2015 Health Insurance Rates for New York State of Health

2015 Health Insurance Rates for New York State of Health

New York health insurance rates for 2015, including those for NY State of Health, the state’s health insurance exchange, were announced Sept. 4. On average, individual and small group health insurance plan rates will increase both on and away from New York’s state-based health insurance exchange—5.7 percent and 6.7 percent, respectively.[1]Proposed premium rates were much higher—on average, 12.5 percent for the individual market and 13.9 percent in the small group market. The New York State Department of Financial Services cut these rates by more than half, a move the DFS estimates will save policyholders more than $1 billion in 2015.

According to a DFS press release, “Rates for individuals will continue to be more than 50 percent lower than they were prior to the establishment of the exchange—even before adjusting for inflation or federal financial assistance that is available to many consumers purchasing insurance.”

Nonetheless, these are average premium increases across all plans. By carrier, approved rate changes for the individual marketplace were as low as -15.32 for United Healthcare of NY and as high as 13.04 percent for Health Republic Insurance of New York. In the small group market, approved rate changes by carrier were as low as -14.61 percent for North Shore LIJ (Care Connect) and as high as 14.41 for MetroPlus Health Plan, Inc.

The premium change individual New Yorkers will experience is dependent on several factors. New York residents will see fluctuation in plan rates dependent upon their health insurance plan, geographical location and subsidy eligibility. Consumers will see their premium tax credit increase or decrease dependent on changes to their income and household size as well as rate changes for the second-lowest-cost exchange-based silver plan available to them—subsidy amounts are based on these factors.

As such, it will be important for all individuals and families to reassess their health insurance coverage when open enrollment begins Nov. 15, 2014, and comparison shop on and away from NY State of Health.

Individuals and family health plans

Those who buy their own health insurance may select coverage on and away from New York’s state-based exchange. Several companies offer qualified health plans in New York.

On the exchange

For the second year in a row, New York’s exchange will have the greatest number of issuers of any state-based health insurance exchange.[2] Sixteen carriers will sell individual health insurance plans through the NY State of Health exchange.[3] One carrier left the individual marketplace—American Progressive, which was marketed as Today’s Options—and another joined for 2015. Six carriers expanded plan offerings into additional counties.

  1. Affinity Health Plan, Inc.
  2. Capital District Physicians Health Plan, Inc.
  3. Health Insurance Plan of Greater New York (EmblemHealth) — expanded
  4. Empire BlueCross and Empire Blue Cross Blue Shield
  5. Excellus (Excellus Blue Cross Blue Shield in Central NY and Universe in Western NY)
  6. Fidelis Care — expanded
  7. Health Republic Insurance Company — expanded
  8. Healthfirst New York — expanded
  9. HealthNow New York, Inc. (Blue Shield of Northeastern NY; Blue Cross Blue Shield of Western NY)
  10. Independent Health
  11. MetroPlus Health Plan
  12. MVP Health Plan, Inc. — expanded
  13. North Shore LIJ (ConnectCare) — expanded
  14. Oscar Insurance Corporation
  15. United Healthcare of New York, Inc.
  16. Wellcare — new

In the private marketplace

Carriers that sell individual health insurance plans exclusively in New York’s private marketplace include Aetna Life Insurance Co. and Oxford Health Plan.[4]

Small businesses

Employers with two to 50 employees may shop for small group health insurance plans on and away from NY State of Health. Those with 25 or fewer employees may be eligible for tax credits when shopping NY State of Health. Companies selling qualified small group health plans in New York for 2015 include the following:

On the exchange

Nine carriers will sell small group health insurance coverage offered through NY State of Health’s small business exchange.[5] One carrier, Oxford Health Plan, will not return to the New York’s exchange in 2015.

  1. Capital District Physicians Health Plan, Inc.
  2. Health Insurance Plan of Greater New York (EmblemHealth) — new
  3. Excellus (Excellus Blue Cross Blue Shield in Central NY and Univera in Western NY
  4. Health Republic Insurance Company — expanded
  5. HealthNow New York, Inc. (Blue Shield of Northeastern NY; Blue Cross Blue Shield of Western NY)
  6. Independent Health
  7. MetroPlus Health Plan
  8. MVP Health Plan, Inc. — expanded
  9. North Shore LIJ (ConnectCare) — expanded

Away from the exchange

The following 13 carriers will sell small group health insurance exclusively in the private marketplace.[6]

