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WNY health insurers get go-ahead to raise rates Increases of up to 15% or more are due in January as state approves requests

Health insurance rates for most customers at the three main companies serving Western New York will jump by as much as 15 percent or more in January, after the state Department of Financial Services approved almost all the requested rate increases.

The insurers offer numerous plans with different rate hikes. Many increases at HealthNow New York, Independent Health Association and Univera Healthcare will be less than 10 percent, while others will be more. Rates for a few plans were held flat, and one dropped by as much as 22 percent.

But all three had their proposed rate filings approved with virtually no change, in stark contrast to big plans in other parts of the state whose rate requests were cut by state regulators by an average of 4.5 percentage points and by as much as 13 points.

"The fact that the state approved the premiums for the overwhelming majority of our plans is evidence of our consistent, disciplined rating and underwriting approach," said Frank Sava, spokesman for Independent Health, whose rates were approved as submitted except for four group plans with 15 subscribers and two state-mandated individual plans covering 260 people.

The state approved Buffalo-based HealthNow's plan to raise rates for its small group traditional insurance by 18.5 percent. Its high-deductible health plans will rise by 3.6 percent to 16 percent, while its HMO and dental plan rise by as much as 19.5 percent, and point-of-service and Aqua plans rise by up to 18.5 percent.

Regulators trimmed its Medicare supplement increase from the proposed 12.1 percent to 9.5 percent. They also blocked any increase on direct-pay plans, despite a request for prices to go up by 19.5 percent. Only 100 customers -- less than 1 percent of members -- use those plans.

Independent Health's Encompass plans for small groups will go up by 4.9 to 5.8 percent, while large group plans will rise by 11.6 to 12.3 percent. Encompass Essential rises by 5.3 to 5.8 percent for small groups and by 10 to 11.7 percent for large groups. For small groups, FlexFit will go up 7.6 percent, while FlexFit Select will rise by 3.9 percent. But for large groups, those plans will rise by 10.8 to 13 percent.

Other plans will rise by 7.5 to 14.9 percent. But its Encompass I2 and Plus I2 plans will see no increase. And three of its five plans with health savings accounts will go up by 14.9 percent.

And Univera's traditional small-group plan will go up by 12.5 percent, while its Value Plus will rise by 9.29 to 12.50 percent, its high-deductible plan will cost between 10.66 and 19.41 percent more, and its PPO plan will cost up to 13.61 percent more.

But its Valumed, Transitions and individual plans will fall by 7.5 percent. And the state trimmed proposed increases for two Medicare plans.

"The approved rates are close to what we submitted, and they are very competitive in our markets," said Univera spokesman Peter B. Kates.

Meanwhile, Benjamin M. Lawsky, superintendent of the Department of Financial Services, announced Tuesday that UnitedHealth Group, the state's largest health insurer and the second-largest in the nation, has dropped its opposition to regulators' new plan to make the full details of its requested rate hike open to the public.

The Minneapolis-based carrier's agreement "to end the secrecy over its request for increased insurance rates" still leaves nine other insurers -- including the three in Western New York -- and an industry trade group opposed to the state's action.

"It's absolutely essential for the public to know the basis for proposed rate increases -- these filings should not be treated like classified material that only a select few may know," Lawsky said in a news release.

"Transparency here will allow the public to rigorously comment on proposed rates and will also help promote competition. The rest of the industry should now follow UnitedHealth's lead and end their policy of secrecy."

Under a 2010 law restoring the state's "prior approval" authority, health insurers must submit their premiums in advance for review by state regulators, who have the power to approve, reject or modify the requests. The law also provides for public comments to be submitted and considered by regulators.

To justify their rates, insurers submit an array of data and documentation, including a summary of how much the insurers spent on medical claims in the last two years, the actuarial assumptions used to analyze how much medical claims are expected in the next year, the amount of administrative expenses and profits, a list of all changes to benefits in policies, and which policies, geographic regions and policyholders are affected.

The department, which has long treated insurers' rate documents as confidential, notified companies in September that it planned to reverse course and make the information public.

In response to the state's letter, the New York Health Plan Association and 10 insurers -- including United, as well as all the three local carriers filed formal legal objections. The department rejected those arguments in a legal ruling last Wednesday, and the carriers now have the right to an administrative appeal and a court challenge.

But United's decision ends its challenge, so its application will be made public.

Tuesday, HealthNow, parent of BlueCross BlueShield of Western New York, voluntarily posted much of its rate information and supporting documents.

"HealthNow, in advance of a final ruling, believes in complete transparency to our customers," said spokeswoman Julie Snyder. "Our rate practices reflect a responsible discipline and we have no objection to the great majority of our data/rate submissions being made available to the public immediately."

The other six insurers, besides United and the three local carriers, are Aetna, Capital District Physicians' Health Plan, Cigna Corp., EmblemHealth, Empire HealthChoice and MVP Health Care.

email: jepstein@buffnews.com

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