This week, the New York State Department of Financial Services released the approved individual and small group health insurance exchange rates. As you know, open enrollment of the NY Health Benefits Exchange is scheduled to go live on October 1st, 2013, with effective dates beginning January 1st, 2014.

It’s important to note that while the DFS has approved the exchange plan costs, this does not necessarily mean that the carriers on the list (see attachment below) will be participating in the individual exchange marketplace in New York come October. For example a few weeks ago, the California Department of Insurance announced that Aetna and United HealthCare pulled out of the individual insurance market, leaving only three carriers participating in their exchange program. As we get closer to October, I’m sure this carrier list will become more stable. For now, we will assume that these will be the carriers involved in the NY individual market.

While the approved rates have been published by NYS, about the only aspects of the plans we know for certain at this moment are as follows:

-Prices for individuals and small groups
-Cost differences based on geographic location in New York
-Plan availability on or off of the exchange
Coinsurance amounts: Platinum = 90%/10%, Gold = 80%/20%, Silver = 70%/30%, Bronze = 60%/40% (% of bill paid by the carrier/subscriber)

What we do NOT know as of yet is as follows:

-Copayment structures?
-Annual medical deductibles?
-Prescription drug deductibles?
-Are the plans HSA qualified? (It was previously mentioned they would be, but it is not indicated in the spreadsheet)

Click the link below to view the approved exchange rates, and the current carrier participation list…

NY Benefits Exchange – DFS Rates

We will publish more information is becomes available to us.