  1. Aetna Health, Inc.
  2. Aetna Life Insurance Co.
  3. Capital District Physicians Health Plan, Inc.
  4. Crystal Run Health Insurance Company — new
  5. Crystal Run Health Plan — new
  6. Empire HealthChoice Assurance
  7. Empire BlueCross BlueShield HMO
  8. Independent Health Association
  9. Managed Health, Inc.
  10. Montefiore Insurance Company — new
  11. MVP Health Services Corp.
  12. Oxford Health Plan
  13. UnitedHealthCare Insurance Co. of NY

Dental insurance

Ten companies will offer standalone dental insurance plans on NY State of Health[7]:

  1. Delta Dental Insurance Company
  2. Dentcare
  3. Dentegra Insurance Company
  4. Emblem
  5. Empire BlueCross and Empire Blue Cross BlueShield
  6. Guardian — expanded to the individual exchange in 2015
  7. HealthNow New York, Inc. (Blue Shield of NENY; Blue Cross Blue Shield of Western NY)
  8. Healthplex
  9. MetLife — offered only on the small business exchange
  10. Solstice

Choosing 2015 coverage

New Yorkers who purchased health insurance on or away from NY State of Health may renew their 2014 coverage in 2015, if it is still available. However, is wise for all consumers to reevaluate their insurance coverage for the year to come and weigh their options carefully.

Some things to consider:

  • Did your family health needs change in the past year? Will they change in the year to come?
  • Did your income change? Are you eligible for a tax credit, eligible for a larger or smaller tax credit, or no longer eligible for one at all?
  • Did you use the coverage you selected? Was it too much? Too little?
  • Did your plan network include your preferred providers and hospitals? Were they conveniently located?

Health and financial needs change, benchmark plan rates used to determine tax credits fluctuate, tax credit eligibility changes, and so do plan rates and networks. Check out the plan options in your area. Compare monthly premiums, annual deductibles and out-of-pocket limits, coinsurance, copayments and network providers and determine which work best for your healthcare needs and budget. Recalculate your premium tax credit subsidy eligibility.

If you qualify for a premium tax credit, you may want to keep your search to the exchange. If your are not eligible for a premium tax credit or the amount is small, you may want to consider options in the private marketplace. Remember: Tax credits are only available when you shop your state’s exchange. If you plan to buy 2015 coverage through NY State of Health, be sure to update your financial and household information with the exchange.

Use HealthCare.com’s Obamacare tax credit subsidy calculator to see if you might be eligible for a tax credit—and estimate how much. While you’re visiting HealthCare.com, enter your ZIP code to find and compare plans in your area. Call (877) 275-0485 to get help directly from an agent.

 

[1] New York State. Department of Financial Services. “Superintendent Tawsky Announces Setting of 2015 Health Insurance Rates for New York, Including Rates for Health Benefits Exchange [Press Release].” Sept. 4, 2014. http://www.dfs.ny.gov/about/press2014/pr1409041.htm.

[2] Gunja, Munira Z. and Emily R. Gee. “Health Insurance Issuer Participation and New Entrants in the Health Insurance Marketplace.” U.S. Department of Health & Human Services. Sept. 23, 2014. http://aspe.hhs.gov/health/reports/2014/NewEntrants/ib_NewEntrants.pdf.

[3] NY State of Health. “NY State of Health Announces 2015 Health and Dental Plans [Press Release].” Sept. 22, 2014. http://www.healthbenefitexchange.ny.gov/news/press-release-ny-state-health-announces-2015-health-and-dental-plans.

[4] New York State. Department of Financial Services. “Superintendent Tawsky Announces Setting of 2015 Health Insurance Rates for New York, Including Rates for Health Benefits Exchange [Press Release].” Sept. 4, 2014. http://www.dfs.ny.gov/about/press2014/pr1409041.htm.

[5] NY State of Health. “NY State of Health Announces 2015 Health and Dental Plans [Press Release].” Sept. 22, 2014. http://www.healthbenefitexchange.ny.gov/news/press-release-ny-state-health-announces-2015-health-and-dental-plans.

[6] New York State. Department of Financial Services. “Superintendent Tawsky Announces Setting of 2015 Health Insurance Rates for New York, Including Rates for Health Benefits Exchange [Press Release].” Sept. 4, 2014. http://www.dfs.ny.gov/about/press2014/pr1409041.htm.

[7] NY State of Health. “NY State of Health Announces 2015 Health and Dental Plans [Press Release].” Sept. 22, 2014. http://www.healthbenefitexchange.ny.gov/news/press-release-ny-state-health-announces-2015-health-and-dental-plans.

About Jenifer Dorsey

Jenifer Dorsey is a regular contributor to HealthCare.com. She has covered health insurance and health and fitness for more than five years. In her free time she is a competitive track cyclist and loves to travel, especially to places with velodromes.

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