New York regulators approved average 2027 health insurance rate increases of 6% for individual plans and 8% for small-group plans, sharply below the increases insurers sought.
The Department of Financial Services said the decisions will save consumers and small businesses about $1.6 billion and affect roughly 860,000 New Yorkers enrolled in the two markets.
Individual plan requests cut by 71%
Insurers requested an average 20.6% increase in the individual market, but DFS reduced the approved average to 6%, a 70.9% cut from the requested level. The department estimated the decision will save individual-market consumers $324 million.
About 224,000 New Yorkers are enrolled in individual commercial plans. DFS said 58% of people currently enrolled in a Qualified Health Plan through NY State of Health receive federal premium tax credits, which can further reduce what eligible consumers pay in 2027.
The individual-market decision does not include New York's Essential Plan. That program is available without a premium to lower-income residents who qualify.
Approved changes vary substantially by insurer. CDPHP, Emblem, IHBC and MetroPlus received no increase, while Anthem HP, formerly Empire HealthPlus, received a 3.1% decrease instead of the 11.3% increase it requested.
DFS approved increases of 12.2% for both Excellus and Highmark, 10.7% for MVP Health Plan, 8.1% for UnitedHealthcare of New York, 8% for Fidelis, 5.1% for Healthfirst and 3.9% for Oscar. The insurers' requests ranged from 1.4% for CDPHP to 52.1% for UnitedHealthcare.
All of the listed individual insurers except Oscar are scheduled to offer products on the NY State of Health marketplace in 2027, according to the DFS rate summary.
Small employers face an 8% average increase
The small-group market covers employers with up to 100 workers and has more than 630,000 New York enrollees. Insurers requested an average 23.7% increase, which DFS reduced by 66.2% to an approved average of 8%, producing an estimated $1.25 billion in savings for small businesses.
Some employers may qualify for additional relief through tax credits, including the federal Small Business Health Care Tax Credit, DFS said.
Approved small-group changes range from a 0.7% decrease for Emblem and no increase for Highmark to increases of 14.4% for Anthem HealthChoice Assurance, 13.6% for MVP Health Plan and 13.5% for Excellus. DFS also approved increases of 9.7% for CDPHP, 7.1% for UnitedHealthcare Insurance Co. of New York, 6.3% for Oxford, 6.2% for IHBC, 5.6% for MVP Health Service Corp. and 3.6% for CDPHP UBI.
The largest reductions from requested small-group rates were made for Emblem, Highmark, UnitedHealthcare and Oxford. UnitedHealthcare had requested a 42.1% increase before receiving approval for 7.1%, while Oxford sought 30.6% and received 6.3%.
DFS said its rate review is part of a broader state effort to limit health care costs. The department also pointed to state actions eliminating out-of-pocket costs for insulin, inhalers and lung cancer screenings as other measures intended to reduce expenses for New Yorkers.
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