State approves reduced rate increases for Excellus, MVP Health Plan, other health insurers

ALBANY, N.Y. — New York has approved a 0.9 percent rate increase for Excellus BlueCross BlueShield in the small-group market; a 1.2 percent rise for MVP Health Plan, and a 2.4 percent increase for UnitedHealthcare Insurance Co. of New York.

That’s according to the New York State Department of Financial Services (DFS).

Rochester–based Excellus — Central New York’s largest health insurer — had requested a 4.4 percent increase. Schenectady–based MVP Health Plan had sought a 4.1 percent hike, and Minnetonka, Minnesota–based UnitedHealthcare had asked for a nearly 11 percent increase.

The average 4.2 percent rate increase for small-group plans is the “second lowest ever approved” by DFS during the last decade.

DFS reduced 2021 requested rates for small-group plans 63 percent, which it says saved small businesses more than $565 million. Over 1.2 million New Yorkers are enrolled in individual and small group plans.

DFS reduced 2021 requested rates in New York’s individual market 85 percent overall, saving consumers over $221 million. 

Some health insurers are reporting record profits for the first half of 2020 due to the postponement of elective and non-emergency services, resulting in “lower claim pay outs than expected,” per DFS.

Any excess premiums that insurers collected must be returned to policyholders under the Affordable Care Act, DFS said.

Later in 2021, the Baltimore, Maryland–based Centers for Medicare & Medicaid Services will determine any rebates that may be owed to consumers based on a review of all 2020 claims.

DFS notes “uncertainty” as to future claims and that profits reported so far this year could be offset by higher than expected claim payouts in the second half of 2020 and in 2021 as elective and non-emergency services resume.

Additionally, the continued rise of health-care costs is the “main driver” of premium rates, “as in prior years,” DFS said. For the 2021 individual rates announced Friday, drug costs account for the largest share of medical expenses (37.7 percent), followed by inpatient hospital costs (17.3 percent), outpatient hospital costs (8.7 percent), primary care (7.7 percent), and radiology (6.4 percent).