The NYS 2020 Rate Requests filings were released today.  The total weighted average increases were a modest 8.4%  for Individual Market and 12.0% Small Group Market. Final rate approval expected early August. The past reductions averaged 10-50%.

The lower requests reflect a stabilizing ACA market. Insurers’ financial performance improved nationwide last year to its highest level since the passage of the law. The average medical-loss ratio, which represents the portion of premiums spent on medical claims and quality improvement, was 70% last year in the individual market nationwide. That led to plans paying $800 million in rebates for failing to meet requirements on medical spending, according to the Kaiser Family Foundation

 This early filing request deadline request requirement is not an Obamacare requirement.  As per NY State Law carriers are required to send out notices of rate increase filings to groups and subscribers.These are simply requests and the state’s Department of Financial Services has authority to modify the final rates. But they are the first indication of what New Yorkers can expect when shopping for health insurance on the individual marketplace at the end of this year.

Background:

By contrast last year’s  NYS 2019 Rate Request early filing request were higher at 7.5% small group and an astounding 24% for individuals. The NYS final August 2020 rate approval are expected to be lower.  For example, the final filing rates were approved  NYS 2019 Final Rates Approved at a modest 3.8% small group and 8.6% for individuals. Using these past figures one projects a 2019 Final Rates of 5% small groups and 8% individuals.

A spokeswoman for the state Health Plan Association said insurers have worked to control costs, which have been driven up by rising prescription drug prices and state mandates that require coverage of certain services. 

“Our member health plans have been committed to making health care more affordable, working hard to rein in rising health care costs and contain their own costs,” she said. “The proposed premium rate requests are reasonable, reflecting the cost of care.”

In the small-group market, insurers asked for a weighted average 12% boost in 2020 after they were granted a 3.8% bump for this year. UnitedHealthcare’s Oxford, which controls more than half of the small-group market, asked for a 15.9% increase, which was the highest among all plans. Oscar, at 15.8%, was close behind. Notably, Healthfirst has requested a 5% reduction.

Conclusion

Defined Contribution Choice:  Instead, the correct approach for a small business in keeping with simplicity is a defined contribution model using a Private Exchange.  This is a true defined contribution empowering employees with the choice of leading insurers offering paperless technologies integrating HRIS/Benefits/Payroll.  Both employee and employers still gain tax advantage benefits under the business.  Also, the benefits, rates and network size are superior under a group plan as THE RISK OUTLINED ABOVE ARE HIGHER FOR INDIVIDUAL MARKETS THAN SMALL GROUP PLANS.

To be clear: These trends affect a small subset of the insurance market—non-group plans that cover less than 2 percent of the population. Many qualify for tax credits that lower their net costs and reduce or eliminate the impact of year-to-year rate increases.However, non-group customers with incomes above 400% of the poverty level ($48,560 for a single adult) get no subsidy—and feel the full brunt of any hikes.

Resource

  • You may view the NYS 2019 Rate Requests DFS press release, which includes a recap of the increases requested and approved by clicking here.
  • For a custom analysis detailing YOUR upcoming 2019-2020 renewal please contact our team at Millennium Medical Solutions Corp  (855)667-4621.  We work in coordination with Navigators to assist with Medicaid, CHIP Child Health Plus, Family Health Plus and Medicare Dual Eligibles.   We have Spanish, Russian, and Hebrew speakers available.  Quotes can also be viewed on our site.
  •  See Health Reform Resource

*These averages may change based on DFS’s review of the rate applications.** Empire submitted a filing that DFS is evaluating.

Learn how a Private Exchange and our PEO Partnership can help your group please contact us at info@medicalsolutionscorp.com or (855)667-4621.

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