Rate Increases in New York
- Wednesday, 06 June 2018 08:14
Rate Increases have started to come out for NY Small group and individuals for January 1, 2019. Note that these are requests, not approvals. That won’t happen until sometime in the fall. Also note that these are averages across all that companies products.
With the elimination of the individual mandate under ObamaCare, the individual market is getting very large increases. The baseline average increase was 12.1%, but an 11.9% additional increase has been applied for to cover the effects of the individual mandate being repealed.
Empire Healthchoice 24.0%
MVP HealthPlan 6.5%
New York releases Paid Family Leave Claim Forms
- Monday, 11 December 2017 08:31
New York State has released generic claim forms for the Paid Family Leave Act. There are different claim forms for bonding, care-giving, and military. Call your DBL carrier or our office with any questions.
Download Generic PFL claim forms from the State of New York here:
PFL Claim Form – Bonding
PFL Claim Form – Providing Care
PFL Claim Form – Military Exigencies
CIGNA NY Fined $2,000,000 by Insurance Department
- Friday, 17 November 2017 06:49
DFS SUPERINTENDENT VULLO ANNOUNCES $2 MILLION FINE AGAINST CIGNA FOR VIOLATIONS OF NEW YORK INSURANCE LAW
DFS Investigation Discovered That Cigna Illegally Sold Stop-Loss and Fully Insured Health Insurance Policies Outside of New York to New York-Based Small Groups
Cigna Cherry-Picked Risks, Undermining the Integrity of New York’s Health Insurance Market
Financial Services Superintendent Maria T. Vullo today announced that the Department of Financial Services (DFS) has fined Cigna Health and Life Insurance Company $2 million for violations of New York State Insurance Law involving the illegal sale of stop-loss insurance and unapproved health insurance policies that would otherwise have been part of New York’s small-group market. Stop-loss insurance may be sold only to large group employers that self-fund underlying medical expenses in order to mitigate liability for losses that result from an unexpected amount of claims. In a consent order entered into with Cigna and announced today, DFS found that Cigna improperly sold stop-loss and fully insured health insurance policies outside of New York to New York-based small groups with employees in New York State, and where, in many cases, the companies solicited business and conducted other activity in the state.
“By deliberately choosing to write New York risks outside of New York, Cigna’s actions harmed New York’s community-rating program for small group employers,” said Superintendent Vullo. “Cigna cherry-picked risks, which may have improperly induced forum shopping in the New York small-group market. DFS will continue to protect New York consumers and take appropriate enforcement action against any company that engages in unfair trade practices to undermine New York’s health insurance market.”
After receiving complaints about Cigna’s practices, DFS requested that Cigna immediately cease selling the illegal stop-loss policies pending a DFS inquiry. The company initially agreed but later resumed selling the policies in question. DFS also became aware that Cigna was issuing fully insured health insurance coverage outside of New York to New York-based small groups based on the fact that those small groups were incorporated outside of New York but where, in many cases, the companies’ solicitation and other activity occurred in New York.
Cigna, based in Connecticut, is licensed as a life insurance company in New York, and is authorized to write life, accident, and health insurance in New York, including stop-loss insurance. Cigna does not have fully insured health insurance coverage products approved to sell to small groups in New York.
A targeted examination by DFS found that Cigna sold 81 group health insurance policies in violation of New York Insurance Law, including 38 stop-loss insurance policies to New York small groups seeking to self-insure and 43 fully insured health insurance policies to small groups as if they were selling to non-New York small groups.
A copy of the consent order can be found here.
Gov. Cuomo announces new state shift pay rules
- Monday, 13 November 2017 07:12
From News 12:
Gov. Andrew Cuomo announced Friday new protections for hourly workers across the state: They’ll have to be paid extra if their employers put them on call.
Along with the announcement, the state Department of Labor released a list of employment guidelines designed to protect and compensate workers who are asked to adjust their schedules on the fly.
“This is really hard-targeted toward industries that are based on shift work,” says Caitlin McNaughton, an employment attorney. “Essentially what this does is allow those people in those industries to at least have two weeks’ notice and plan their lives.”
The new regulations will outline a system in which employers would have to pay workers additional “call-in pay” if they failed to provide their employees with adequate notice. For scheduled work days, that means two weeks. It also mandates additional pay for employees whose shifts are cancelled less than 72 hours before they were scheduled to begin.
The plan has its supporters, like Syosset’s Vin Ritraj, who says it just makes sense. But critics say the added expense might lead some employers to reduce staff.
The regulations take effect in early January, following a 45-day comment period.
New York Individual Rate Increases
- Monday, 12 June 2017 07:32
New York State has announced the requested increases for individual health insurance. Note that, typically, they decrease this on approval:
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