The state Department of Financial Services has given health insurers the green light to increase premium rates next year by an average of 9.7% for individual plans and 7.9% for small-group plans, the agency announced Wednesday.
The average increase for individual plans is 48% less than what insurers had requested in May, when they submitted their proposals. Department officials said the reduction translates to $167.1 million in savings for the roughly 262,000 New Yorkers enrolled in individual plans.
The increase comes after two years of record-low rate increases in the individual market; the department approved an average rate increase of 3.7% for 2022 and of 1.8% for 2021, citing economic fallout from the pandemic.
For small-group plans, which cover businesses with up to 100 employees, insurers had requested an average rate boost of 16.5%. The department slashed that by 52%, saving small businesses about $632 million.
The department also held insurers’ profit provisions to 0.5%. Before 2021, it held profit to 1.5% or 2%, a departmental spokesperson said.
“Rising medical costs and inflation continue to put upward pressure on premiums,” Superintendent of Financial Services Adrienne A. 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.”
Some New Yorkers and small businesses may qualify for tax credits to lower their premium costs, the department said.
Not-for-profit health insurer CDPHP was approved for a 16.5% premium rate increase for its individual plans, more than any other insurance carrier in the state. It had originally requested a 28.4% increase for 2023.
Dr. John D. Bennett, president and CEO of the Albany-based insurer, said the organization continues to battle rising costs due to Covid, pent-up demand for medical services, provider consolidation and government taxes and fees.
“Heading into 2023, our commitment to value-based care could not be stronger,” Bennett said in a statement. “We know that any price increase is difficult for families to absorb, which is why we will continue to work to find innovative solutions to make health care more affordable.”
According to the department’s list of approved rate increases, no insurance company plans to lower its premiums next year, as three did for 2022.
Eric Linzer, president and chief executive of the New York Health Plan Association, which represents the state’s health plans, said that insurers’ proposed increases for 2023 had reflected the continued impact of Covid and the rising costs of drugs, hospitals and medical services as health care utilization increases.
“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,” he said in a statement. “Unfortunately, the final approved rates do not fully account for the factors driving underlying health care costs.”
Employers widely expect that providing health coverage to their employees will become much more expensive next year. A recent survey, which was conducted by consulting firm Mercer, found that companies are predicting those costs to rise 5.6%.
The roughly 1 million New Yorkers enrolled in the state’s Essential Plan, which charges no premium for lower-income members, will not be affected by the rate increases released Wednesday. —Maya Kaufman
Northwell, Empire renew agreement, focus on value-based payments
Northwell Health and health insurer Empire BlueCross BlueShield have renewed their reimbursement agreement, creating new structures for Northwell and expanding the pilot programs its patients can be part of, Empire announced today. The insurer did not disclose details on the reimbursement structures.
Northwell and Empire began negotiations for this agreement, which goes into effect next year, in 2021, said Jordan Vidor, regional vice president of provider solutions at Empire. Starting early made the agreement more collaborative than a typical system agreement, he added.
The renewal will develop a partnership for Northwell’s House Calls program, in which the health system delivers in-home care to patients with complex conditions.
Additionally, Vidor said, the new agreement will increase the reimbursement structures between the companies when it comes to value-based care. These types of payment arrangements allow Empire to pay Northwell for services the system provides that aim to keep patients healthier, such as performing a screening for breast cancer earlier instead of waiting until the patient already has breast cancer, which is more expensive. Empire will now reimburse Northwell in this way for every Empire member who gets care from Northwell, including Medicare, Medicaid, commercial and employer-based health plan members, Vidor said.
“There will now be a greater percentage of revenues paid to the [Northwell] health system in accordance with a value-based agreement than ever,” he added.
Northwell was already an in-network provider for Empire. It is now a participating provider in all of Empire’s product lines and provider networks, including its Connection network, which aims to provide affordable care to members.
Empire is the largest health insurer in New York with more than 4 million members and 38,000 employers. Northwell Health is the largest health care provider in the state, operating 21 hospitals and more than 850 outpatient facilities and employing about 80,000. —Jacqueline Neber
Zocdoc founder’s new telehealth startup raises $8M
Dr. B, a telehealth platform started by Zocdoc founder Cyrus Massoumi, has raised $8 million in seed financing, it announced Tuesday.
