NYS 2016 Rates Approved

NYS 2016 Rates Approved

NYS 2016 Rates Approved

The rate requests for 2016 marked the first year in which insurers could rely on actual data from exchange enrollees. In many cases, insurers participating in exchanges in other states requested double-digit rate increases. New York is the second-largest state to receive final approval of its rate requests. Earlier this week, California insurance regulators approving an average rate increase of just 4 percent.

To the relief of customers of industry leader Oxford/UnitedHealthcare  the rate increase for groups will be 3.9 to 6.5%.  Importantly, the rates are a collective average and may range depending on one’s particular health plan. Additionally,  Helath Insurers can opt to tweak or remove plans.   Reminder: be sure to check back again our site in 30-60 days.   Rates will be posted upon Health Insurer’s release. Also 2016 Individual Exchange Marketplace opens Nov 15th.

Individual MarketNYS DFS 2016 Rates

On average, insurers requested a 10.4 percent increase in health insurance rates for 2016 in the individual market. DFS reduced that average increase more than 30 percent to 7.1 percent – which is below the approximately 8 percent average increase in health care costs.

Starting on January 1, 2016, New York will add a new Basic Health Plan a.k.a ” Essential Health Plan” to the plans that can be purchased by lower income New Yorkers through NY State of Health. Households at or below 150 percent of the federal poverty level ($17,655 for a household of one; $36,375 for a household of four) will have no monthly premium for the Basic Health Plan.  Those with slightly higher incomes at 200 percent of the federal poverty level ($23,540 for a household of one; $48,500 for a household of four) will have a low monthly premium of $20 for each adult.

The Basic Health Plan will provide the same covered services as other plans offered on the Marketplace.  The Basic Health Plan has no annual deductible and lower copayments, making health care even more affordable for hundreds of thousands of New Yorkers.  For example, a person who earns about $20,000 a year and uses moderate health care services including an inpatient hospital stay, prescription drugs and doctor’s visits, will pay about $730 a year for premiums and out-of-pocket costs under the Basic Health Plan in 2016 as compared to about $1,830 in 2015 if they were enrolled in a Qualified Health Plan.

Small Group Market

On average, insurers requested a 14.4 percent increase in health insurance rates for 2015 in the small group market. DFS reduced that average increase by 32 percent to 9.8 percent. A number of small businesses will also be eligible for tax credits that would lower those premium costs even further.

2016 Small Group Rate Actions – Overall Summary


Aetna Life23.87%21.47%-2.40%
CDPHP HMO*-19.84%-19.84%0.00%
CDPHP UBI*16.56%16.56%0.00%
Emblem HIP*29.74%29.74%0.00%
Empire Assurance8.70%3.40%-5.30%
Empire HMO9.21%4.37%-4.84%
Health Republic*20.00%20.00%0.00%
Independent IHA*-15.60%-15.60%0.00%
Independent IHBC-6.19%-6.19%0.00%
Managed Health5.60%3.94%-1.66%
Metro Plus*-0.81%-0.81%0.00%
MVP Health Plan*7.28%6.36%-0.92%
MVP Services*16.71%15.90%-0.81%
North Shore LIJ*3.27%3.27%0.00%
Oxford OHI13.61%6.75%-6.86%
Oxford OHP10.58%3.90%-6.68%
United UHIC18.79%11.61%-7.18%
All Companies Combined14.41%9.80%-4.61%


You may view the DFS press release, which includes a recap of the increases requested and approved by clicking here.

For specific details on all available health plans in 2015, contact our team at Millennium Medical Solutions Corp  (855)667-4621.  We work in coordination with Navigators to assist with Medicaid, CHIP Child Health Plus, Family Health Plus and Medicare Dual Eligibles.   We have Spanish, Russian, and Hebrew speakers available.  Quotes can also be viewed on our site.

See Health Reform Resource

      NYS 2015 Rates Approved 

5 Things You Need to Know AFTER Buying Obamacare

5 Things You Need to Know AFTER Buying Obamacare

5 Things You Need to Know AFTER Buying Obamacare

How to Enroll on NYS Exchange Marketplace

Congratulations – you just signed up successfully for Obamacare!  You made it right before the March 31st deadline and avoided the individual penalty and getting blocked out for 2014. Don’t relax just yet.  If you’re one of the many people who applied on the first open enrollment it’s smart to expect some bumps over the next few weeks. Shifting deadlines and technical glitches have left many insurance companies scrambling to catch up to the flood of requests. To make sure you start things right, here are some easy ways to stay vigilant:

  1. Pay  the premium –Until you pay for the plan you do not truly have a plan just yet.  Some states and insurance companies have extended the deadline to pay, but its best to do this as soon as possible.  For maximum peace of mind, get written confirmation from your new insurance company.  If you go to the doctor before you pay your premium, you may end up footing that medical bill if the insurance company doesn’t have a record of your premium payment.
  2. Member ID Cards –in about 1–2 weeks after you receive your first bill you will receive your Member ID card from your carrier after you’ve made your first premium payment. This is the card you’ll share with medical providers and pharmacies when you receive service. Your carrier may allow you to print a temporary ID card if you need care prior to receiving your Member ID card(s). Your insurance card will (hopefully) arrive in your mailbox in early January.  You’ll present it wherever you need services: at the pharmacy, doctor’s office or hospital.  Since insurance companies had a very short turnaround time to process new members, you may see a delay.  Don’t panic! Go to the insurance company’s website to see if you can print a temporary ID card. (This is a lifesaver!) If you turn up empty, call the company’s customer service number to confirm that you are in their system as an enrolled member.
  3. Don’t rush to the doctors – If you have an immediate need for a prescription or an appointment, by all means take care of it asap. But if you can, wait a few weeks before scheduling your doctor’s visit.  This will give time for the insurance companies and doctors to update their systems with all the new plans and enrollees. This way, you help ensure that the medical claim for your doctor’s visit will be processed accurately – and that you dodge some of the early-stage craziness.
  4. Double check –  that your doctor is in your new plan’s network . Most of the new insurance plans also came with new provider networks.  Its smart to double check that your favorite doctor is in the network for the exact plan you just enrolled in. There are specific networks for different insurance products, so make sure you are checking the right one.  If your doctor is not in the network, keep in mind that you may have to pay significantly more money to see an out-of-network doctor, so you may consider switching.  See States Pushing Back Against Smaller Networks
  5. Keep records – Keep a record of your payments, calls, emails with your insurance company and physicians.  Just in case of a technical glitch in the insurance or doctor’s computer systems, you can show evidence of your payment or confirmations from your insurance company.

 Obamacare 2014 Deadline Nearing.    You are now more knowledgable than most after reading this article.  Given all the new changes thanks to the new insurance plans, new enrollees, and changing deadlines, being aware of these simple tips will help you avoid unnecessary headaches. And remember, if you are still shopping for insurance, you only have until March 31st to enroll in a plan.

For enrollment help before the deadline  information  please contact our team at Millennium Medical Solutions Corp  (855)667-4621.   We have Spanish, Russian, and Hebrew speakers available.  Quotes can also be viewed on our site.


Health Exchange FAQ
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Federal government health care site: www.healthcare.gov

Kaiser Health Reform Subsidy Calculator:http://healthreform.kff.org/subsidycalculator.aspx

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