Cigna Oscar Enroll Groups with Cigna Oscar User Guide

: May 15, 2024
: Cigna Oscar

Table of Contents

How to: Enroll Groups with Cigna + Oscar
Getting started
References
Read User Manual Online (PDF format)
Download This Manual (PDF format)

How to:
Enroll Groups with Cigna + Oscar

Cigna + Oscar cover age is insured by Cigna Healt hand Life Insurance Company.

How to: Enroll Groups with Cigna + Oscar

App licable to Ar izona, Calif ornia, Connect icut , Georgia, Illinois, Kansas, Missouri, and Tennessee Cigna + Oscar service areas.

Getting started

– Create an account or log in to the Oscar Broker Portal at: business.hioscar.com
– Complete your appointment. You must be appointed with Cigna + Oscar to enroll a group on a Cigna + Oscar plan. Check out our appointments how-to- guide for step by step instructions.
– Run a quote. In order to enroll a group on a Cigna + Oscar plan with composite rates, begin by clicking on a saved quote. See our quoting how-to guide to learn more.
– Review our Underwrit ing Guidelines. Reference our Underwriting Rules for important details on Cigna + Oscar eligibility requirements:
– Arizona Underwrit ing Guidelines
– California Underwriting Guidelines
– Connect icut Underwrit ing Guidelines
– Georgia Underwrit ing Guidelines
– Illinois Underwrit ing Guidelines
– Missouri Underwrit ing Guidelines
– Kansas Underwrit ing Guidelines
– Pennsylvania Underwrit ing Guidelines
– Tennessee Underwrit ing Guidelines

(For age-rated pricing, skip to Step 3b, pg. 6)
Step 1: Open a saved quote from your Oscar Small Group Dashboard. The dashboard can be found after logging in and clicking on ?Group Book? in the upper right. In the quoting dashboard, you?ll see all of your saved quotes. Your saved quotes are searchable by business title and quote name. Quotes can have the following statuses:
Saved – An editable quote for a future enrollment date
Applied – A quote that you?ve used for a group application.
Expired – A quote for a past effective date. These quotes cannot be edited or applied. Cigna Oscar Enroll Groups with Cigna Oscar - setting
1 Step 2: Start the final review process from your saved quote. Fill out all applicable business information. Note: You will not be able to edit the pricing type for your group once you begin your enrollment application. Step 3: Review group details. All previously selected plans from your saved quote will carry over. Click on the blue ?Start application? button to begin the group?s enrollment application. Cigna Oscar
Enroll Groups with Cigna Oscar - setting 3 Step 4: Business Info
Enter in the business?s key contact information. Cigna Oscar Enroll Groups
with Cigna Oscar - setting 4 Step 5: Eligibility
Select the group?s preferred coverage start date and fill additional business eligibility details. Please make sure to reference our Underwriting Guidelines for more details on eligibility requirements.

Arizona Underwrit ing Guidelines
California Underwriting Guidelines
Connect icut Underwrit ing Guidelines
Georgia Underwrit ing Guidelines
Illinois Underwrit ing Guidelines
Missouri Underwrit ing Guidelines
Kansas Underwrit ing Guidelines
Pennsylvania Underwrit ing Guidelines
Tennessee Underwrit ing Guidelines

Key callouts:

The zip code of the business enrolling must be within a Cigna + Oscar service area. You will not be able to proceed if the business zip code is outside of the Cigna + Oscar service area.
At least 70% of eligible employees must live within the Cigna + Oscar service area.
Any enrolling employees that reside out of the Cigna + Oscar LocalPlus® service area must enroll in an Open Access Plus Plan.