The Tribeca startup, which offers virtual visits to prescribe Covid-19 antiviral pills, will use the proceeds to expand its prescribing capabilities to other types of medications, such as for reproductive, cardiac and dermatological care.
Virtual prescription consultations cost $15, although Dr. B offers no-cost consults to patients based on their income level. The company does not accept insurance.
Massoumi said the financing will also enable Dr. B to make its platform more accessible and offer services in languages other than English and Spanish.
The all-equity round included participation from SoHo-based early-stage venture capital fund Lerer Hippeau and PayPal cofounder Peter Thiel’s Founders Fund, a tech-focused venture firm based in San Francisco.
Dr. B’s telehealth services are available in 41 states.
Massoumi declined to specify how long the seed financing could last.
“Right now we aren’t thinking about our next funding round,” he said. “Our team is heads-down and focused on expanding the platform to prepare for what we expect to be a very busy fall.”
Dr. B was formed in 2021 as a platform for matching people to available Covid vaccine doses. It launched telehealth services this week. —M.K.
Governor Hochul launches $50M life sciences competition for Long Island companies
Gov. Kathy Hocul has launched a $50 million life sciences competition for Long Island companies to accelerate their start-ups and create new technologies in the life sciences, medical device and health technology sectors, the governor’s office announced Wednesday.
The $50 million will allow a business accelerator to work with Long Island universities and research institutions to help startups that have the potential to create permanent, high-paying jobs and commercialize their technology. A request for proposal process will start the competition.
This business competition is part of the state’s $350 Long Island Investment Fund, which also includes $250 million for regional development projects and $50 million for a workforce development center. The fund is included in Hochul’s enacted budget for fiscal 2023.
Life sciences businesses and institutions that are already established on the island include the Feinstein Institutes for Medical Research in Manhasset, the Cold Spring Harbor Laboratory, Brookhaven National Labs, and Stony Brook University in Suffolk County. —J.N.
AT A GLANCE
TOWN HALL: The state’s commissioner of health, Dr. Mary Bassett, conducted a virtual town hall with the Office of Aging and Long-Term Care to review its organizational structure and goals, which include creating policies that meet the needs of older and disabled New Yorkers who need long-term care, licensing providers, surveying facilities and collecting data. The town hall came after the state Department of Health announced the formation of the office in July.
POLICY PAPER: The Federal Trade Commission released a paper Monday which advises state lawmakers against enacting Certificate of Public Advantage laws. COPA laws allow hospitals to merge if the state determines the benefits of the merge would outweigh the disadvantages of less competition and more consolidation–but the FTC argues that lessening competition through these laws drives health care prices up for patients and makes the quality of care worse. Read the full report here.
UTILIZATION LAGS: Hospitals saw lower levels of inpatient service utilization in the second quarter of this year, Modern Healthcare reportedWednesday, because of staff shortages, more patients using telemedicine and fewer acute Covid-19 patients coming in. Large health insurance companies were able to raise their profit forecasts because of these trends while hospitals saw negative financial impacts.
WHO'S NEWS:The "Who's News" portion of "At a Glance" is available online atthis linkand in the Health Pulse newsletter. "Who's News" is a daily update of career transitions in the local health care industry. For more information on submitting a listing, reach out to Debora Stein:[emailprotected].
CONTACT US: Have a tip about news happening in the local health care industry? Want to provide feedback about our coverage? Contact the Health Pulse team at [emailprotected]
FAQs
What is the average increase in health insurance premiums for 2023? ›
Insurers requested an average rate increase of 18.7% in the individual market, which DFS cut by 48% to 9.7% for 2023, saving consumers $167.1 million.
Will insurance premiums increase in 2022? ›Term Insurance Premium May Go Up By 20-40% From 2022; Know Why. Getting life insurance coverage may cost you 20-40% more in 2022, as insurance companies are likely to raise premiums on term insurance policies, said a news article by the Economic Times.
Why insurance companies are increasing the premium amount? ›Time and inflation affect expenses of your life, including that of your health insurance premium. And like most things in life, one of the primary reasons for this increase is due to inflation. This may surprise you (or not) but the inflation in the healthcare industry is a lot higher than most other industries.
