Introducing Cigna OAP and Medical Infusion Carve-Out Program

HealthEZ, an innovative third-party benefits administrator, announces the launch of several new product solutions aimed at helping self-funded and level-funded employers achieve significant cost reductions of up to 20% or more. These additions build upon HealthEZ’s renowned Cost Containment methodology, enhancing clients’ Discount Methodology, Smart Coverage Design, and Access Management capabilities.

Discount Methodology Product Solutions

HealthEZ has expanded its national network solutions by introducing Cigna Open Access Plus (OAP) and Cigna Local Plus in key markets nationwide. These new offerings emphasize greater discounts and feature high-quality, cost-effective providers. Cigna OAP, an exclusive network by Cigna Health Plans, delivers discounts 4% better than standard PPO networks. Additionally, HealthEZ introduces Cigna Local Plus, strategically designed to include top-tier, lower-cost providers across 30 national markets, potentially reducing plan costs by up to 9% compared to traditional PPO plans.

Access Management

Having pioneered alternative pharmacy benefit programs, HealthEZ has achieved 29% lower costs than industry benchmarks for self-funded health plans over the past decade. Building on this success, HealthEZ launches the Medical Infusion Carve-Out (MICO) program, targeting over 275 high-cost specialty infusion services. Introduced in beta in 2023 and now broadly available, MICO has demonstrated savings ranging from 30% to 70% compared to PPO network contracts.

Josh Schreiner, Chief Product Officer at HealthEZ, commented, “Employers facing escalating drug costs are reevaluating health plan and pharmacy benefit structures. Our new solutions for self-funded and level-funded health plans offer another effective tool to provide high-quality, cost-efficient health benefits while controlling expenses related to conditions like Oncology, Crohn’s Disease, Psoriasis, Ulcerative Colitis, Rheumatoid Arthritis, and more. This program not only delivers savings on stop-loss premiums and eliminates lasers, but also helps maintain flat renewals, benefiting employers, members, and providers alike.”

More on MICO:

MICO focuses on reducing costs for over 275 high-cost specialty infusion services through innovative approaches such as Manufacturers Assistance Programs (MAP) and HealthEZ’s proprietary Cost-Plus solution. This program ensures financial relief for members burdened by medical infusion expenses while preserving access to premier centers of excellence. HealthEZ’s bundled Care Advocacy program simplifies the process for providers and members, ensuring seamless care and substantial savings for plan sponsors and members.

HealthEZ will host a webinar on Thursday, July 25th to delve into the program details, present case studies, and offer insights on how HealthEZ can assist in reducing specialty drug costs. Register for the webinar here.

About HealthEZ:

Based in Bloomington, Minnesota, HealthEZ is a national independent third-party health benefits administrator of employer-sponsored, self-funded medical plans and America’s PPO, the nation’s first preferred provider organization. HealthEZ is on a mission to make health insurance easy to understand and more efficient from provider to patient and the employers who fund their plans. The company partners with employers throughout the United States to deliver better access to healthcare for their employees while ensuring value and improving outcomes. More information about HealthEZ can be found at healthez.com.

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