HealthPlus HP, LLC Individual 2023 Public Comments
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HealthPlus HP, LLC
Individual
2023 Public Comments
My insurance company is requesting a 5.8% rate hike. This request is not merited. As compared to my previous
employer sponsored coverage (which cost $700/month less, even without employer subsidies), this insurance is
accepted by fewer doctors (My family had to switch all of our providers) and they pay those providers nothing. I have
yet to have a bill in which the insurance company has paid anything. It seems like I pay the monthly fees, the doctors
submit the forms, and the insurance company says that instead of $2,000 billed, the doctor can take the copay, thank
you very much. So currently, I'm paying $2,511.53 a month. I think, considering what we get, that the actual rates
should come down. In any case, please do not allow this company to take more of my money than they already are
taking.
As a homeowner and individual health insurance purchaser in I am writing to oppose 2023 rate increases
by Empire BCBS on the NYS Marketplace. I received a letter notifying me of this rate change from Empire BCBS citing
rising costs. This reasoning is absurd in the face of record profits reaped by Empire over the past two years. The
citizens of NYS are depending on this agency as a line of defense against this life threatening extortion driven by
corporate greed. Basic coverage with RX is currently $881.24. The 5.8% increase noted in the letter brings this very
basic coverage to $932.35 for an individual. DFS must defend our citizenry from this obscenity. The marketplace has
failed to provide affordable health coverage for our state. We can not continue to sanction outrageous costs for basic
healthcare. Please reject multi billion dollar profit making by these corporations at the expense of the physical and
financial health of the people of New York State. (NOTE: notification letter was given for marketplace health plan:
. This is not listed in DFS comments drop down selection box. Please update plan
selections to avoid confusion for commenters)
My family's health plan - for 4 people - is $2,800 A MONTH!!! We are self employed. It is not even a PPO plan. This is a
ridiculous amount for anyone to pay and this is not even the top tier plan that is offered. and
needs regular attention and medication and so do I. No increase should be permitted and if anything the rates should
go down. THe corporate profits are HIGH enough.
If this Plan was subsidized I could not complain but for the absurd amount of money it costs for a couple let alone a
Family an increase is purely unneeded. Will there be additional benefits at this cost or lower deductibles? I can answer
that myself which is no better service no more coverage, just no added value for $25,000 a year plus $8000 deductible
on top. Someone needs to rein this train wreck of a industry in before it collapses on itself. Inflation, Covid, Labor
shortage and so on lets be honest the medical industry was heavily subsidized by tax payers during covid to begin with,
helping further push consolidation in the industry creating higher premiums and medical costs. Poor Policy needs to be
held accountable especially in this sector. Someone needs to be brave enough to tackle this in politics.HealthPlus HP, LLC Individual 2023 Public Comments I vigorously oppose the rate increase. Despite the affordable care act, my insurance goes up over a hundred dollars every year and the amount of coverage declines every year. I'm and have to pay almost a thousand dollars a month for crappy health care that is a fraction of what I used to get for $400/month. That's equivalent to half my mortgage and is becoming unaffordable. To whom this concerns, I know Empire is trying to raise my premium 6.2% in this coming year and I'm writing to contest this request. Instead of raising our premiums, they should turn some of their profits from the past few years into better services, reduced rates, and improving the health care system. It's unacceptable to me that my monthly premium, for decent health care, to be half of my rent. Thank you,
HealthPlus HP, LLC Individual 2023 Public Comments Please see https://hcfany.org/resources/comments-on-the-2023-individual-market-rate-requests/ for Health Care For All New York's full comments on the individual market rate requests. HealthPlus, formerly Empire, is a for-profit health insurer that offers individual HMO plans in the Albany, Long Island, Mid-Hudson, New York City, and Upstate regions. In 2022 these plans cover 11,254 people, down from 14,719 in 2021. This continues a precipitous decline in membership that started in 2017, when it covered 54,058 members. Membership declines were driven by two factors: (1) a major reduction of network size; and (2) consumer confusion caused by multiple years of substituting new products and networks, causing major disruptions in the enrollment experience. HealthPlus receives large payments from the federal risk adjustment program because its members utilize more health care services than those in other plans. This year the risk adjustment payment allowed HealthPlus to adjust its proposed rates downwards by 16%. However, it is still the third most expensive plan in the state. HealthPlus is asking for a 6.9% increase, which would mean a weighted average premium of $905 per-member per-month in 2023. This is lower than the average request. However, there are many reasons that the Department should consider rejecting its request for higher rates. Most importantly, it has not met the state’s MLR requirements for several years. Other factors that should be closely scrutinized are its overly inflated trend and profit projections. 