New York State law requires all insurers and HMOs, including EmblemHealth, to provide their members and customers with written notices detailing proposed rate increases for the coming year.
Starting August 2022, we are releasing notices to our Large Group plan members and customers about our rate proposals for plans renewing in 2023.
Starting June 2022, we are releasing notices to our Individual and Small Group plan members and customers about our rate proposals for plans renewing in 2023. The New York State Department of Financial Services (DFS) may approve, modify or deny these proposed adjustments. We will notify all impacted subscribers and groups of their final, approved rate at least 60 days before their renewal date.
Why do we need to increase premiums?
We increase premiums due to the rise in the cost of medical care, including the costs of hospital stays, prescription drugs, and other health services. Most of your premium goes toward paying for medical and pharmacy claims for members. In fact, New York State requires that at least 82% of the premium you pay directly covers member medical costs. As the cost and use of pharmacy drugs and medical services go up, so does the cost of medical care we must pay for. We expect that medical and pharmacy costs will continue to go up, on average, by 12% in 2022 and 2023.
Contact us or DFS for additional information. Employer groups or brokers should contact their account manager or call Broker Services at 866-614-6040 (TTY: 711). Our hours are 9 a.m. to 6 p.m., Monday to Friday. You may also submit your comments to DFS within 30 days of the date printed on the letter you receive from us. Please see your letter for details on how to submit your comments or questions. To find out more about our rate filings, please click on the narratives below:
2023 Large Group Rate Narrative
HMO Prime, HIPaccess I, HMO Preferred, HMO Plus, Vytra HMO, and GHI HMO Plans.
2023 HIP Individual Rate Narrative
EmblemHealth Platinum, EmblemHealth Gold, EmblemHealth Gold Premier, EmblemHealth Silver, EmblemHealth Silver Value, EmblemHealth Silver Bold, EmblemHealth Bronze, EmblemHealth Basic, EmblemHealth Platinum D, EmblemHealth Gold D, EmblemHealth Gold Premier D, EmblemHealth Silver D, EmblemHealth Silver Value D, EmblemHealth Silver Bold D, EmblemHealth Bronze D, EmblemHealth Catastrophic D.
2023 HIP Small Group Rate Narrative
EmblemHealth Platinum Premier-P, EmblemHealth Platinum Value-P, EmblemHealth Platinum Premier-S, EmblemHealth Platinum Value-S, EmblemHealth Platinum Premier-M, EmblemHealth Platinum Value-M, EmblemHealth Gold Premier-P, EmblemHealth Gold Value-P, EmblemHealth Gold Premier-S, EmblemHealth Gold Value-S, EmblemHealth Gold Premier-M, EmblemHealth Gold Value-M, Healthy New York, EmblemHealth Silver Plus H.S.A., EmblemHealth Silver Premier-P, EmblemHealth Silver Value-P, EmblemHealth Silver Premier-S, EmblemHealth Silver Value-S, EmblemHealth Silver Premier-M, EmblemHealth Silver Value-M, EmblemHealth Bronze Plus H.S.A., EmblemHealth Bronze Premier-P, EmblemHealth Bronze Value-P, EmblemHealth Bronze Premier-S, EmblemHealth Bronze Value-S, EmblemHealth Bronze Premier-M, EmblemHealth Bronze Value-M
2023 EHIC Small Group Rate Narrative
EmblemHealth Platinum PPO-N, EmblemHealth Gold PPO-N, EmblemHealth Gold Virtual EPO-N, EmblemHealth Gold Virtual EPO-M