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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
FORM 8-K
CURRENT REPORT
PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
DATE OF REPORT (DATE OF EARLIEST EVENT REPORTED): JULY 20, 1999
OXFORD HEALTH PLANS, INC.
(Exact name of registrant as specified in its charter)
Delaware 0-19442 06-1118515
(State or other jurisdiction) (Commission (IRS Employer
of incorporation) File Number) Identification No.)
800 Connecticut Avenue, Norwalk, Connecticut 06854
(Address of principal executive offices) (Zip Code)
(203) 852-1442
(Registrant's telephone number, including area code)
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ITEM 5. OTHER EVENTS.
In September 1998, the Company's New Jersey HMO subsidiary, Oxford
Health Plans (NJ), Inc., entered into an agreement with Heritage New Jersey
Medical Group, P.C. ("Heritage") to provide network management services for
individual Oxford Medicare Advantage members who reside in New Jersey.
In view of uncertainties in the regulatory environment and other
considerations, the Company has decided to wind down the network management
agreement with Heritage. The Company is committed to a smooth transition of
network management responsibilities back to the Company's operations and the
agreement with Heritage provides that Heritage will cooperate with the
transition.
Over the next several weeks, the Company will finalize the details of
plans to transition the previously delegated services associated with its 13,000
Medicare members in New Jersey. Through this transition, the Company will work
directly with New Jersey health care providers so that valid claims are paid
according to applicable contractual agreements. The Heritage agreement is not
applicable to the Company's 287,000 commercial members in New Jersey.
The wind-down of the Heritage agreement will result in an increase in
the Company's health care and administrative costs for this business for the
second quarter of 1999 and is expected to result in increases for the remainder
of the year. The Company has not completed preparation of its second quarter
results; however, given the relatively small membership in the Heritage
arrangement, the wind-down is not expected to prevent the Company from achieving
its financial goals for the quarter or the year. The Company also expects that
there will be a significant decrease in New Jersey Medicare membership going
into next year.
CAUTIONARY STATEMENT REGARDING FORWARD-LOOKING STATEMENTS
Certain statements in this statement, including statements concerning
future results of operations, future health care and administrative costs, and
other statements contained herein regarding matters that are not historical
facts, are forward-looking statements (as such term is defined in the Securities
Exchange Act of 1934, as amended); and because such statements involve risks and
uncertainties, actual results may differ materially from those expressed or
implied by such forward-looking statements. Factors that could cause actual
results to differ materially include, but are not limited to:
- - Changes in Federal or State regulation relating to health care and
health benefit plans.
- - Rising medical costs or higher utilization of medical services.
- - High administrative costs in operating the Company's business.
- - Any unexpected costs incurred in the wind-down of the Heritage
agreement, including medical costs, litigation expenses, damages,
administrative costs or other costs.
- - Those factors included in the discussion under the caption "Business -
Cautionary Statement Regarding Forward-Looking Statements" in the
Company's Annual Report on Form 10-K/A for the fiscal year ended
December 31, 1998.
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SIGNATURES
Pursuant to the requirements of the Securities Exchange Act of 1934, the
Registrant has duly caused this report to be signed on its behalf by the
undersigned, thereunto duly authorized.
OXFORD HEALTH PLANS, INC.
Date: July 22, 1999 By: /s/ YON. Y. JORDEN
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YON Y. JORDEN
Chief Financial Officer
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