1. HealthPlus has a history of low medical loss ratios that suggest it does not need a rate increase for 2023. In 2020, Healthplus had a medical loss ratio (MLR) of just 68.3%, far below any of the other carriers (the next lowest was 77.2%) and the legally required 82%. In 2021, the last year in which actual MLRs are available, it was only 83.1%. In fact, HealthPlus will likely pay rebates to customers in 2022 because its three-year average MLR was only 79.9%. This year, HealthPlus seeks to keep 11.8% of its premium payments for an MLR of 88.2%. Given its failures over the past few years to meet the legally required minimum MLR, it should be expected to strive for a higher MLR before receiving another rate increase. 2. HealthPlus may be over adjusting for the loss of the American Rescue Plan Act’s enhanced premium subsidies. None of the carriers should be granted increases for a federal policy change that may or may not happen. If these increases are allowed, the Department should closely look at HealthPlus’ adjustment. HealthPlus is suggesting premiums will increase by 1% due to the loss of the subsidies. However, HealthPlus is receiving one of the largest risk adjustment payments (resulting in a downward adjustment of 16%) and is one of the most expensive plans in the state. Both of these factors indicate that its plans are unlikely to attract consumers who are on the fence about purchasing health insurance. The Department should consider whether it is logical for HealthPlus to be so affected by the premium subsidies, especially considering that six other plans are estimating no effect. 3. HealthPlus says that medical inflation will be 7.2%, but this should be reduced to 5.9%. The Department should cap medical trend at 5.9% for all carriers, the average medical trend approved for the 2022 rates. 4. HealthPlus should not be granted a 2% profit for 2023. HealthPlus is asking to keep 2% of its premium revenue as profit. Only two other plans matched or exceeded this request. The Department should limit HealthPlus’s profits to 0.5% as has done in the past for all carriers. It should also consider whether HealthPlus should be allowed to build any profit into its 2023 rates given its excessively high premiums and MLR failures over the past few years. 5. HealthPlus quality and appeal data The Department should refer to its Consumer Guide in determining whether HealthPlus, a subsidiary of Empire, warrants a substantial rate increase. According to the 2021 Consumer Guide, Empire’s enrollees filed the largest number of external review requests (443 out of 1,253). Its reversal rate was above the state’s average of 38 percent, indicating that its enrollees may be experiencing unnecessary claim denials for the large premiums that they pay. Likewise, Empire ranks dead last in prompt payment complaints. In addition, Empire’s overall complaint ranking of 50 (out of 58) is amongst the lowest in the state. Empire’s quality of care rankings in several measures, including breast cancer screening, rank below the state average. These indicators should be considered as the Department conducts its review of Empire’s rate increase request.
HealthPlus HP, LLC Individual 2023 Public Comments I have Empire BCBS by Anthem. Couldn’t find in DropDown. I received a notice of BCBS submitting a request to you for my premium increase going up to nearly $900. It has already increased 47% in the last decade. This is unacceptable in this climate, with a looming recession having yet getting paid less than any other generation before me. I desperately want you to deny the increase. I need to be able to receive without suffering. This topic has even taken up space in . We cannot live in a world where healthcare is a business of greed and not a human right. BCBS also recently had to pay a billion dollar settlement and we wonder why they want more money. I hope the people reviewing this complaint can take it in with empathy, compassion and action. BCBS even tried to deny me of . I had to argue on the phone with an innocent representative. We deserve healthcare at a reasonable cost and not even now is it reasonable. But I need a plan that still takes my doctors and this was the only choice. You have the power. Please do something Premiums are already extremely high to cover the multitude are people who are under-insured in NYC. A 5.8% rate increase would be usurious and punitive.
Please Do Not allow these overly High rate hikes, we the people are just getting back to work and are needing help to recover financially!
July 6, 2022 Josh Riley Candidate for Congress New York’s 19th District P.O. Box 6806 213 Tioga Street Ithaca, NY 14851 Hon. Adrienne A. Harris Superintendent New York State Department of Financial Services 1 State Street New York, NY 10004-1511 Superintendent Harris, I urge you to reject the proposed rate increases that recently were submitted to your Department by various health insurance companies. Having met with so many folks across New York’s new 19th Congressional District, one thing is very clear: Upstate New Yorkers cannot afford to pay higher costs for health insurance right now. In their recent filing with your Department, health insurance companies in the individual market proposed an average rate increase of 18.7%, and health insurance companies in the small group market proposed an average rate increase of 16.5%. Some insurance companies have even proposed increases of 30% or more, a staggering amount for which there is no discernible justification. If approved, these increases could raise Upstate New Yorkers’ monthly costs by $100 per month or more. With rising costs for everything from groceries to gas, folks in New York’s new 19th Congressional District are already making difficult decisions to balance their family budgets. I’ve spoken with folks who have had to cancel summer vacations because prices are too high, and I’ve spoken with seniors who have had to make impossible choices between their medications or groceries. A
substantial increase in health insurance premiums right now would be too
much for many families to bear.
I encourage you to reject, or at least substantially reduce, the rate proposals
that have been submitted to your Department. Working families across
Upstate New York need relief from rising costs, not more of them.
Sincerely,
Josh Riley
Candidate for Congress
New York’s 19th DistrictYou can also read
