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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
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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.
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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
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Better Experience
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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
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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
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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!”
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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.
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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Thank you!HiOscar.com/brokers
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