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Consumer Guide Will Help New Yorkers Make Informed Health Care Choices

Governor George E. Pataki today announced that the 2004 New York Consumer Guide to Health Insurers is now available in hard-copy and electronic form. Published and updated for the sixth consecutive year, the guide allows New Yorkers to compare commercial and not-for-profit health insurers as well as health maintenance organizations (HMOs) based on a wide range of factors, from services offered to overall consumer satisfaction.

"Making an educated choice about health insurance is one of the most important decisions for a family to make," Governor Pataki said. "We have worked hard to expand coverage and make health insurance more available to New York's families, and as we do this it is also important to provide New Yorkers with the information necessary to make informed choices. The 2004 New York Consumer Guide does that, offering descriptions of health insurance products available, such as the newly enhanced Healthy NY program, information on how to choose a health plan, and easy-to-read tables with comparisons of health insurers that offer plans in New York State."

Healthy NY is a state-sponsored health insurance program that helps ensure affordable health insurance benefits are accessible to New York State's small business owners, sole proprietors, and working uninsured individuals.

The 2004 edition of the guide assesses health care plans based on quality of care indicators, such as the appropriate use of medications for asthmatic children and adults, the percentage of women who received cervical cancer screenings within the past three years and the percentage of individuals with hypertension between the ages of 46 and 85 whose blood pressure was under good control.

Superintendent of Insurance Gregory V. Serio said, "Health insurance decisions are ones that are important to all New Yorkers. If you already have coverage, this guide will make it easy for you to compare the benefits you now receive from a health insurer with those offered by others in the industry. If you're looking for health care coverage, this guide offers an ideal starting point."

State Health Commissioner Antonia C. Novello, M.D., M.P.H., Dr.P.H., said, "Our priority is to ensure that New Yorkers have access to the most up-to-date information on health insurers, including the benefits they offer, as well as their quality performance rating for ensuring access to and coverage for primary, preventive and specialty care for patients. The 2004 consumer guide, in addition to annual State Managed Care Performance Reports, builds on the Governor's commitment to making sure that New Yorkers are well-informed about the health insurance options available to them and continue to have access to the best health care in the nation."

One of the guide's highlights is the Insurance Department's annual complaint ratio ranking of HMOs, which typically use a network of providers to treat members. The complaint ratio -- the number of upheld complaints divided by a health insurer's total annual premiums --allows for a direct comparison of insurers.

According to the state Insurance Department's complaint ratio rankings, the top three HMOs in 2003 were (1) Rochester Area HMO, Preferred Care, (2) Capital District Physicians' Health Plan, and (3) Empire HealthChoice. Using this same criterion, the bottom three ranked HMOs were (15) CIGNA, (16) HIP, and (17) MDNY Healthcare. New York State's HMOs, unlike commercial and not-for-profit health insurers, must offer coverage to individuals who buy health insurance on their own.

The 2004 New York Consumer Guide to Health Insurers is available on-line at the Insurance Department's Web site: Hard copies of this guide can be obtained by calling 1-800-342-3736. The National Committee for Quality Assurance (NCQA) provided editorial and research support for the 66-page guide. NCQA is a private, non-profit organization dedicated to improving health care quality which also accredits managed care plans nationwide.

In addition, the Insurance Department's Web site is also the home of the 2004 Interactive Guide to HMOs, which allows consumers to find information about HMOs operating within their home county.


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