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Hi, we’re Oscar. Smart, simple health insurance. Open Enrollment | Plan Year 2017 The information contained within is confidential and proprietary to Oscar Insurance Corporation, its parent and its affiliates (“Oscar”). This information may not be reproduced, distributed or disclosed in any form to any third party without the written permission of Oscar.
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Hi, we’re Oscar....• Oscar receives member, benefit, and agency info. • Oscar will bill member first check. Binder check is NOT required. • Oscar will send ID cards, process

Sep 03, 2020

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Page 1: Hi, we’re Oscar....• Oscar receives member, benefit, and agency info. • Oscar will bill member first check. Binder check is NOT required. • Oscar will send ID cards, process

Hi, we’re Oscar.Smart, simple health insurance.Open Enrollment | Plan Year 2017

The information contained within is confidential and proprietary to Oscar Insurance Corporation, its parent and its affiliates (“Oscar”).

This information may not be reproduced, distributed or disclosed in any form to any third party without the written permission of Oscar.

Page 2: Hi, we’re Oscar....• Oscar receives member, benefit, and agency info. • Oscar will bill member first check. Binder check is NOT required. • Oscar will send ID cards, process

Hi, We’re Oscar

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Founded in 2012

by Mario Schlosser, Kevin Nazemi and Joshua Kushner

Raised over $850M to date

From top investors Fidelity Investments, Google Capital, Goldman Sachs, Khosla Ventures, Founders Fund, General Catalyst,

Thrive, who were early supporters of PayPal, Tesla, Space X, Palantir, Warby Parker, Instagram and Facebook.

Grew from 14,000 members in our first year to over 135,000 by year 3

Expanded to California and Texas in 2016

400 employees and growing

Top talent from Apple, Google, Facebook, Bridgewater, McKinsey, Aetna and Cigna just to name a few.

Headquartered in downtown New York City with offices in Los Angeles and Dallas.

About Us

We wanted a better healthcare company.So we built one.

Page 3: Hi, we’re Oscar....• Oscar receives member, benefit, and agency info. • Oscar will bill member first check. Binder check is NOT required. • Oscar will send ID cards, process

Hi, We’re Oscar

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Healthcare is confusing. We’re fixing that with simpler plans, powerful tools and concierge service

What’s New for 2017

Get ready for 2017 with Oscar.

Simpler Plans

Copays for most routine care from day one. Deductible = Out-of-Pocket Maximum means Silver & Gold plans differ by one number

Powerful Tools

Log in to manage all your care in one place at hioscar.com or with the Oscar app for iPhone or Android

Concierge Service

Connect with your concierge service team every time you call

Page 4: Hi, we’re Oscar....• Oscar receives member, benefit, and agency info. • Oscar will bill member first check. Binder check is NOT required. • Oscar will send ID cards, process

Better Experience

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Page 5: Hi, we’re Oscar....• Oscar receives member, benefit, and agency info. • Oscar will bill member first check. Binder check is NOT required. • Oscar will send ID cards, process

Better Experience

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Agents often ask us, “What really makes Oscar different?!…”

High Tech & High Touch

We’ve designed a better health care experience. It’s like having a doctor in the family.

Understand the Product Simple Plan Designs Member Welcome Kits

Find Health Care Formulary Search Provider Search

Receive Health Care Doctor on Call Care Router

Get Personal Service Concierge Team Direct Message

Manage the Account Health History Easy Bill Pay

Page 6: Hi, we’re Oscar....• Oscar receives member, benefit, and agency info. • Oscar will bill member first check. Binder check is NOT required. • Oscar will send ID cards, process

Better Experience

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What are Oscar Concierge Teams?

Introducing Concierge Teams

We are redefining high touch customer service.Introducing Oscar Concierge Teams.

• Personal care teams for members

• Dedicated team of 3 Care Guides and 1 Concierge Nurse

• Members routed directly to their respective team

• Teams communicate via secure messaging, phone and email

• Teams reach out to healthy and sick members, and can:

• Help members find the right doctor or service

• Answer questions about follow up procedures

• Review medical claims

• Educate members on insurance benefits and Oscar perks

Page 7: Hi, we’re Oscar....• Oscar receives member, benefit, and agency info. • Oscar will bill member first check. Binder check is NOT required. • Oscar will send ID cards, process

Better Experience

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Our Members Love Us

Our Members Love Us.

They appreciate how simple we make it.

96% agree that Oscar made it easy to sign up for a plan

They use our tools.

Many members log in to their portal weekly, and we’ve rewarded our members

over $1M to date for hitting their daily step goals

They recommend us to friends & family.

Word of mouth is the #1 way people hear about Oscar, and we’re three times

as likely to be recommended vs. industry average

“The healthcare process was always a little intimidating until I was introduced

to Oscar. You guys are super personable, and you made it easy to understand

exactly what I was getting. You truly made me feel like my health was worth

your time.”

