Skip to Content

Translate | Disclaimer

Press Release

September 4, 2014

Contact: Matt Anderson, 212-709-1691

SUPERINTENDENT LAWSKY ANNOUNCES SETTING OF 2015 HEALTH INSURANCE RATES FOR NEW YORK, INCLUDING RATES FOR HEALTH BENEFITS EXCHANGE

Individual Rates for 2015 Will Continue to Be More than 50 Percent Lower on Average than Before Establishment of the Health Exchange

DFS Reduced Insurers' Overall Proposed Rate Increases By More Than Half

Benjamin M. Lawsky, Superintendent of Financial Services, announced today the setting of New York health insurance rates for 2015, including rates for the health benefits exchange (NY State of Health) established in 2013.

Rates for individuals will continue to be more than 50 percent lower than they were prior to the establishment of the exchange – even before adjusting for inflation or federal financial assistance that is available to many consumers purchasing insurance. A substantial influx of new, previously uninsured customers has helped drive down overall premium rates in this market significantly. Nearly one million New Yorkers enrolled in individual health insurance coverage through NY State of Health during its first open enrollment period, including approximately 370,000 who enrolled in private plans.

Overall, in both the individual and small group markets, DFS cut by more than half the average proposed premium rate increases that health insurers requested for 2015. This action will save policyholders an estimated $1 billion next year.

Superintendent Lawsky said: "We closely scrutinized the proposed rate increases insurers requested and reduced them significantly where appropriate. While we have made substantial progress in reforming our health care market and holding down costs, there is much more work ahead. We will continue to engage with consumer groups, insurers, providers, and other stakeholders as we move forward with that effort."

"New York is continuing to serve as a leader in implementing health care reform," said Donna Frescatore, Executive Director of NY State of Health. "The success of our state’s health exchange and commitment to doing the job right is delivering a dramatic improvement in the affordability and accessibility of high-quality health insurance coverage for New Yorkers."

Individual Market

On average, insurers requested a 12.5 percent increase in health insurance rates for 2015 in the individual market. DFS reduced that average increase more than in half to 5.7 percent – which is below the approximately 8 percent average increase in health care costs.

Most of the average increase (4.5 percent) in individual rates is due to an expected reduction in a federal reinsurance program for insurers, which is provided through the federal Affordable Care Act (ACA). Without the impact of that ongoing phase out, the average increase would have been approximately 1.2 percent.

Many New Yorkers meeting certain income thresholds are also eligible for federal financial assistance when purchasing coverage on the NY State of Health, which would lower costs even further for them. Individuals with incomes below 400 percent of the federal poverty level ($46,680 for individuals and $95,400 for a family of four), can qualify for financial assistance that lowers cost of coverage. These subsidies generally increase in line with premiums – offsetting the impact of rate increases for many consumers. Specific subsidy amounts are based on a consumer's income level and other factors.

Small Group Market

On average, insurers requested a 13.9 percent increase in health insurance rates for 2015 in the small group market. DFS reduced that average increase more than in half to 6.7 percent – which is also below the approximately 8 percent increase in health care costs. Moreover, a number of small businesses will be eligible for tax credits that would lower those premium costs even further.

The following is a summary chart of each companies’ requested rates increases and DFS approved rates, including 16 companies that are selling on the NY State of Health Individual Marketplace and 10 companies that are selling on NY State of Health Small Business Marketplace.

2015 INDIVIDUAL MARKET RATE ACTIONS - OVERALL SUMMARY

Company Requested Average Increase Approved Increase Reduction

Aetna Life Insurance Co.

19.96%

5.32%

-14.64%

Affinity Health Plan*       

-12.58%

-15.21%

-2.63%

CDPHP*     

6.69%

0.15%

-6.54%

Emblem-HIP*     

9.81%

6.72%

-3.09%

Empire BlueCross BlueShield HMO*     

18.40%

7.37%

-11.03%

Excellus*       

19.59%

9.23%

-10.36%

Fidelis*        

7.14%

3.23%

-3.91%

Health Republic Insurance of New York*

15.35%

13.04%

-2.31%

Healthfirst*    

-9.67%

-11.95%

-2.28%

HealthNow*      

7.24%

1.41%

-5.83%

Independent Health Benefits Corp.*

5.44%

-2.01%

-7.45%

MetroPlus Health Plan*     

17.78%

6.90%

-10.88%

MVP Health Care*     

18.31%

11.97%

-6.34%

Care Connect (North Shore LIJ)*

-1.24%

-3.22%

-1.98%

Oscar*          

6.28%

3.88%

-2.40%

Oxford Health Plan     

1.08%

-9.41%

-10.49%

UnitedHealthcare of NY*  

-5.85%

-15.32%

-9.47%

All companies

12.50%

5.70%

-6.80%

* Companies that offer individual coverage on the NY State of Health Individual Marketplace
Note: Freelancers Insurance Company, Crystal Run Health Plan, Montefiore Insurance Company and Wellcare of NY are new entrants to the market and are selling new products with new premium rates, and therefore did not request rate increases.

2015 SMALL GROUP MARKET RATE ACTIONS - OVERALL SUMMARY

Company Requested Average Increase Approved Increase Reduction

Aetna Health, Inc.

22.27%

7.98%

-14.29%

Aetna Life Insurance Co.

25.81%

10.19%

-15.62%

CDPHP     

13.49%

8.92%

-4.57%

CDPHP Universal Benefits, Inc. *   

11.24%

7.46%

-3.78%

Emblem-HIP*   

11.88%

10.32%

-1.56%

Empire HealthChoice Assurance

23.34%

12.53%

-10.81%

Empire BlueCross BlueShield HMO    

22.62%

11.87%

-10.75%

Excellus*       

16.45%

12.20%

-4.25%

Health Republic Insurance of New York*

5.89%

3.36%

-2.53%

HealthNow*      

-1.82%

-2.31%

-0.49%

Indpendent Health Association

4.35%

2.80%

-1.55%

Independent Health Benefits Corp.*

5.44%

3.87%

-1.57%

Managed Health, Inc.        

0.83%

-2.59%

-3.42%

MetroPlus Health Plan*     

30.60%

14.41%

-16.19%

MVP Health Plan, Inc.*    

13.62%

11.76%

-1.86%

MVP Health Services Corp.   

14.54%

12.66%

-1.88%

Care Connect (North Shore-LIJ)*

-14.61%

-14.61%

0.00%

Oxford Health Insurance*     

12.23%

3.21%

-9.02%

Oxford Health Plan     

16.18%

8.79%

-7.39%

UnitedHealthCare Insurance Co. of NY     

17.04%

2.12%

-14.92%

All companies

13.90%

6.90%

-7.00%

* Companies that offer small group coverage on the NY State of Health Small Business Marketplace

Note: Crystal Run Health Insurance Company, Crystal Run Health Plan and Montefiore Insurance Company are new entrants to the market and are selling new products with new premium rates, and therefore did not request rate increases.

The next New York State of Health open enrollment period begins on November 15, 2014 for coverage starting on January 1, 2015. New Yorkers eligible for Medicaid and all children can enroll in coverage through NY State of Health at any time during the year.

The Small Business Marketplace for employers with 50 or fewer employees is open to enrollment throughout the year. For more information about the New York State of Health exchange, please visit, https://nystateofhealth.ny.gov/.

To view a chart of insurers' approved rates by region, please visit, link.

About DFS

Contact DFS

Reports & Publications

Licensing

Laws and Regs

Connect With DFS

DFS Facebook page

Follow NYDFS on Twitter