Empire Blue Cross Blue Shield which is the largest insurer in New York State, (owned by Wellpoint) is effectively pulling out of the small group market, effective April 12, 2012.
I have my small group insurance with this predatory company, and I am now one of the people, who will either go without, or now go into a mad scramble trying to replace my already woefully inadequate coverage with even worse coverage for lots more money. As it is, I am paying $600 a month. The problem in New York is, there are few options available in the individual and small group market. So the future for obtaining any health insurance coverage at all for tens of thousands of small businesses in this state is very bleak indeed.
It is beyond distressing that hundreds of thousands of New Yorkers find ourselves in this terrible situation, after the passage of the Affordable Care Act. We were assured, things were going to improve, our skyrocketing premiums, would skyrocket a but less. If we liked our doctor, we could keep our doctor.
I'm asking Senator Gillibrand (who is up for re-election in 2012), and Senator Schumer, to step in and do their damn jobs. They need to apply all the pressure of their offices on Blue Cross, and urge this company to rethink its abominable business decision.
Could you please help us disturb these public servants today. Would you please let them know that the people of New York, need access to guaranteed and affordable healthcare.
Kirsten Gillibrand:New York City Office
780 Third Avenue
Suite 2601
New York, New York 10017
Tel. (212) 688-6262
Fax (866) 824-6340Washington, DC Office
478 Russell
Washington, DC 20510
Tel. (202) 224-4451
Click here for all Senator Charles Schumer contact information
Also Governor Andrew Cuomo who you can reach here.You may contact the Governor's office by phone (518) 474-8390
You can help New Yorkers by calling their offices and telling them, we need help now, today.
Here in a nutshell is what hundreds of thousands of New Yorkers are facing this morning.
Empire Blue Cross Blue Shield, the largest health insurer in the region, is reportedly set to announce to health insurance brokers on Friday that it will eliminate most of its small group plans in the New York market effective April 1, 2012—a move one industry insider has said would be “catastrophic” for the insurance marketplace.A South Fork broker, who spoke on condition of anonymity, said Empire is set to make the announcement in a conference call with brokers Friday; a second area broker confirmed the report. The source said Empire’s plan is to eliminate all but three higher-priced plans available to small groups, effectively reducing its presence in the New York market.
Officers of New York State Association of Health Underwriters, the professional trade association representing health insurance brokers and employee benefits consultants, sent a letter dated November 2 addressed to the superintendent of the State Department of Financial Services, stating concerns that the carrier—which it does not mention by name—is withdrawing from the small group market because of rate request denials/reductions in the last five consecutive quarters.
“The major carrier’s pending withdrawal from the small group market is nothing short of catastrophic to small employers in the state,” it says. “Multiple small employers with literally tens of thousands of employees are going to be left without coverage, as there will be only two to three other carriers left in which brokers may try to place coverage. If the other carriers follow suit, the availability of coverage will dry up entirely.”
In New York State we have what is called in insurance-talk guaranteed issue and community rating. This means, the insurers must sell to anyone who can pay them for their junk products.
We also have some modest rate review. Effective December 1, my premiums will be going up 20%, my co-pay for a doctor visit, will go to $50.00. But this is till insufficient for this murderous company. They are pulling out because they say their profit margins are less then perfect.
This is from the New York State website extolling the virtues of the Affordable Care Act. New York sounds like healthcare paradise, until you realize that the insurance that's available is unaffordable and isn't worth the paper it's printed on.
Ways in which health reform affects New York differently than other statesFederal health reform establishes significant nationwide consumer protections in commercial health insurance markets. A number of key consumer health insurance protections already in place in New York have been adopted as a part of federal reform. As a result, New York will go through less transition than many states with respect to these reforms. These include:
Guaranteed Issue
Guaranteed issue means that health insurance companies must issue a health insurance policy to anyone who applies for it. Specifically, no insurer can reject an individual or business based on age, sex, occupation or health status. Therefore, people seeking insurance are "guaranteed" to have a policy "issued" to them. New York has already enacted guaranteed issuance in our individual and small group markets.Adjusted Community Rating
New York has pure community rating, which means that in the individual and small group market, people are charged the same health insurance premiums regardless of age, sex, health status or occupation. Federal health reform introduces "adjusted community rating," which would permit limited differences in rating based on age and tobacco use. It is our understanding that because New York's standards exceed federal standards, New York can maintain its current requirements.
AffordabilityNew York's individual health insurance market, which guarantees comprehensive benefits and takes all applicants without regard to age, sex, health status or occupation, is currently more expensive than the individual markets in states that reject or charge higher prices to those who are sick. So, although access is not as big of a problem for individual consumers in New York, affordability is a bigger problem in New York than it may be in states that allow denials of coverage based on health status. Because New York is a high cost, high premium state, the subsidies to purchase health insurance described above will be instrumental to make health insurance in New York more affordable.
Pre-existing Condition Waiting Periods
A "pre-existing condition" is a health condition where treatment was recommended or received in the six months before a person applies for new health insurance coverage. Although New York does not allow insurers to deny coverage to those with pre-existing conditions, it is currently permissible for insurers to impose pre-existing condition waiting periods. Pre-existing condition waiting periods ensure that people do not wait until they have a health condition or are sick before they purchase health insurance coverage (just as you cannot wait to buy home insurance until your house is burning). Such waiting periods cause insured people to wait up to twelve months after buying a health insurance policy to have coverage for the specific condition that is pre-existing, although they will have coverage in place for all other conditions. There are protections in place that limit what may be considered a pre-existing condition. Protections also exist that reduce waiting periods when people with pre-existing conditions switch their health insurance. Under federal health care reform, New York will need to eliminate these waiting periods for children in 2010 and for adults by no later than 2014.