Does premium of insurance increase every year? ›If you're wondering whether your health insurance premium increases upon renewal every year; the answer is yes. Every year, your expenses like rent, fuel, food, etc. increase due to inflation and so does your health insurance premium.
What is the ACA affordability percentage for 2023? ›The ACA affordability percentage for the 2023 tax year is 9.12%, a historic low, and a significant drop from 2022's 9.61%. As a result of the lower percentage, employers will need to contribute more toward their employees' monthly health insurance premiums next year.
What is medical trend? ›Medical Trend Rate is defined as the percentage of change in the cost of health care prior to any cost-containment measure undertaken by plan sponsors.
Is third-party insurance increasing? ›Insurers have been allowed to raise their third-party motor premium rates after two COVID-affected years. The hikes for car- and bike-owners are in the range of 0.1-20.7 percent. After a two-year delay, third-party motor insurance premium rates are set to go up, starting this month.
Does progressive raise rates after 6 months? ›Yes, Progressive does raise rates after 6 months in some cases. If you're a new Progressive customer, you'll see your auto insurance premium go up after your first 6-month policy period if you file a claim or traffic violations get added to your driving record during that time.
What can people do to lower their auto and life insurance premiums? ›- Increase your deductible.
- Check for discounts you qualify for.
- Compare auto insurance quotes.
- Maintain a good driving record.
- Participate in a safe driving program.
- Take a defensive driving course.
- Explore payment options.
- Improve your credit score.
In general, when you make a claim against your insurance policy above a specific amount due to an incident that is primarily your fault, an insurer will increase your premium by a certain percentage.
What increases your premium? ›
Your age — and years of driving experience — may also have an impact. The type of coverage you choose affects your premium. Coverages that may be optional, like collision or comprehensive, cost extra. One last thing to keep in mind: Limits and deductibles affect the cost of your policy.
Is term insurance going to increase? ›Since the pandemic began, term plan rates have gone up between 25 per cent and 30 per cent, said a source. Factoring in the current hike, the increase in term plan rates will be anywhere between 50 per cent and 60 per cent.
Does health insurance premium increase with age on renewal? ›Remember that premium for health plans always increases with age. So, even your existing health plan premium rises with age. But for your existing health plan, the company will surely have to renew it as long as you pay your premium and your coverage will never cease to exist.
Will insurance premium increase with age? ›With the age of the policyholder, the health insurance premiums also rise. The younger. Similarly, the older your age is, the higher will be the health insurance premium.
Does existing health insurance premium increase with age? ›The premium usually remains constant as long as you are in the same age bracket. But once you shift from one age bracket to another the premium will increase.
How to calculate affordability for ACA? ›To calculate ACA affordability for the 2022 tax year under the Rate of Pay Safe Harbor using hourly workers' earnings, take the employee's lowest hourly rate as of the first day of the coverage period and multiply it by 130, the minimum total of hours an employee must work on average to be ACA full-time.
Is ACA affordability based on plan year or calendar year? ›Note that the ACA adjusted affordability percentage is applied on a plan year basis. This means that non-calendar year plans with plan years prior to January 1, 2023 will continue to base affordability calculations for employee contributions on the 2022 standard of 9.61% until their new plan year begins.
What is the affordability threshold? ›The affordability threshold, which affects employers' potential liability for ACA shared-responsibility penalties, is adjusted annually based on health plan premium growth relative to income growth, using national health expenditure data from the Centers for Medicare & Medicaid Services.
Will health care costs continue to rise? ›Despite the decrease in health services accessed in 2020 due to the COVID-19 pandemic, national health expenditures are expected to reach $6.8 trillion by 20302. With no end in sight to rising health insurance costs, it's important to understand what exactly causes these spikes in the first place.
Why is healthcare so expensive? ›The price of medical care is the single biggest factor behind U.S. healthcare costs, accounting for 90% of spending. These expenditures reflect the cost of caring for those with chronic or long-term medical conditions, an aging population and the increased cost of new medicines, procedures and technologies.
What is the medical trend for 2022? ›
Where is the medical cost trend headed in 2022? PwC's Health Research Institute (HRI) is projecting a 6.5% medical cost trend in 2022, slightly lower than the 7% medical cost trend in 2021 and slightly higher than it was between 2016 and 2020.