"Since joining @OscarHealth,

I’ve gotten Amazon $$ for

walking… Color me impressed.”

"Can I tell u how much I LOVE my

@OscarHealth Insurance!!!!! The dial a doc

feature is SO great for when you can't make it

to the office!”

Page 8: Hi, we’re Oscar....• Oscar receives member, benefit, and agency info. • Oscar will bill member first check. Binder check is NOT required. • Oscar will send ID cards, process

Product Demo

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Page 9: Hi, we’re Oscar....• Oscar receives member, benefit, and agency info. • Oscar will bill member first check. Binder check is NOT required. • Oscar will send ID cards, process

Better Care

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Page 10: Hi, we’re Oscar....• Oscar receives member, benefit, and agency info. • Oscar will bill member first check. Binder check is NOT required. • Oscar will send ID cards, process

Better Care

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California Network Overview

All our California plans have the same great provider network.

Key healthcare system providers include UCLA Medical Centers, St.

Joseph Hoag Health and the UCSF Hill Physicians Group.

Oscar’s integrated system of doctors and hospitals mean we are

able to offer members services other health insurers can’t match:

• Automated alerts to a member’s PCP if they visit the Emergency Room

• Detailed information to help members select the best doctor for their specific needs

60,000+Pharmacies Nationwide

27Hospitals

San Francisco County

We’ve built a quality provider network, the Oscar way.Get the care you need when and where you need it.

Page 11: Hi, we’re Oscar....• Oscar receives member, benefit, and agency info. • Oscar will bill member first check. Binder check is NOT required. • Oscar will send ID cards, process

Better Care

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Care Away From Home

What’s covered when you need care away from home?Members can access great care across the nation.

Talk to a Doctor for Free 24/7 Board-certified doctors for free over the phone 24/7 for common conditions like pink eye or the flu

When You Need an Rx

When It’s Urgent

In Case of Emergency

Over 60,000 nationwide pharmacies through partners CVS, Walgreens, WalMart and many more

Visit an urgent care center for things like cuts, sprains and other non-life-threatening issues

If there’s a life-threatening emergency when away from home, don’t panic. Visit the closest ER

Page 12: Hi, we’re Oscar....• Oscar receives member, benefit, and agency info. • Oscar will bill member first check. Binder check is NOT required. • Oscar will send ID cards, process

Better Plans

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Page 13: Hi, we’re Oscar....• Oscar receives member, benefit, and agency info. • Oscar will bill member first check. Binder check is NOT required. • Oscar will send ID cards, process

Better Plans

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2017 Plans Overview - CA

Oscar’s Plans. Health insurance without the headache.All plans come with access to great care and the Oscar experience.

Our plan design philosophy

Support if you’re sick.Deductible & Max

limits exposure to major medical bills.

Care Management

Doctors & nurses are here to help with complex care.

Concierge Service Team

for help with billing, claims and everything in between.

Easy access to routine care.with all Oscar plans

Free preventive care

Free, unlimited telemedicine

No referrals necessary

Fitness rewards

and our most popular plans have

$10 primary care visits

$25 labs (through Quest)

Free generic drugs

Page 14: Hi, we’re Oscar....• Oscar receives member, benefit, and agency info. • Oscar will bill member first check. Binder check is NOT required. • Oscar will send ID cards, process

The Plans

Our CA plans

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MarketPlans

SimplePlans

Competitive pricing

No referrals

Quality network:

UCLA Medical Center

St. Joseph Hoag Health

UCSF Hill Physicians Group

Selling Tips

Available

On & Off Exchange

On and Off Exchange

O

Available

Off Exchange

Most affordable premiums

+ best pre-deductible perks

Many tiers include

Free generic drugs

$10 primary care visits

$25 lab tests

$25 physical therapy visits

$50 preferred brand drugs

Page 15: Hi, we’re Oscar....• Oscar receives member, benefit, and agency info. • Oscar will bill member first check. Binder check is NOT required. • Oscar will send ID cards, process

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Deductible = Out-of-pocket maximum.

No coinsurance. Plans differ only by one number.

Better PlansThe Anatomy of Simple - CA

Increased protection from large medical bills and monthly savings

Coverage for everyday costs can allow some clients to choose a higher deductible plan for a lower premium.

Simple plans are only available off exchange in California

Silver and Gold plans include $10 PCP visits, free generic drugs,

$25 labs, $25 therapy visits and more…

Bronze plan includes $5 generic drugs

$7,150 $7,150 $3,000

Bronze Silver Gold

Max

Page 16: Hi, we’re Oscar....• Oscar receives member, benefit, and agency info. • Oscar will bill member first check. Binder check is NOT required. • Oscar will send ID cards, process

Work With Us

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Page 17: Hi, we’re Oscar....• Oscar receives member, benefit, and agency info. • Oscar will bill member first check. Binder check is NOT required. • Oscar will send ID cards, process

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1. Learn About Oscar

Visit the website to find training videos and downloadable content like plan comparison grids and FAQ responses.

