DFS Announces 2023 Health Insurance Premium Rates, Saving New Yorkers $799.5 Million

Superintendent of Financial Services Adrienne A. Harris announced today that the New York State Department of Financial Services (DFS has approved health insurers’ premium rate increases for 2023, saving consumers and small businesses almost $800 million.  In the individual market, DFS reduced insurers’ requested rates 48%.  In the small group market, DFS reduced insurers’ requested rates 52%.  Over 1.1 million New Yorkers are enrolled in individual and small group plans.  

“Rising medical costs and inflation continue to put upward pressure on premiums,” said Superintendent Harris. “With our rate actions announced today, we continue to prioritize the financial wellbeing of consumers while ensuring that New Yorkers have access to a robust, stable health insurance market.” 

The rising cost of medical care, including in-patient hospital stays and drug costs, continue to be the main driver of insurance premium rate increases, and medical claims have increased as New Yorkers catch up on medical appointments and services postponed due to the pandemic.       

Also DFS, recognizing the continued uncertainty of the pandemic’s effect on consumer’s health care costs and the economy, held insurers’ profit provisions to a historically low 0.5%. 

 Individual Market   

 Insurers requested an average rate increase of 18.7% in the individual market, which DFS cut by 48% to 9.7% for 2023, saving consumers $167.1 million. These rates will be further reduced for many consumers who are eligible for federal tax credits.  Last year, over 60% of individuals who enrolled in a Qualified Health Plan through New York State of Health received the federal premium tax credits to lower the costs of premiums.  Approximately 262,000 New Yorkers are currently enrolled in individual commercial plans.   

These rate decisions do not include the Essential Plan, available through NY State of Health, which as of June 1, 2021 charged no premium for lower-income New Yorkers who qualify.  More than one million New Yorkers were enrolled in the Essential Plan. 

DFS INDIVIDUAL MARKET RATE ACTIONS   

Company 

Requested 2023 Rate Actions 

Approved 2023 Rate Actions 

DFS Modification (In Percentage Points) 

CDPHP* 

28.4% 

16.5% 

-11.9% 

Emblem (HIP)* 

34.6% 

9.0% 

-25.6% 

Excellus* 

14.0% 

10.0% 

-4.0% 

Fidelis (NY Quality Healthcare Corp)* 

23.2% 

12.4% 

-10.8% 

Healthfirst Ins Co, Inc. 

12.6% 

8.0% 

-4.6% 

Healthfirst PHSP, Inc.* 

13.0% 

8.3% 

-4.7% 

HealthPlus HP, LLC (Formerly Empire)* 

6.9% 

0.5% 

-6.4% 

Highmark (Formerly HealthNow)* 

20.5% 

12.8% 

-7.7% 

IHBC* 

10.2% 

6.1% 

-4.1% 

MetroPlus* 

13.0% 

8.1% 

-4.9% 

MVP Health Plan* 

19.2% 

10.1% 

-9.1% 

Oscar* 

14.6% 

6.5% 

-8.1% 

UnitedHealthcare of NY Inc.* 

16.1% 

9.2% 

-6.9% 

Summary 

18.7% 

9.7% 

-9.0% 

*Indicates the Company will offer products on NY State of Health Marketplace in 2023. 

Small Group Market   

Almost 850,000 New Yorkers are enrolled in small group plans, which cover employers with up to 100 employees. Insurers requested an average rate increase of 16.5% in the small group market, which DFS cut by 52% to 7.9% for 2023, saving small businesses $632.4 million. A number of small businesses also will be eligible for tax credits that may lower those premium costs even further, such as the Small Business Health Care Tax Credit. 

DFS SMALL GROUP MARKET RATE ACTIONS   

Company 

Requested 2023 Rate Actions 

Approved 2023 Rate Actions 

DFS Modification (In Percentage Points) 

Aetna Health 

30.6% 

9.7% 

-20.9% 

Aetna Life 

31.0% 

9.7% 

-21.3% 

CDPHP UBI* 

20.1% 

11.0% 

-9.1% 

CDPHP* 

17.4% 

11.5% 

-5.9% 

Emblem (HIP)* 

19.0% 

13.6% 

-5.4% 

Emblem Health Ins Co* 

45.7% 

13.6% 

-32.1% 

Empire Healthchoice Assurance* 

17.6% 

12.1% 

-5.5% 

Excellus* 

12.9% 

9.4% 

-3.5% 

Healthfirst Ins Co, Inc.* 

15.0% 

8.4% 

-6.6% 

Highmark (Formerly HealthNow) 

15.3% 

10.7% 

-4.6% 

IHBC* 

15.9% 

12.9% 

-3.0% 

MVP Health Plan* 

14.2% 

11.7% 

-2.5% 

MVP Health Service Corp* 

13.6% 

8.6% 

-5.0% 

Oscar 

19.4% 

12.2% 

-7.2% 

Oxford Health Insurance Inc.* 

16.8% 

6.0% 

-10.8% 

UnitedHealthcare Ins Co NY 

19.1% 

6.0% 

-13.1% 

Summary 

16.5% 

7.9% 

-8.6% 

*Indicates the Company will offer products on the New York State of Health Marketplace in 2023. 

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