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Health plans file range of requested rate changes for 2016

Thousands of members of Univera Healthcare and BlueCross BlueShield of Western New York would pay higher average health insurance premiums in 2016, and members of Independent Health would pay lower premiums, under rate requests filed by the region’s three largest health insurance companies with the state Department of Financial Services.

The proposed rate changes apply to individual and small-group plans sold through the state’s health insurance exchange, which make up a small portion of the companies’ membership. And state regulators often reduce the requested rates before granting final approval.

Univera parent Excellus Health Plan of Rochester is seeking an average rate increase of 12.8 percent for individual plans sold on or off the NY State of Health exchange and an average increase of 13.9 percent for small-group exchange plans. The plans cover about 16 percent of the insurer’s members across upstate New York, including in the Buffalo area.

“The proposed rate adjustment is based on the need to recover from operating losses in previous years, anticipated increases in medical costs and changes in the health insurance market driven by federal and state actions,” Excellus said in its state filing.

BlueCross BlueShield parent HealthNow New York of Buffalo is seeking an average rate increase of 6.7 percent for individual plans and an average increase of 8.1 percent for its small-group plans.

“The proposed 2016 rates across HealthNow’s markets for individual and small group reflect the cost of medical care in the New York markets we serve. In 2014, 90 cents of every premium dollar we received was paid out for our members’ medical care, including pharmacy, physicians, inpatient hospitalization and outpatient services,” HealthNow spokeswoman Julie Snyder said in a statement.

In contrast, Amherst-based Independent Health has requested an average 10.4 percent decrease for its individual plans and a 6.2 percent decrease for its small-group plans.

“Independent Health is proposing rate decreases on all of its small group and individual products for 2016, due to lower expected claims cost trends, lower administrative expenses and anticipated reimbursement through a risk adjustment provision of the Affordable Care Act,” Nora McGuire, the insurer’s chief marketing officer, said in a statement.

Other insurers that have enrolled a good number of Western New Yorkers through the state exchange are proposing rate increases for 2016. They include Health Republic Insurance, with a 14.4 percent increase for individuals and a 20 percent increase for small-group members, and Fidelis Care, with a 4.7 percent increase for individual plans.

The rate changes sought by the main Buffalo-area plans are lower than the rate increases requested by many other plans across the state.

Overall, according to the Department of Financial Services, the state’s insurers are seeking an average increase of 13.5 percent for individual plans and of 14.3 percent for small-group plans.

The requests were posted to the department’s website this week and regulators will decide on them by the end of the summer.

Last year, state insurance officials reduced the average requested increases by half.