too. What’s encouraging for us and the broker community, is the rapid acceptance of virtual meetings. This has allowed us all to be more efficient by spending less time commuting — both carriers with brokers and brokers with their clients. At Oscar, we’re a tech company and an insurance carrier rolled into one. So, in some ways putting on a good virtual meeting has always been part of our existence. Fast forward a year and a half and almost everyone in the industry is an expert, with fancy backgrounds and other enhancements, to stage webinars.

While I don’t think everything can be replaced by virtual meetings and we’ll get back to in-person work in due time, the decrease in commuting time has led to an increase in efficiency, effectiveness, covering more ground in any given day. I think that is something that will be fine-tuned as we find the right balance between virtual and in-person. It’s also been nice to see people create different connections while working from home — a barking dog or crying baby in the background, while an “oops” in the past, can now create connections now that we wouldn’t have had before.

Phil: What support is available for brokers to bring the Cigna + Oscar program to their clients?
Troy: One way we’ve been supporting brokers through these changes is with our ability to deliver virtual care. This was an effort we were focused on before the pandemic and have doubled down since. For example, we recently launched Virtual Primary Care in Georgia and Tennessee. We also recognize the need for concierge care: I mean true concierge teams who form relationships with our members, guide care and answer the simple to the most complex questions –– all without needing to pick up the phone if you don’t want to. And we wouldn’t be able to reach employers to offer these solutions without supporting brokers in the ways they prefer to be supported. For that reason, we are happy to support — and are grateful for the support of — our general agent partners and tech integrations, who helped launch our products very early. And are now helping us through our big expansion to Southern California. Our general agent partners have been incredible in supporting Cigna + Oscar, getting resources to our brokers and making sure small group employers know the new standard that’s available to them. For that, I want to thank them as well.

Phil: Can you tell us a little bit more about that? What trends brokers should prepare for in 2022?
Troy: More acceptance and demand for virtual care. It’s interesting to think how far telemedicine has come over the past two years. The idea of seeing a doctor online used to be a hard sell. But when the pandemic hit, virtual care visits grew exponentially. In a survey by the McKinsey Institute, about 40% of consumers said they will keep using telehealth after the pandemic. As we move forward, offering healthcare plans with a virtual component is a must, especially if you are a small business owner. Prior to the pandemic, large employer groups were happy to get anywhere close to 10% adoption. In small group, utilization of telemedicine was virtually nonexistent.
Telehealth is more than just a convenient way to get answers about health concerns while wearing your pajamas. Virtual care is changing how we provide and invest in healthcare. The Deloitte Center for Health Solutions surveyed healthcare executives and found that “by 2040, a major portion of care, prevention, and well-being services will shift to virtual settings.” Additionally, three out of four executives predict ‘industry wide investments in virtual health would be more than 25% over the next decade than today.’

Although virtual care won’t replace in-person care, we believe it’s here
to stay. While the convenience and affordability make it an attractive offering for both patients and providers, the benefits are also there for small business owners. Out of 1,594 doctors and qualified health care professionals surveyed in the Telehealth Impact Physician Survey, more than 75% said that virtual care allowed them to give quality care for chronic disease management, emergency room follow-up appointments, mental health and more.

Phil: Does Oscar have personalized assistance for members in need of a higher level of help?
Troy: Yes. Oscar’s Concierge makes a difference by being truly personal. While most carriers have something called concierge, it is often just a rebrand of their customer service line. Have you ever had to call an insurance carrier, picked up your card, looked at that 888 number and couldn’t wait to dial? You can order a pizza from your phone with a few clicks and track it on a map down to the second it is actually delivered. Why does health insurance have to be so archaic?

When we talk about accessible care, it is not just having access to the best providers in the country. Guided care means getting help finding the right providers and getting answers to everyday questions, without long holds or being directed to a confusing website. At Oscar, we anticipate this need growing as consumers have  more complex questions and concerns about their coverage. The standard has been set for the business administrator or broker to be the first line of contact for some of these questions but we feel that we can build that foundation of trust directly with our members by having a truly personal relationship.

There are certainly some challenges that are unique to California, where each region operates like its own market.

At Oscar, we support each one of our members by pairing them with a Care Team. This is a team of care guides and nurses who can help answer questions and guide them towards the most affordable and highest quality care in their area. One of the many benefits of having this relationship is that it’s an efficient way to gather health-related information, and empowers the member to make well-informed decisions about their care. Members will always have access to the same team who know them personally, and they can reach out anytime via our convenient app.

If members trust their carrier, it frees up our brokers’ time and quite frankly, the business administrators too, allowing them to add value to the business itself and not by servicing employees.

Phil: Outside of the platform Oscar has built, what are some other ways you’re helping employers attract and retain talent?
Troy: Employee benefits can get complicated. When you look at the different moving pieces that make up a plan, you can make it pretty simple for an employer. They want to know what their employees are going to pay when they need care (ie: copay/deductible), who they can get care from (network) and what they pay each month to have the plan (premium).
We like to think we’re creating a new category with the better member experience I mentioned earlier. With that said, there is typically a balance between those points — that’s where the broker community is so important. Offering the best benefits out of the box through a Platinum plan is one way to attract and retain talent — we’re seeing a lot of that as the Oscar experience
has a more “luxury” feel.

But there is also a growing community of brokers who see the value in consumer driven healthcare: namely, how to use a high deductible plan in conjunction with a health savings account or health reimbursement arrangement. I’m fortunate to know a lot of those brokers from my previous roles in healthcare and they’re doing incredible work for their clients. It’s not often you can get better than platinum benefits for the cost of a silver plan. But the brokers who understand how the numbers work on those plans and how to complement them with the tools provided by Oscar are doing amazing things for their clients.

Phil: How has Oscar grown over the past year?
Troy: On March 3, 2021, Oscar officially went public after nine years of offering affordable access to healthcare for our members. Additionally, during the upcoming Open Enrollment period, we plan to offer health insurance to individuals and families in three new states and 146 new counties. With this expansion, Oscar will have a footprint in a total of 22 states and 607 counties across our Individual & Family, Medicare Advantage, and Small Group (including Cigna + Oscar) plans. 2022 will mark the fifth consecutive year we expand our footprint. In total, Oscar is serving 560,000+ members as of June 30, 2021.

Phil: What message do you want brokers to take away from this conversation?
Troy: Brokers who take a deep look at their relationships with their carriers can consider how those carriers operate as their partner through the changes we’re seeing throughout the state and even the country. Are they ready to adapt to the market changes? Are they ready to support you through your changes? Does their “product” still fit your customers’ changing needs? Do they value your time and what it takes to serve small businesses in this evolving climate? The standard for what members, business administrators, brokers and general agents expect from their carriers is changing quickly. I’m proud to say that Cigna + Oscar is uniquely positioned, because of the foundation we’ve built, to serve brokers through these changes.


TROY PARANT is the senior director of Sales (West) for Cigna + Oscar.
For more info about Oscar, contact your general agency partner or email GetCoveredForBusiness@HiOscar. com




PHIL CALHOUN is the president of Integrity Advisors in Tustin, California. Reach out to Phil here: Phil@integrity-advisors.com.