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The NYS 2021 Rate Requests filings were released today.  The total weighted average increase request was 11.4% for  Small Group Market with some citing Coronavirus as necessitating higher premiums next year.That figure is heavily influenced by the request of UnitedHealthcare’s Oxford, which has recently controlled about half the market and requested an 13.6% increase.  The total weighted Indiv market request is an 11.7%.


Health Insurers have been meeting the COVID-19 challenge by paying 100% for diagnosis and treatments at no cost to the consumers. Additionally, health insurers have been advancing cash payments to hospitals while also absorbing sustained premium losses. 

This early filing request deadline request requirement is not an Obamacare requirement.  As per NY State Law carriers are required to send out notices of rate increase filings to groups and subscribers.These are simply requests and the state’s Department of Financial Services has authority to modify the final rates. But they are the first indication of what New Yorkers can expect when shopping for health insurance on the individual marketplace at the end of this year.

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.

In the small-group market, national insurers such as UnitedHealthcare’s Oxford and Empire Blue Cross have requested 13.8% and 16.6% rate hikes. Recent start-up, Oscar Health has requested a 29.1% increase. Disappointingly, the google-backed health insurer has been a leader in health technology and had supposedly righted the ship with new plan designs.

Fortunately, the localized hospital-owned network such as Healthfirst has requested a modest 5.5% increase. This is consistent with last years 4.7% increase and their inflation busting average of 5% last 3 years. Similarly, the Fishkill-based, MVP Healthcare, is asking for only a 4.1% hike which is even lower than their 7% for 2020. MVP has averaged a stable 6% increase last three years. 


Final rate approval are expected in early August. The past rate reductions averaged 10-50% savings. Last year, plans asked for an average increase of 9.2% and NYS 2020 Final Rates Approved at a 7.9% increase. 

Defined Contribution Choice:  Instead, the correct approach for a small business in keeping with simplicity is a defined contribution model using a Private Exchange or a PEO.  This is a true defined contribution empowering employees with the choice of leading insurers offering paperless technologies integrating HRIS/Benefits/Payroll.  Both employee and employers still gain tax advantage benefits under the business.  Also, the benefits, rates and network size are superior under a group plan as THE RISK OUTLINED ABOVE ARE HIGHER FOR INDIVIDUAL MARKETS THAN SMALL GROUP PLANS.

To be clear: These trends affect a small subset of the insurance market—non-group plans that cover less than 2 percent of the population. Many qualify for tax credits that lower their net costs and reduce or eliminate the impact of year-to-year rate increases.However, non-group customers with incomes above 400% of the poverty level ($48,560 for a single adult) get no subsidy—and feel the full brunt of any hikes.


  • For a custom analysis detailing YOUR upcoming 2019-2020 renewal please 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.  
  •  See Health Reform Resource

Learn how a Private Exchange and our PEO Partnership can help your group please contact us at [email protected] or (855)667-4621.

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