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NY State of Health Announces Open Enrollment Dates for 2018

Sep 7th, 2017

NYSOH Sets the 2018 Open Enrollment Date

Posted on September 7, 2017, | Updated on September 18, 2017


The New York State of Health (NYSOH) Marketplace has just announced the dates of their Open Enrollment Period this year for all qualified health plans to be held from November 1, 2017, through January 31, 2018. Previously, NYSOH followed’s Open Enrollment however this year, there is a sudden departure. announced their Open Enrollment earlier in the year and respectively for future years to coincide with that of Medicare’s Open Enrollment. will have its Open Enrollment from November 1st through December 15th.  That’s 45 days for the nation’s largest health insurance exchange which has roughly 12 million members as compared to 3.5 million for NYSOH.


Who Makes Up the NYSOH Population?

Most NYSOH applicants have primarily been Medicaid and Child Health Plus recipients with only 400,000 members enrolling in traditional on-exchange New York Health Insurance plans. With a pool of 400,000 persons expected to renew coverage, why did NYSOH double the Open Enrollment of Reasons in their press release indicated that they want their members to have ample time to renew and select coverage options and that younger persons usually wait until the end of the Open Enrollment to enroll.


Realistically, the number of younger applicants enrolling throughout the country has been abysmal, and with  Trump’s first executive order on healthcare which doesn’t hold up the penalties on persons who don’t purchase healthcare, it seems that the younger generation is not going to be running to NYSOH or any other exchange to purchase a costly health plan.  Let’s also keep in mind that New York is a state that doesn’t allow insurers to charge based on age – a 21-year-old will pay the same rate as that of a 64-year-old.  Certainly, tax subsidies are very promising to low-income persons; however, the message hasn’t resonated with the younger generation yet.


NYSOH Confirms Affinity and CareConnect Leaving the Marketplace

NYSOH has also cited that the departure of CareConnect and Affinity only accounts for roughly 9% of the NYSOH market share. They failed to mention that these were two of the most cost-effective options in the downstate region which is the 10 most populated counties in New York State.


Speculation Regarding Empire HealthCare Departing the Individual Marketplace

What NYSOH has also failed to mention is that there’s speculation that Empire HealthCare which operates in 28 counties may be dropping out of the individual marketplace. E mpire mailed out notices on August 4th to all of its exchange members indicating that they won’t be offering the same plans in 2018 as they have in 2017; however, all carriers selling on NYSOH are required to offer standardized plan versions. Standardized on-exchange plan benefits cannot be adjusted.  Carriers participating in NYSOH must offer standardized plan versions, otherwise consumers cannot realistically compare plan benefits between carriers.

UPDATED 09/18/2017: Empire Healthcare has reaffirmed its commitment to the NY Marketplace and indicated it will continue offering individual NYS health insurance plans. All current individual plans will discontinue at the end of 2017  and current Empire members will be required to re-enroll into Empire’s new product line for 2018.

Empire has confirmed that plans will be structured as an Exclusive Provider Organization (EPO). An EPO is a plan design that does not require members to obtain referrals to seek the care of a specialist.

Another troubling tale is that each carrier had to submit their 2018 rate adjustment requests to the Department of Financial Services (DFS) for approval. Empire has not submitted any individual rates to date, though DFS does footnotes indicating that Empire rates aren’t detailed because new plans are forthcoming. Empire holds 16% of the individual market share that’s non-Medicaid. If Empire does drop out, that brings the total to three carriers exiting the NYSOH marketplace with a combined 25% market share.


Remaining New York Health Insurance Companies

While several carriers have dropped out of the individual marketplace many New York health insurance companies remain committed to the marketplace. Use the following link for an updated list of New York Health Insurance Companies.

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