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Press Release
September 4, 2014

Contact: Matt Anderson, 212-709-1691


Individual Rates for 2015 Will Continue to Be More than 50 Percent Lower on Average than Before Establishment of the Health Exchange

DFS Reduced Insurers' Overall Proposed Rate Increases By More Than Half

Benjamin M. Lawsky, Superintendent of Financial Services, announced today the setting of New York health insurance rates for 2015, including rates for the health benefits exchange (NY State of Health) established in 2013.

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. A substantial influx of new, previously uninsured customers has helped drive down overall premium rates in this market significantly. Nearly one million New Yorkers enrolled in individual health insurance coverage through NY State of Health during its first open enrollment period, including approximately 370,000 who enrolled in private plans.

Overall, in both the individual and small group markets, DFS cut by more than half the average proposed premium rate increases that health insurers requested for 2015. This action will save policyholders an estimated $1 billion next year.

Superintendent Lawsky said: "We closely scrutinized the proposed rate increases insurers requested and reduced them significantly where appropriate. While we have made substantial progress in reforming our health care market and holding down costs, there is much more work ahead. We will continue to engage with consumer groups, insurers, providers, and other stakeholders as we move forward with that effort."

"New York is continuing to serve as a leader in implementing health care reform," said Donna Frescatore, Executive Director of NY State of Health. "The success of our state’s health exchange and commitment to doing the job right is delivering a dramatic improvement in the affordability and accessibility of high-quality health insurance coverage for New Yorkers."

Individual Market

On average, insurers requested a 12.5 percent increase in health insurance rates for 2015 in the individual market. DFS reduced that average increase more than in half to 5.7 percent – which is below the approximately 8 percent average increase in health care costs.

Most of the average increase (4.5 percent) in individual rates is due to an expected reduction in a federal reinsurance program for insurers, which is provided through the federal Affordable Care Act (ACA). Without the impact of that ongoing phase out, the average increase would have been approximately 1.2 percent.

Many New Yorkers meeting certain income thresholds are also eligible for federal financial assistance when purchasing coverage on the NY State of Health, which would lower costs even further for them. Individuals with incomes below 400 percent of the federal poverty level ($46,680 for individuals and $95,400 for a family of four), can qualify for financial assistance that lowers cost of coverage. These subsidies generally increase in line with premiums – offsetting the impact of rate increases for many consumers. Specific subsidy amounts are based on a consumer's income level and other factors.

Small Group Market

On average, insurers requested a 13.9 percent increase in health insurance rates for 2015 in the small group market. DFS reduced that average increase more than in half to 6.7 percent – which is also below the approximately 8 percent increase in health care costs. Moreover, a number of small businesses will be eligible for tax credits that would lower those premium costs even further.

The following is a summary chart of each companies’ requested rates increases and DFS approved rates, including 16 companies that are selling on the NY State of Health Individual Marketplace and 10 companies that are selling on NY State of Health Small Business Marketplace. MORE...

Click here for the full press release and corresponding charts with approved increases