"My head literally exploded" People are getting their proposed health insurance premium hikes

ROCHESTER, N.Y. (WHEC) – Inflation is hitting your health insurance now.
Letters are showing up at homes with proposed rate increases for next year.

Scroll to the bottom of the page for a link to share a comment with the NYS Department of Financial Services

Each plan is different so you’re going to see different numbers even from the same insurance company.

In the letter that arrived at Laurie Fessler’s home, MVP Health wrote it wants to raise her health insurance premiums 24.9 percent.

"I told my husband, you know what? I’m at the point right now that I’m ready to cancel my insurance and I will have no insurance and I won’t pay a penalty for not having insurance and I’ll take that premium every month and save it for when I need it," Fessler said.

82 percent of a premium must pay for health care costs.

These are the main factors behind an increase.
– the cost of doctors and hospitals.
– the amount of care: did a plan get 10 knee replacements or 100?
– the intensity of care: were there more x-rays at $50 a pop or CT scans which run $1,200?

Price Waterhouse Cooper pins medical inflation at 7 percent last year and 6.5 percent this year.

A viewer shared a letter from Excellus Blue Cross Blue Shield. The proposed hike is 16 percent.

In its application to the state, Excellus blamed the rising cost of health care including the cost of prescription drugs which makes up 22 percent of its payouts.

"I can grab it right here," Marcus Kroll said reaching into his briefcase.

He pulled out a letter from Excellus which included a 15.64% premium increase.

Brean: "When you received that letter and you saw that number, what did you think?"
Marcus Kroll, Kroll Law Firm, LLP: "My head literally exploded."

"I’m not an economist. I only have a masters in international economics," Kroll said. "But my understanding is inflation is around seven to nine percent. And this is about double that."

There’s an approximate 2 percent profit built into premiums and that’s usually what the state tries to chip away at.

Here is a link to see the proposed premium increases for individual or small group plans by all of the insurance companies that do business in New York.

So let’s look at Excellus, MVP and United Healthcare last year. This are for people who are fully insured working in small businesses.
The first number was the proposed increase, the second number was the increase approved by the state and the third number was the difference.

Excellus

6.2% 4.5% -1.7%

MVP Health Plan

16.9% 8.5% -8.4%

UnitedHealthcare of NY Inc.

13.9% 7.1% -6.8%

The state Department of Financial Services will make a decision by mid-August.

Here is the statement from MVP Health we received Monday at 5:18pm:

“At MVP Health Care, our locally focused, mission driven organization has always put the health and well-being of our customers and communities at the center of everything we do, which is reflected in our plans for both employers and individuals throughout New York. MVP continues to invest in improving access to high-quality health care by expanding virtual care services including urgent and emergency care, primary and specialty care, prescription, and lab orders, and much more for all our customers.

While these rates reflect the value of our plans, they also reflect the increased price of specialty pharmaceutical drugs, medical care, hospital budgets, and an anticipated increase in the utilization of health care services. Additionally, the rate increase request will go through a rigorous actuary and standard review process with the New York State Department of Financial Services before it is finalized.

It is also important to note that this proposed rate increase does not necessarily mean that a customer’s health care costs would increase. Under federal law, many individuals and households are eligible for financial assistance and their total premium is capped based on their income.

We encourage our customers to reach out to us if they have any questions about this proposed rate increase.”

If you want to comment to the state, click here.