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NYS Health Insurance Rate Increases Reduced

The NYS Department of Financial Services (DFS) released a press release on August 17, 2022 notifying the public that it had evaluated the 2023 small and individual market health insurance rate requests submitted by insurers and reduced them. Health insurance rates specific to an individual or small group plan have not been released by insurance carriers as of the date of this post. However, we expect the updated rates to be available by early to mid-September.

All individual and business contacts were obligated to receive notification from their insurance carrier earlier this year notifying them of the specific percentage increase they were requesting from the NYS Department of Financial Services for the 2023 plan year. Many consumers were perturbed to see double-digit increase requests for the plan they and their employees are covered by currently. The change in actual rate per plan isn’t known, but the DFS press release does provide an aggregate reduction percentage applied to the individual and small group market plans.

Why Do They Need an Increase?

Our large, experience rated book of business have been receiving double-digit rate increases in their January 1, 2023 renewal presentations from insurance carriers. The increases do not appear to be justified by the actual claim utilization of the entities population; however only a portion of that actual claim history is used in the development of the rate increase by the carrier. The portion of actual claim data used is called the groups “credibility factor.” This utilization is blended with the insurance carriers overall book of business – they call this their “book rate.” The insurance carriers are claiming they experienced an “unexpected number of catastrophic claims” in the period used to develop their book rate.

Whatever the reason, consumers continue to be burdened by increases in the cost of health insurance. Most consumers have moved to a High Deductible Health Plan model to control premium costs already. Unfortunately, they have little choice after moving in that direction other than to accept the rate increases that continue to exceed our inflationary environment.

What Can You Do?

We encourage our clients to utilize our services to evaluate their options. Also, we remind our clients to utilize the services available to them in their health plan to help them control their own costs. Utilize the 100% covered Preventive Care services annually. Access any bells and whistles your health plan includes like Wellness benefits and Telemedicine. Don’t hesitate to reach out to KBM Management with any questions about your plan and options.

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