New Yorkers facing health insurance rate increases in January

For people who work at companies with 100 or fewer employees, the average rate hike will be 7.9 percent, while the individual commercial marketplace increases are slightly higher at 9.7 percent.

That covers about 1.1 million workers in the state, about 10 percent of the total workforce. The majority of large employers are self-insured, meaning they manage health care costs for their employees directly. Others get their insurance through government programs. 

Health insurers in the Capital Region and elsewhere in New York were requesting much higher rate increases than what the DFS approved.

For instance, CDPHP, a major local health insurer, requested a 17.4 percent increase for its small company clients but was only approved for an 11.5 percent increase.

MVP, another local health insurer, requested a 14.2 percent increase for its small company plans but was granted an increase of 11.7 percent.

Those increases are for what companies pay so some companies may choose to pass on all the increases to their workers. 

Rates on plans for individuals buying insurance directly are generally more expensive, and the rate increases are higher. 

For instance, CDPHP requested a 28.4 percent increase in individual plans and received a 16.5 percent increase from DFS.

Although these are significant increases that will pinch average workers, DFS says its decisions on rates kept health insurer profits to half of 1 percent, which it said was “historically low” compared to previous years. 

The agency says it saved customers nearly $800 million in potential rate increases that would have cost New Yorkers about $100 extra a month. The increases will be less than half that instead, on average.

When submitting their requests this year, insurers said they needed to charge more due to the COVID-19 pandemic, inflation and new government regulations and taxes.

“Rising medical costs and inflation continue to put upward pressure on premiums,” DFS Superintendent Adrienne Harris said in a statement. “With our rate actions announced today, we continue to prioritize the financial wellbeing of consumers while ensuring that New Yorkers have access to a robust, stable health insurance market.” 

However, the industry was not happy that their requests were watered down and do not reflect the reality of the health insurance industry.

“The rate submissions were reasonable and appropriate, reflecting underlying costs and taking into account the premium reductions the state has imposed the last several years,” Eric Linzer, CEO of the New York Health Plan Association said in a statement. “Unfortunately, the final approved rates do not fully account for the factors driving underlying health care costs.”