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Health insurance premiums to rise average of 7.1% in NY

Health insurance premiums for individuals and families for next year are rising an average of 7.1 percent in New York, the state has announced.

On Long Island, the average rate for the silver plan -- the most popular -- for individuals and families in 2016 will rise a little less than 6.1 percent, according to the premiums announced July 31 by the state Department of Financial Services.

In the small-business market -- which includes businesses with 2 to 100 employees -- premiums grew an average of 9.8 percent statewide and an average of 13.8 percent on Long Island.

Insurance companies request rates each year with the Department of Financial Services, which then approves or modifies the rates. Overall, insurers had requested a 10.4 percent rate hike in individual and family plans and a 14.4 percent increase in the small business market.

More than 2.1 million New Yorkers signed up this year for health insurance on the exchange, about 1.5 million of them on Medicaid, the state Department of Health said on July 29.

Anthony Albanese, acting superintendent of financial services, said in a statement that the influx of new consumers using the state's health exchange "means that rates for individuals will continue to be nearly 50 percent lower" than before its creation.

But, he said, "underlying increases in medical costs continue to be the primary factor contributing to the cost of insurance."

Paul Macielak, president of The New York Health Plan Association, which represents 37 health insurers statewide, said in a statement that the lower-than-requested increases "continue an artificial suppressing of rates."

"The approved rates do not, in many cases, accurately reflect the financial status of plans as indicated in their rate submissions," he said.

He blamed higher pharmacy costs, such as drugs for hepatitis C, and hospital consolidations, which give hospitals more bargaining leverage, for rising insurance costs.

Neil Weingarten, vice president of Conference Associates in Patchogue, group insurance administrators, agreed.

He noted that Health Republic received the heftiest statewide increase, 14.03 percent. The federally backed cooperative currently has the second highest percentage of individual and family enrollees on the exchange, 19 percent, and the highest on the state's Small Business Health Options exchange for small businesses, 35 percent. But it has struggled and has withdrawn from the mid-Hudson market, which includes Albany, Hudson Valley and Utica/Watertown regions, for next year.

Health Republic spokeswoman Tara Schuh said the co-op withdrew from the mid-Hudson market because "losses incurred there would not allow us to remain sustainable and provide access to affordable high quality care."

On Long Island, Health Republic's hike for the silver plan on the individual and family market is 13.61 percent and 19.04 in the small-business market.

The changes among the 10 plans offered on Long Island range from, on the silver plan, a 17.46 percent increase by Empire HMO to an 11.40 decrease by Oxford OHP, a health plan not offered on the state's health exchange.

In the small business market, the changes in Long Island on the silver plan range from a 29.5 percent hike by Emblem HIP to a 2.46 percent increase by North Shore-LIJ CareConnect.

Alan Murray, chief executive of North Shore-LIJ CareConnect, attributed the company's modest increases -- only 1.18 percent on the silver plan for individuals and families on Long Island -- to its "unique model" as an insurer directly connected to the North Shore-Long Island Jewish Health System.


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