Costs of health plans in New York State are set to rise next year as insurers say they are grappling with higher drug and medical costs, and government regulation.
But the changes will not be uniform – The Buffalo News reported that some insurers seek double-digit increases, while others might implement modest changes.
Blue Cross Blue Shield of Western New York, for example, is reportedly aiming for an average 48.8% hike for individual health plans sold on the state’s health insurance exchange, as well as those purchased directly from insurers. On the other hand, Univera Healthcare looks for an average increase of 4.4% for its individual plans, the paper added.
The requests apply to private health plans that individuals buy and also plans for small groups of 100 or fewer people, said the report. They do not apply to health plans for larger groups, self-insured groups, Medicare Advantage, Medicaid, or the state’s Essential Plan.
New York State law requires insurance companies to file an application with the Department of Financial Services (DFS) for prior approval to increase their health insurance premium rates. The Department has the authority to review the assumptions behind the proposed rates and it can also review the financial condition of the insurer to make certain proposed rates are fair and appropriate.
The Buffalo News also reported that Independent Health and Fidelis Care New York seek 25.9% and 8.1% rise in rates, respectively, for individual plans.
The DFS maintains the authority to approve, reject or modify the insurers’ proposed rates.
“We have a history of the state reducing rate requests, sometimes significantly,” said Leslie Moran, senior vice president of the New York State Health Plan Association as quoted by the paper. “There is no reason to believe it won’t happen again. If you’re a health plan, you probably think that you better ask for more, figuring that it will probably be cut.”
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