The North Shore-LIJ Health System became the first private health care provider to create a commercial health insurance company with the introduction of insurance plans from North Shore-LIJ CareConnect on Tuesday.
As a major health care provider, North Shore-LIJ will sell insurance coverage to individuals, and small and large businesses for exclusively in-network coverage of treatment by physicians employed by North Shore-LIJ or affiliated with it.
“North Shore-LIJ is one of the largest providers in the region. That’s really the backbone of launching an insurance company that uses that system as its mainstay,” said Alan Murray, president of North Shore-LIJ CareConnect. “Without that health care system, we wouldn’t be able to launch an insurance company that connects all the dots.”
The creation of the insurance company and its health insurance products coincides with the introduction of state insurance exchanges under the Affordable Care Act.
The New York State of Health site (www.nystateofhealth.ny.gov), which allows consumers to buy insurance online, crashed two hours after it was launched as two million users attempted to access it.
Murray said North Shore-LIJ CareConnect seeks to simplify navigating the health care system for its customers by working “hand in hand” with physicians in overseeing their medical treatment needs.
“We’re going to make sure they get through the health care system as efficiently and effectively as possible,” he said. “It really brings an entire level of coordination of the individual than just an insurance company on its own. We can make sure the path to an outcome is the most efficient outcome possible”
North Shore-LIJ currently maintains a network of 16 hospitals in the New York metropolitan area, with more than 7,000 participating health care providers and more than 400 ambulatory and ancillary sites. While its plans are restricted to in-network coverage, Murray said its health insurance plans will cover emergency care anywhere.
He said North Shore-LIJ CareConnect, which will be sold on both the state’s online health exchange and directly, can provide referrals to physicians for customers who need treatment.
North Shore-LIJ CareConnect premiums for individual coverage range from $180.53 a month for catastrophic care coverage with a $6,350 deductible to $568.13 per month with no deductible for its platinum care coverage. Three other plans, designated as bronze, silver and gold provide individual coverage for $330.13 a month with a $3,000 deductible, $419.62 a month with a $2,000 deductible and $487.34 a month with a $600 deductible respectively.
Health insurance for individuals and businesses are available in Nassau, Suffolk, Queens and Richmond counties.
Plans offered outside of the online state insurance exchange also will be available in New York County.
Murray said North Shore-LIJ sees the potential to grow its health care network through CareConnect and establish new relationships with other private health insurers.
“It makes sense for North Shore to expand its footprint and go into other markets,” he said. “This facilitates the ability to bring in new paying models.”
Murray said North Shore-LIJ CareConnect is currently in discussions with other private insurers about establishing business relationships with them.
He said North Shore-LIJ CareConnect could partner with a provider such as Blue Cross/ Blue Shield, which would pay fees to CareConnect and provide incentives for customers to use physicians in the North Shore-LIJ network.
Consumers can access information about North Shore-LIJ CareConnect coverage or purchase insurance on its Web site at www.nslijcareconnect.com or by calling 1-855-706-7545. Information is also available on the New York State of Health Web site.
Murray said North Shore-LIJ CareConnect is currently building a customer care center at 2200 Northern Blvd. in East Hills that will open in early December. He said consumers will be able to get answers about coverage options at that office, including information on other companies’ coverages and the opportunity to purchase another company’s health care plan.
“It’s a different philosophy. It’s about providing the best coverage for the community,” Murray said.