What is basic TP premium? ›The basic premium for TP cover depends on the Engine capacity or cubic capacity of the car. The more the cubic capacity, the higher is the premium. While the total premium paid is the **sum of basic premium and the amount for personal accident cover** for owner/driver*.
What is TP rate in insurance? ›Two-wheelers over 150 cc but not exceeding 350 cc will attract a premium of ₹1,366 and for two-wheelers over 350 cc the revised premium will be ₹2,804. After a two-year moratorium due to the COVID-19 pandemic, the revised TP insurance premium will come into effect from June 1.
What is the cost of third party car insurance? ›| Cubic Capacity of the Car | Third Party Insurance Premium for the Car |
|---|---|
| Not more than 1000cc | ₹2,094 |
| Over 1000cc but not more than 1500cc | ₹3,416 |
| More than 1500cc | ₹7,896 |
That's because Progressive has special savings opportunities for drivers in this category, such as lower rates for drivers who have not had any accidents or tickets for at least three years. Your final premium is based on a variety of factors, though, such as your driving record, insurance history, and more.
How much is car insurance in NY per month? ›The average cost of full coverage car insurance in New York is $2,020 per year, or about $168 per month, according to NerdWallet's analysis. Minimum coverage in New York is $941 per year on average, but we found you can likely get a cheaper policy.
Did GEICO rates go up 2022? ›Inflation impacting auto insurance rates
Several major auto insurers, including Allstate, Progressive, Geico and State Farm, already increased rates in early 2022 in many states, according to Bankrate.
- Review your policy coverage. Look over your policies annually, because prices can change from year to year. ...
- Check your deductibles. ...
- Make home improvements. ...
- Discontinue extra coverage. ...
- Ask for discounts.
You should get umbrella insurance when your net worth exceeds the limits of your homeowners or auto liability insurance policy. Umbrella insurance extends your liability limits to $1 million or more, which can better protect you against expensive claims or lawsuits if you have a particularly high net worth.
Why is new driver insurance so expensive? ›Young drivers are more expensive to insure because they're statistically more likely to have an accident — around 25% of all claims are made by drivers under the age of 25. Insurers also look at lots of other things when working out how much you should pay for a policy, including your: Vehicle. Job title.
What is the 80/20 rule in insurance? ›
The 80/20 Rule generally requires insurance companies to spend at least 80% of the money they take in from premiums on health care costs and quality improvement activities. The other 20% can go to administrative, overhead, and marketing costs. The 80/20 rule is sometimes known as Medical Loss Ratio, or MLR.
Does increasing your deductible decreases the premium? ›In most cases, the higher a plan's deductible, the lower the premium. When you're willing to pay more up front when you need care, you save on what you pay each month. The lower a plan's deductible, the higher the premium.
Why did my life insurance premium double? ›The longer the term period, the higher the premium because the older, more expensive to insure years are averaged into the premium. At the end of the term period, your premium can increase dramatically. Therefore, it is important to choose the proper term period and to be aware of when that period ends.
How do insurance companies determine your premium? ›Some common factors insurance companies evaluate when calculating your insurance premiums is your age, medical history, life history, and credit score. Insurance companies also hire actuaries or statisticians to get a better idea of the number of insurance premiums they should charge a particular client.
Is Allstate losing customers? ›Allstate's retention of existing customers fell to 87.0% in 2021 from 88.6% in 2019—its worst performance in at least two decades. The net result: a lot of transformation and little growth. Total Allstate brand auto policies in 2021 were 21.97 million, up a fraction from 21.91 million in 2019.
How much does car insurance go down after 1 year no claims? ›How much discount will you get? All insurance companies have their own no claims discount scale, but a typical example might be: 30% discount after 1 year's claim-free insurance. 40% discount after 2 years.
Which term insurance is best in India 2022? ›| S.No. | Plan | Sample Annual Premium* |
|---|---|---|
| 1. | HDFC Life Click 2 Protect Life | INR 7,185 |
| 2. | ICICI Pru iProtect Smart | INR 8,021 |
| 3. | Max Life Smart Secure Plus Plan | INR 6,095 |
| 4. | Tata AIA Life Insurance Sampoorna Raksha Supreme | INR 6,844 |
According to data from MyInsuranceClub. com, a Rs 5 lakh family floater covering self, spouse and one child will cost anywhere between Rs 10,000 and Rs 17,000 annually. A Rs 5 lakh individual health plan will cost a 35-year-old Rs 4,000-7,000 a year.
