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Fourth Annual Consumer Guide To Health Insurers Is Important Educational Resource For All New York Families

Superintendent Gregory V. Serio today announced that the State’s fourth annual edition of the New York Consumer Guide to Health Insurers is now available. The comprehensive Guide, produced in conjunction with National Committee for Quality Assurance (NCQA) and Consumers Union, publisher of Consumer Reports, provides New York State consumers access to key facts about choosing and comparing health insurers.

"When making health care decisions for you and your family it is critical to know how health insurers are treating their customers, how they handle complaints and grievances, and the quality of care that they provide," said Serio. "The New York Consumer Guide to Health Insurers is important for consumers because it highlights real differences in performance among the plans and presents the information in a standard format that is easy-to-understand."

The Guide includes a comprehensive review and comparison of quality of care indicators and other performance measures such as breast cancer screening, early prenatal care, cholesterol screenings after acute cardiovascular events, and follow-up care after hospitalization for mental illness. It also explains to consumers how to contact the health insurers, how they can appeal adverse utilization review decisions under the State’s External Review Law and gives results of the law by all types of health insurers.

"With the open enrollment season upon us for health insurance, it is a perfect time for consumers to use our Guide as many New Yorkers are making important decisions about their health coverage," said Serio. "Health insurers are accountable to their customers and this guide will show New Yorkers how each health insurer stacks up."

Also included is the State Insurance Department’s annual ranking of health insurers according to the number of consumer complaints. Complaint ratios are determined by the number of upheld complaints in proportion to the plan’s size.

The HMOs with the best complaint ratios are:

1. Rochester Area HMO (Preferred Care) -0.005

2. Excellus -0.009

3. MVP Health Plan -0.017

4. Empire Health Choice -0.018

5. IHA -0.098

The HMOs with the worst complaint ratios are:

12. GHI-HMO Select -0.522

13. Aetna Health -0.630

14. MDNY -0.803

15. CIGNA -0.818

16. United Healthcare of NY -1.022

Important information provided by the Department of Health is also included, such as certain rates of treatment, health plan enrollee primary care visit rates, and other indicators of a health plan’s quality of care. In addition, consumers are offered a comprehensive review and a comparison of the major quality-of-care indicators and other performance measures for HMOs, not-for-profit insurers and commercial insurers. Standard indicators that are measured include mammography screenings, child immunizations and prenatal care.

It has been a top priority to enact meaningful and practical health insurance reform for New Yorkers. Landmark legislation such as the Heath Care Reform Act of 2000 establishing the Healthy NY Program covering New York’s working uninsured, Point-of-Service Law of 1995, the Managed Care Reform Act of 1996, the Women’s Health and Cancer Rights Act of 1997, the Child Health Plus insurance program expansion, and 1998 legislation guaranteeing consumer a right to external review of health insurance coverage decisions are examples of major health insurance initiatives signed into law by Governor Pataki.

The report can be accessed on the Insurance Department’s Web site at in the consumer section and hard copies can be obtained by calling the consumer hotline at 1-800-342-3736.

Department of Financial Services


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