TRENDING: "I was told I would get a grandfather."

No grandpa for you!

There is an article out in the Associated Press that seems to be raising a lot of eyebrows across the internet this morning.  Titled, “Like your insurance? You may be losing it,” it explains how a lot of folks who currently have limited benefit health coverage may have to upgrade this coming fall.

This information may seem to fly in the face of what many folks have been told about Obamacare: “If you like your coverage, you can keep it.”  While this may still hold true for a lot of folks, the devil – as always - is in the details.

Most health plans that existed before the ACA was signed in March of 2010 were eligible for grandfathered status.  This means that they are exempt from having to provide most (but not all) of the comprehensive benefits and consumer protections that the ACA requires.  But, if in the past three years or so, the insurer or the employer have made significant changes to a plan’s benefits or how much members have to pay, then the plan would have lost its grandfathered status.

So, there you go.

This should not be cause for panic. Chances are, if your current health plan is a good one, then it probably meets the requirements set forth in the ACA (or has already changed to do so), in which case you are fine. Those who may have to get a new health plan are the folks with non-grandfathered plans that have not changed to meet the new requirements.

This is not a bad thing. Yes, folks might be confused about it at first. Yes, some folks will end up having to pay more. But the new benefits and consumer protections will mean better health insurance and greater financial protections for you when you get sick.  And you will get sick.*

The important thing to keep in mind here is that people need to be vigilant of their health insurance. Talk to your HR department and find out if your plan is changing (which may or may not be due to Obamacare). If you buy coverage on your own, just keep an eye out in the mailbox for a notice from your insurer or the Department of Financial Services. If your insurance is being discontinued, and you need help figuring out your options, you can always get free help from Community Health Advocates by calling (888) 614-5400.

 

*I use the term “sick” catch-all term for any illness or injury (even good ones like childbirth) - physical, mental or dental - or even just plain growing old. 

Yes folks, it's the Hoover Dam!

A press release issued by Governor Cuomo’s office yesterday announced that New Yorkers will save over $500 million on health insurance premiums this year thanks to the Department of Financial Services’ (DFS) utilization of the State’s prior approval law.  As you may remember, New York’s 2010 prior approval law allows DFS officials to review insurance rate increases before they go into effect and scale them back if they are too high.

Health insurers had requested overall increases averaging around 12.4%, which were then cut down to an average of 7.5% by DFS.  Rate increases for small group plans will increase an average of 9.5%, down from the average 15.7% increase requested by the insurance plans.  Prior to passage of the prior approval law, annual premium rate increases averaged 14%.

These modest increases stand out at a time when many states are experiencing double-digit increases in premiums.  For example, an article in Saturday’s New York Times notes that states like Florida and Ohio have seen rates rise by as much as 20%, with similar rate increases proposed in California.

The Affordable Care Act requires states to review any proposed rate increases above 10%, however New York is one of 37 states which allows state officials to deny excessive rate increases (an issue that is explored further in the Times article).

So, thanks again to our Senate Democrats who really championed this issue back in 2010 and made savings like this possible today.  We appreciate the work you do!!!

See below for a breakdown of the average requested rate increase and what the DFS ended up actually approving.  For the full list of increases by insurance plans, see the Governor’s press release.

 

Health Insurance Market Segment
Total Number
of Members Affected
Requested Annual Rate Increase (Weighted Average)
Approved Annual Rate Increase (Weighted Average)
Reduction by DFS
Individual, direct-pay
52,383
+9.54%
+4.48%
-5.06%
Small Group
1,280,649
+15.77%
+9.59%
-6.18%
Large Group
611,780
+7.84%
+5.20%
-2.64%
HealthyNY
117,859
+24.84%
+11.81%
-13.03%
Medicare Supplement
319,722
+3.27%
+2.59%
-0.68%
Overall
2,382,393
+12.37%
+7.52%
-4.85%

Click here to read the Governor’s press release.

Click here to read the NYTimes article, titled “Health Insurers Raise Some Rates by Double Digits.”

 

 

If you have been able to take your eyes off of the gripping action of the summer olympics, you may have noticed that the health insurance rate increase applications continue to be posted onto the Department of Financial Services (DFS) website.

HCFANY has been working diligently to comb through the rate increase requests and accompanying documents, and has submitted objections to the DFS on two more products – Excellus (and related products), who has requested increases of up to 18.6%, and MVP, who has requested rate increases of up to 19.9%.  You can read the letters below:

Some of you may have also noticed that the DFS has taken some steps to reorganize its website this year, particularly the section on prior approval.  While it is a little bit more organized, it may be a little bit harder to find what you are looking for.  Here is the link to find the rate applications by company.

 

Keeping in line with our “independence” theme this week, Forbes.com posted a great article on how the recent decision by the Supreme Court to uphold the Affordable Care Act (ACA) is improving many folk’s financial ability to retire.

And just how is it doing that, you ask?  Well, there’s a number of ways.  Basically, all of these things that the ACA is doing for folks - discounts for folks with Medicare who hit the donut hole, the pre-existing condition insurance plan (called the NY Bridge plan), tax-credits, etc - amounts to more money in your pockets.  More money in your pockets means more money that you can put towards other things – like retirement.

It’s pretty interesting stuff! You can check out the full article by clicking here.