health insurance companies propose 8.4% price increase for 2020 - Crain's New York Business

New York health insurers are seeking more moderate premium increases in 2020 compared to their requests to the state Department of Financial Services a year ago. 

The weighted average requested increase was 8.4% among the 12 companies selling Affordable Care Act plans to individuals next year. 

The requests affect how much people who aren't covered through an employer will pay for health insurance. More than half of customers receive income-based federal subsidies that lower prices. 

Last year, with the Trump administration slated to zero out the individual mandate penalty in 2019, insurers asked for 24%. The state cut those proposals by two-thirds, making the weighted average increase in premiums 8.6% this year.

The lower requests reflect a stabilizing ACA market. Insurers’ financial performance improved nationwide last year to its highest level since the passage of the law. The average medical-loss ratio, which represents the portion of premiums spent on medical claims and quality improvement, was 70% last year in the individual market nationwide. That led to plans paying $800 million in rebates for failing to meet requirements on medical spending, according to the Kaiser Family Foundation. 

In New York, UnitedHealthcare, which has consistently been one of the highest-price plans in the individual market, asked for the highest premium increase, 27.1%. 

Fidelis Care, the individual-market plan with the greatest market share, asked for a 6% price increase. The national insurer Centene agreed to acquire Fidelis in 2017. 

EmblemHealth’s HIP asked for 13.5%, Empire BlueCross BlueShield’s HealthPlus asked for 2.4%, MetroPlus asked for 8.6%, and Oscar asked for 27.1%. Healthfirst, which operates two plans in the marketplace, requested increases of 6% and 10%, respectively. 

A spokeswoman for the state Health Plan Association said insurers have worked to control costs, which have been driven up by rising prescription drug prices and state mandates that require coverage of certain services. 

“Our member health plans have been committed to making health care more affordable, working hard to rein in rising health care costs and contain their own costs," she said. "The proposed premium rate requests are reasonable, reflecting the cost of care."

In the small-group market, insurers asked for a weighted average 12% boost in 2020 after they were granted a 3.8% bump for this year. UnitedHealthcare’s Oxford, which controls more than half of the small-group market, asked for a 15.9% increase, which was the highest among all plans. Oscar, at 15.8%, was close behind.

The state Department of Financial Services is expected to announce approved rates in August. 

http://bit.ly/2YYFDWS