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June 1, 2018

PROPOSED 2019 HEALTH INSURANCE PREMIUM RATES
FOR INDIVIDUAL AND SMALL GROUP MARKETS

Health insurers in New York have submitted their requested rates for 2019, as set forth in the charts below.  These are the rates proposed by health insurers, and have not been approved by DFS.

Financial Services Superintendent Maria T. Vullo said: New York’s insurance market remains robust despite federal actions, with consumers having choices in every county of the State.  The average rate requests for the small group market reflect the increased stability of that market in New York State.  With respect to the individual market, the single biggest justification offered by insurers for the requested increases is the Trump Administration’s repeal of the individual mandate penalty.  The individual mandate, a key component of the Affordable Care Act, helped mitigate against dramatic price increases by ensuring healthier insurance pools.  Insurers have attributed approximately half of their requested rate increases to the risks they see resulting from its repeal.  Without the federal action, the average requested rate increase  would be  12.1%.  As DFS reviews all of the submissions, we will continue to ensure that any rate increases are fully and actuarially justified by appropriate medical cost increases and are not inadequate, excessive or unfairly discriminatory, in accordance with New York law.

INDIVIDUAL MARKET 

Company Name 2019 Requested Rate Change without the Individual Mandate Repeal Additional Percentage Associated with the Individual Mandate Repeal Total 2019 Requested Rate Change
CDPHP* 5.1% 0.0% 5.1%
Crystal Run Health Plan, LLC 12.0% 3.7% 15.7%
Emblem* 19.5% 12.0% 31.5%
Empire Healthchoice Assurance* 19.8% 4.2% 24.0%
Excellus* 1.6% 7.3% 8.9%
Fidelis (New York Quality Healthcare Corp)* 12.7% 25.9% 38.6%
Healthfirst Insurance Company, Inc. 8.5% 6.5% 15.0%
Healthfirst PHSP, Inc.* 8.5% 6.5% 15.0%
Healthnow New York* -3.2% 0.0% -3.2%
IHBC* 4.7% 16.6% 21.3%
MetroPlus* 12.3% 1.1% 13.5%
MVP Health Plan* 1.8% 4.7% 6.5%
Oscar* 17.0% 8.2% 25.2%
UnitedHealthcare of New York Inc* 17.7% 5.9% 23.6%
Weighted averages: 12.1% 11.9% 24.0%

 

SMALL GROUP MARKET

Company Name 2019 Requested Rate Change
Aetna Life 16.2%
CDPHP 6.7%
CDPHP UBI 6.1%
Crystal Run Health Insurance Company 11.5%
Crystal Run Health Plan, LLC 12.5%
Emblem 12.0%
Empire Healthchoice Assurance 6.0%
EmpireHealthchoice HMO 5.2%
Excellus* 3.8%
Healthfirst Health Plan, Inc. 21.0%
Healthfirst Insurance Company, Inc. 7.0%
Healthnow New York -0.1%
IHBC* 3.8%
MetroPlus* 4.7%
MVP Health Plan 7.0%
MVP Health Service Corp* 10.3%
Oscar 3.0%
Oxford Health Insurance Inc* 8.3%
UnitedHealthcare Ins Company of New York 7.2%
Weighted average: 7.5%

 

* Indicates the Company offers products on the NY State of Health Marketplace.

Summary of Requested 2019 Rate Actions (portal)

 

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