How much does health insurance premium increase? ›According to experts, health insurance premiums have increased anywhere between 10% and 25% after the pandemic, for a number of reasons, including high payouts during the last two years. In the case of senior citizens, according to policybazaar.com, “Health insurance premiums have increased by up to 100%".
Why health insurance premiums are going up? ›A new analysis of marketplace insurers' early rate filings in 13 states and the District of Columbia finds that they are seeking higher premium increases than in recent years, largely due to rising prices paid to hospitals, doctors and drug companies and increased use of services by enrollees.
Why is insurance more expensive for older people? ›
Older people pay higher premiums for health coverage because they typically need more medical care. Federal rules place caps on rates charged for individual Affordable Care Act (ACA) plans, but some states regulate health insurance premiums even more.
Why does the premium rate increase as the age increases? ›With an increase in age, individuals become vulnerable to various critical illnesses such as cancer, stroke, etc. This is one of the reasons why individuals are required to pay a higher premium amount.
At what age should you stop term life insurance? ›If you want your life insurance to cover your mortgage, consider how many years you have left until you pay off your house. You don't want your policy to expire after 20 years if your mortgage payments will last another decade after that.
At what age should you stop life insurance? ›Most life insurance policies have an upper age limit for applications. Many insurers stop taking life insurance applications from shoppers who are over 75 or 80, while some have much lower age limits and a few have higher limits.
Does term insurance premium increase every year? ›Premiums. Even though the coverage of the increasing term insurance plan increases every year, the premium rate of the policy usually remains the same throughout the policy term. While computing the premium at the initiation of the policy, the insurance company accounts for the increase in the sum assured amount.
Is health insurance premium same every year? ›If you're wondering whether your health insurance premium increases upon renewal every year; the answer is yes. Every year, your expenses like rent, fuel, food, etc. increase due to inflation and so does your health insurance premium.
Is health insurance premium fixed for life? ›Unlike term insurance or endowment plans, health insurance does not come with a fixed payment period; therefore, the burden of paying health insurance premium must be looked at as a lifetime commitment.
Will there be an increase in Medicare premiums for 2023? ›Medicare Part D Premiums Are Expected to Drop in 2023 -- but Seniors Shouldn't Celebrate Just Yet.
Why are healthcare costs increasing? ›Americans spend a huge amount on healthcare every year, and the cost keeps rising. In part, this increase is due to government policy and the inception of national programs like Medicare and Medicaid. There are also short-term factors, such as the 2020 financial crisis, that push up the cost of health insurance.
What is the projected COLA for 2023? ›Continued inflations means retirees are on pace for a substantial cost-of-living adjustment for 2023. Social Security recipients are up for a big raise next year: benefits are projected to climb 8.7% in 2023, the biggest increase in more than 40 years.
How much is the COLA for 2023? ›
At its September meeting, the Board unanimously voted to approve a 2.5% cost-of-living adjustment (COLA) increase for eligible retirees and beneficiaries in 2023.
What will the Medicare deductible be in 2023? ›Average premiums for Medicare prescription drug coverage are set to dip to about $31.50 a month in 2023, deductibles to rise. A small drop in monthly premiums to roughly $31.50 from $32.08 is expected for Part D prescription drug coverage in 2023, the government announced late last week.
Why healthcare in the US is so expensive? ›The price of medical care is the single biggest factor behind U.S. healthcare costs, accounting for 90% of spending. These expenditures reflect the cost of caring for those with chronic or long-term medical conditions, an aging population and the increased cost of new medicines, procedures and technologies.
How many Americans have no health insurance? ›Roughly 26 million people remain without health insurance in the U.S. Just under 2 percent of children are now uninsured. “We know that access to quality, affordable health care is key to healthier lives, economic security, and peace of mind,” HHS Secretary Xavier Becerra said in a statement Tuesday.
What country has the highest health care costs? ›Health Expenditure in the U.S.
The United States is the highest spending country worldwide when it comes to health care. In 2020, total health expenditure in the U.S. exceeded four trillion dollars. Expenditure as a percentage of GDP is projected to increase to around 20 percent by the year 2028.