Cigna Oscar Enroll Groups with Cigna Oscar - setting 5 Step 6: Coverage
You may select up to 3 plans to offer for coverage. In states without employee classes, the class field will be populated to ?default? which will include all eligible employees. All of your previous plan selections from Step 1 will carry over. Make adjustments to your plans as needed here.
Note: Final rates are based on the group?s init ial enrollment and effect ive date and as a result may vary from quote. Cigna Oscar Enroll Groups with
Cigna Oscar - setting 6 Make sure to review the “Update this coverage” section to select domest ic partners and deduct ible accumlator information. Step 7: Employee Manager
Finalize the employee application. Group census information that was previously entered from your quote will be carried over here. Edits can be made manually or by uploading a spreadsheet in the .csv format.
Employees can enroll in 2 ways:

Manually by broker – Add all employee information. Where possible, it ‘s important to add employee email information so your clients can easily access their digital ID cards and receive key updates and notifications about their Cigna + Oscar plans.
Manually by employee – Employees can be sent an email prompting them to complete their application. After an employee submits their information, the Broker of record and/or General Agent will be notified and then has the ability to include all employee details as part of the group application.

Manually by broker and/ or GA
The employee application requires the following details:

Employee contact information
Employee demographic information (if applicable, family member information)
Plan selection

Manually by employee
After an employee?s application is submitted, the status and color of the bullet point will be updated with plan details. Cigna Oscar Enroll Groups
with Cigna Oscar - setting 8 Step 8: Payment Details
A group can make payments in one of 2 ways:

By bank account. Confirm the group?s bank routing information. This method is preferred so that groups can get their ID cards as quickly as possible.
By check. Note that payments may take up to 10 days to process. Groups can mail their checks to the address listed on their invoice. Note: The bank account on file will be automatically drafted within 48 hours.

Step 9: Document Upload
Upload the required documentation for the group. Note: Required documentation varies by state. Review the Underwriting Guidelines if you have any additional questions.

Arizona Underwrit ing Guidelines
California Underwriting Guidelines
Connect icut Underwrit ing Guidelines
Georgia Underwrit ing Guidelines
Illinois Underwrit ing Guidelines
Missouri Underwrit ing Guidelines
Kansas Underwrit ing Guidelines
Pennsylvania Underwrit ing Guidelines
Tennessee Underwrit ing Guidelines

Cigna Oscar Enroll Groups with Cigna Oscar - setting
11 Step 10 (Final step!): Review & Submit
A final enrollment application checklist will appear. For any pages with incomplete or invalid information, a warning sign will appear next to the page name.
Quoted Rates are subject to change based on final enrollment.
Once all steps are completed, click on the Submit Application to submit. If any information or documentation is still missing, you and the group will receive a notification outlining the missing documentation and how to submit it. Please be sure to check your inbox and spam filter.
Final Rates:

Locked for 12 months after group approval regardless if any off-cycle member enrollment changes (additions, terminations, etc.)
Can be viewed on the employee manager section for age-banded groups or our quarterly rate grids
Can be viewed on the employee manager section for composite rated groups and on the landing page when clicking the plan design

Cigna Oscar Enroll Groups with Cigna Oscar - setting
12 After you submit your application, Cigna + Oscar?s Eligibility Team will make the final decision to accept or decline the group for coverage, specify terms of coverage, or grant requests for changes, subject to Cigna + Oscar?s policies and applicable law. Agents and Brokers aren?t authorized to bind or guarantee coverage, premium rates, or effective dates. Businesses should maintain their existing coverage during the application process.
Be on the lookout for a confirmat ion email and any follow up quest ions the Cigna + Oscar Eligibility Team may have about your applicat ion.
Deductible Credits:

We can accept the deductible credit form with copies of EOB’s OR we can take spreadsheet reporting from the prior carrier.
Credits are only eligible for groups enrolling with a calendar year deductible
Must be submitted within 60 days of a groups effective date

Cigna + Oscar coverage is insured by Cigna Health and Life Insurance Company. CA: benefits administered by Oscar Health Administrators. Other states: benefits administered by Oscar Management Corporation. Pharmacy benefits provided by Express Scripts, Inc. Cigna + Oscar health insurance contains exclusions and limitations. For complete details on product availability and coverage, please refer to your plan documents or contact a representative.

Learn more at hioscar.com/brokers/cigna