NY On-Exchange Approved Rates

[RayNY]

http://www.nytimes.com/interactive/2013/07/16/health/17insurance-document.html

Document leaked by the NY times. Rates are about 5% under the off-exchange filings for equivalent plans/carriers/regions. Where this decrease comes from is yet to be seen.

Official release still has not yet happened, I will update this thread whenever it goes public.

Some interesting decisions on who is On or Off exchange, what regions companies enter, and the new companies breaking in.

 

[AllenChicago]

Re: New York Rate Chart - http://s3.documentcloud.org/documents/727416/approved-individual-premium-rates-2014.pdf

Ray, how old is the "sample" person that these exchange premiums are based on? Have New York insurers been directed to charge 1 price per adult, no matter the age, and one price for having children on the policy...be it 1 child or 10? Certainly looks like it based on the information provided.

Sidebar -- Story Related to Wide Range of N.Y. Premiums:
http://www.lifehealthpro.com/2013/07/17/new-york-state-exchange-rates-to-vary-widely
-Allen

 

[RayNY]

http://www.dfs.ny.gov/about/press2013/pr1307171_health_rates_2014.pdf

Our DFS released the Indiv and Small group Approved on-exchange rates. Rate filings are still not public (and may not ever be...)

Allen: We haven't had age banding in years. Tobacco surcharges are gone. A "family" or "employee/child(ren)" tier plan does not ask for the amount of dependents (you may remember my comment about a client with 15 kids. Doesn't matter.)

Small Group will have 9 of the 22 carriers (15 total companies, some split HMO products off, allowing them to define which products go in/out of exchanges) participating on-exchange. Only 5 are offering Platinum/Gold in the metro/island area. About 16 million of the total 19.5 million New Yorkers live in these two regions.

HIP, GHI, Empire BCBS are not offering platinum/gold plans. Empire HMO only offers Gold.

Oxford/UHC, for filing purposes, has split themselves into three companies, United, Oxford HMO, and Oxford OHI.

Empire BCBS, HIP, CDPHP (Capital District physicians health plan-Upstate Only), and MVP split their HMO line off.

For fun, Platinum HIP off-exchange plan is just over $2900/mo for a family plan with no riders. Cheapest Bronze is NorthShore LIJ (Yes, a hospital network, the biggest in the state, and a near monopoly bargaining wise, became their own insurer, and proceeded to undercut everyone...) at $940/mo

I recognize Fidelis has a lower rate, they are a "State-sponsored free or low-cost comprehensive health insurance provider through the Family Health Plus, Child Health Plus, and Medicaid Managed Care programs" and my gut tells me they are not going to be a normal carrier on-exchange, so it's not fair for comparison.

 

[AllenChicago]

Thankyou for that insight into how New York health plans work, Ray. I had no idea. These premiums constitute an average decrease of 30% to 50%? Holy cow.

I just found and read a really good article that describes how New York's health insurance environment became so different from most other states. Here's a link to it:

http://www.forbes.com/sites/theapot...e-obamacare-from-health-insurance-rate-shock/
-ac

 

[RayNY]

That article looks pretty accurate. For those who don't want to read, moral of the story is: NY instituted many of PPACA's revisions on their own (GI, community rating, minimum coverage, etc), went above and beyond on many matters (no tobacco or age rating, dependent coverage to age 29 (with rider, 26 without), 82/87% MLR ratios, rate increase review with power to deny or modify, etc).

All of this, with no mandate. Premiums quickly got obscene, 10-20% increases per quarter for years. Even halving them still makes us most expensive in the nation. We're a poster child for the necessity of mandates in a system this open, not a poster child for the effectiveness of PPACA.

Please note: the rate decreases are on the Indy side. Small business looks like next to nothing happened premium wise.