N.Y. GOVERNOR ANNOUNCES APPROVAL OF HEALTH INSURANCE PLAN RATES

(The following is a reformatted version of a press release
issued by New York Governor Andrew M. Cuomo and received via e-mail. The release was confirmed by the sender.) 
July 17, 2013 
GOVERNOR CUOMO ANNOUNCES APPROVAL OF 2014 HEALTH INSURANCE PLAN
RATES FOR NEW YORK HEALTH BENEFIT EXCHANGE 
17 Health Insurers Have Rates Approved to Provide Coverage on
the Exchange 
NEW YORK, NY - Today, Governor Andrew M. Cuomo announced that
the Department of Financial Services (DFS) has approved health
insurance plan rates for 17 insurers seeking to offer coverage
through New York’s Health Benefits Exchange, including eight new
entrants into the market that do not currently offer commercial
health insurance plans. Last year, Governor Cuomo took action to
issue an Executive Order establishing the New York Health
Benefit Exchange, which is expected to help more than one
million uninsured New Yorkers access quality, affordable health
care coverage.
Consumers and businesses will be able to choose among plans in
four easy-to-compare metal tiers (bronze, silver, gold, and
platinum) on the exchange. The plans within each metal tier will
have standardized contract terms and product offerings, making
it easier for consumers to truly comparison shop and encourage
real price competition among insurers. Previously, New York
insurers offered more than 15,000 plans that widely varied in
terms of level and quality of coverage provided - which
encouraged ‘competition through confusion’ and made it difficult
for purchasers to effectively compare plans side by side. 
“New York’s health benefits exchange will offer the type of real
competition that helps drive down health insurance costs for
consumers and businesses,” said Governor Cuomo. “The opportunity
to choose among affordable, quality health insurance options
will mean improved health outcomes, stronger economic security,
and better peace of mind for New York families.” 
Benjamin M. Lawsky, Superintendent of Financial Services: “In
setting these rates, we worked hard to do right by consumers and
small businesses so they have access to affordable, quality
health insurance. Moreover, where New York previously had a
dizzying array of thousands upon thousands of plans, small
businesses will now be able to truly comparison shop for the
best prices. New York will continue to move ahead rapidly so the
exchange is up and running for 2014.” 
“The approval of health plan rates marks a significant milestone
for the New York Health Benefit Exchange,” said New York State
Health Commissioner Nirav R. Shah, M.D., M.P.H. “The state
continues to be on target to begin enrolling consumers and small
business owners and their employees in health insurance coverage
on October 1, 2013. Access to affordable, quality health care
will mean better health, peace of mind and financial security
for New Yorkers.” 
On average, the approved 2014 rates for even the highest tier of
plans individual New York consumers could purchase on the
exchange (gold and platinum) represent a 53 percent reduction
compared to last year’s direct-pay individual rates. The fact
that these average individual rates are effectively being cut
more than in half is primarily because a greater number of
uninsured individuals are expected to obtain coverage in the
individual insurance market - lowering overall premiums. (Note:
That 53 percent reduction does not include the impact of federal
financial assistance for individuals meeting certain income
thresholds who are purchasing coverage on the exchange, which
would lower costs even further for many consumers.) 
Furthermore, despite the fact that health care costs per capita
are approximately 18 percent higher in New York than the
national average, the average approved rates for the benchmark
individual “silver plan” in New York would be in line with
(nearly 10 percent lower) the nationwide average previously
forecast by the independent, non-partisan Congressional Budget
Office (CBO) for when health care reform is implemented. 
For approved 2014 small group plan rates, existing premium rates
do not provide a functional year-over-year comparison. In 2013,
insurers offered more than 15,000 different small group plans
that significantly varied in terms of the quality and level of
coverage provided. This year, insurers are offering standardized
contracts and product offerings within metal tiers (bronze,
silver, gold, and platinum). 
The approved small group rates, however, are generally lower
than indicated by the estimates of other independent
forecasters. The average approved small group rate in New York
for the benchmark “silver plan” is well below (nearly 32 percent
lower) the nationwide average previously forecast by the
independent, non-partisan CBO - notwithstanding the relatively
higher per capita health care costs in New York compared other
states. Moreover, a number of small businesses will be eligible
for tax credits that would lower those premium costs even
further. 
The following companies had health insurance plan rates for the
health benefits exchange approved today by DFS. The rates
approved today are subject to final certification of the
insurers’ participation in the exchange. 
· Aetna
· Affinity Health Plan, Inc. 
· American Progressive Life & Health Insurance Company of New
York 
· Capital District Physicians Health Plan, Inc. 
· Health Insurance Plan of Greater New York 
· Empire BlueCross BlueShield 
· Excellus 
· Fidelis Care 
· Freelancers Co-Op 
· Healthfirst New York 
· HealthNow New York, Inc. 
· Independent Health 
· MetroPlus Health Plan 
· MVP Health Plan, Inc. 
· North Shore LIJ 
· Oscar Health Insurance Co. 
· United Healthcare 
Individuals with incomes below 400 percent of the federal
poverty level ($45,960 for individuals and $94,200 for a family
of four), could qualify for financial assistance that lowers
cost of coverage. Enrollment for the exchange begins on October
1, 2013 for coverage that will be effective January 1, 2014.
“These plans and rates deliver on the promise that the Exchange
will offer quality health insurance coverage at a price that
works for New Yorkers,” said Donna Frescatore, Executive
Director, New York Health Benefit Exchange. “We were pleased to
see that there was much interest from health plans regarding
participation in the Exchange. Our partners at the New York
State Department of Financial Services did a thorough job of
negotiating affordable prices while ensuring that consumers will
have access to the providers they need. Robust competition among
health plans has resulted in meaningful choices and better
options for consumers.” 
For more information about the New York Health Benefit Exchange,
please visit, HealthBenefitExchange.ny.gov. 
### 
It is challenging to compare existing premium rates to those
that have been approved for 2014. The 2014 health insurance
plans are for new products with new rates. However, plans in the
existing “direct-pay” market where individual New York consumers
who do not have insurance through their employer can purchase
coverage have relatively uniform terms with high standards for
the level and quality of coverage provided. These existing
“direct-pay” plans are generally comparable to 2014 gold and
platinum plans. For the lower-cost tiers of individual coverage
(silver, bronze, and catastrophic), the approved 2014 rates
would represent a even greater reduction than 53 percent
compared to last year’s average direct pay rates - however,
those plans are not directly comparable to existing offerings. 
(sgp) NY 
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