All health insurance companies serving downstate New York recently filed their 2015 rate requests with the NYS Department of Financial Services. While these rate requests must be approved by the state, the requests themselves indicate how well a company is operating in the individual small group health insurance market.

Winners and Losers

There are many factors involved on how a health insurance company determines premiums for an upcoming year. The number of enrollments, claims to premiums paid ratios, plan structures, operating efficiency, and other reasons all play a part on how much an individual or business owner will pay for health insurance every month. With that said, most carriers are requesting prices increases (very high in some cases), while others are actually requesting rate reductions.

The following is a partial list of health carriers supporting individual and small group plans in the downstate NY area, and their requested rate amounts for 2015 (indicated by a % spread range compared to 2014 pricing). Actual renewal cost changes will vary based on plan medal levels. If approved by the state of New York, these rates will go into effect on January 1, 2015 (for individuals), or upon renewal for small groups:

Individual Market

Empire Blue Cross: +12.6% to +18.5%
Oxford Health Plans: -0.6% to +1.2%
North Shore LIJ CareConnect: -7.9% to +3.6%
Health Republic: +12.9% to +16.5% (excludes catastrophic only plans)
Oscar: +1.0% to +9.5%

Small Group Market

Empire Blue Cross: +18.8% to +25.3%
Oxford Health Plans – Liberty HMO’s: +15.6% to +22.3%
Oxford Health Plans – Liberty/Freedom EPO’s: +9.2% to +13.1%
North Shore LIJ CareConnect: -21% to -9%
Health Republic: +5.5% to +5.5%
United HealthCare: +14.3% to +15.8%

NYS Rate Approvals

Once again, these are only rate filing requests with the New York State Department of Financial Services. The state must approve these rates first, which will occur as we move closer to 2015. Final rate approvals and plan structures will be released by the carriers later this year.

For more information about securing individual or small group health insurance in downstate NY, contact an insurance broker.