2. Get Appointed

Work with your General Agent to get appointed through the online program.

3. Enroll Members

Sell plans both on and off the exchange. Oscar can be found on most online quoting and enrollment tools. Enroll off-exchange

members via Oscar’s website and create a custom enrollment link to share with clients

4. Get paid

We reward enrollments with competitive commission rates. Commissions are paid through our GA partners.

Work With UsBroker Resources

We make selling healthcare user friendly too.Visit our broker page at hioscar.com/brokers to get started today

Page 18: Hi, we’re Oscar....• Oscar receives member, benefit, and agency info. • Oscar will bill member first check. Binder check is NOT required. • Oscar will send ID cards, process

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Work With UsPro Tips

Selling health insurance can be just as complicated as using it.Here’s a few helpful hints and tips.

Enrollment & Eligibility

• If signing up a couple, make sure the policyholder will be on the plan for the full year

• If your client is close to receiving a subsidy (e.g., 420% FPL) enroll them on exchange

• Make sure on exchange clients submit relevant legal residency status and income documentation

• For clients receiving subsidies, check in with them during the year to update their expected income

Protecting Your Client

• Set your client up for auto payment through their web account so they don’t miss a payment

• Set your client up for a great Oscar experience by walking them through their Welcome Kit

• Show clients how to use the provider search tool so members know how to find in-network care

• If your client has a detailed benefit or claims question, direct them to their Oscar Concierge team

• Ensure the member completes the correct 1095 with an accurate SSN to submit with their taxes

Page 19: Hi, we’re Oscar....• Oscar receives member, benefit, and agency info. • Oscar will bill member first check. Binder check is NOT required. • Oscar will send ID cards, process

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2017 Commission Schedule for Oscar’s products in CA:CA Contracts Sold PMPM Fee

New Enrollment $15 PMPM

Renewal $10 PMPM

• You must be licensed and appointed to earn fee

• Receive PMPM commission fee on subscriber, spouse, and up to 3 child dependents

2017 Commission Schedule - CA Work With Us

Page 20: Hi, we’re Oscar....• Oscar receives member, benefit, and agency info. • Oscar will bill member first check. Binder check is NOT required. • Oscar will send ID cards, process

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2016 Commission Schedule for Oscar’s products in CA:California Contracts Sold PMPM Fee

New Enrollment $15 PMPM

Renewal $10 PMPM

• You must be licensed and appointed to earn fee

• Receive PMPM commission fee on subscriber, spouse, and up to 3 child dependents

Work With Us2017 Commission Schedule - CA

Page 21: Hi, we’re Oscar....• Oscar receives member, benefit, and agency info. • Oscar will bill member first check. Binder check is NOT required. • Oscar will send ID cards, process

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Grab your personalized enrollment link

Use our custom link builder to generate a unique link you

can send out to clients.

Clients enroll themselves online via our secure enrollment

platform. You get credit (and commission!) just as if you

submitted the application.

Work With UsBroker Resources

Personalized Enrollment Link

Page 22: Hi, we’re Oscar....• Oscar receives member, benefit, and agency info. • Oscar will bill member first check. Binder check is NOT required. • Oscar will send ID cards, process

Work With Us

Enrolling members

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Enrollment (choose one of the following options)• Broker submits off exchange application via our online enrollment form.

• Broker submits paper application to the GA for processing.

• Broker enrolls client on exchange via the marketplace website.

• Client enrolls with Oscar directly through the Broker’s Personalized Enrollment

Link, which gives the broker credit for the enrollment.

Onboarding• Oscar receives member, benefit, and agency info.

• Oscar will bill member first check. Binder check is NOT required.

• Oscar will send ID cards, process claims and bill members.

Agency• Oscar will provide a PCPM marketing/admin fee for services rendered

• Agency disburses commission payments.

Broker/ Agency

General Agency

Page 23: Hi, we’re Oscar....• Oscar receives member, benefit, and agency info. • Oscar will bill member first check. Binder check is NOT required. • Oscar will send ID cards, process

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Work With UsContacts

Got Questions? Here’s who you can talk to for more help…

Contact Your GA

• Getting Appointed

• Commission Inquiries

• Upcoming training opportunities

Contact Broker [email protected]

1-855-OSCAR-88 (option 4)

• Verity Member Enrollment, Premium Payment or ID Number (have member DOB, last 4 SSN digits, AOR ready)

• Ask a sales or product question

• Plan changes (e.g., add / remove dependent, member demographic information, etc.)

• Member Claims (you must complete a HIPAA authorization form to ask about specific claims)

• Make a Premium Payment

Contact Member Services1-855-OSCAR-55

Page 24: Hi, we’re Oscar....• Oscar receives member, benefit, and agency info. • Oscar will bill member first check. Binder check is NOT required. • Oscar will send ID cards, process

Thank you!HiOscar.com/brokers

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