2015 Open Enrollment Report shows Increases in Every County in the State
ALBANY, N.Y. (July 29, 2015) - NY State of Health (NYSOH), New York’s official health plan Marketplace, today released demographic enrollment data on the more than 2.1 million New Yorkers who enrolled in a health plan through the Marketplace through February 28, 2015, the end of the open enrollment period. The data show that enrollment through the Marketplace increased more than two-fold and more than 89 percent of enrollees reported being uninsured at the time of application.
“Year two of NY State of Health was nothing short of an overwhelming success,” said NYSOH Executive Director Donna Frescatore. “We built upon our first year’s solid foundation with significant increases in enrollment and high satisfaction rates across the board. As we move closer to the third open enrollment period slated to begin on November 1, this data will inform our efforts to reach more New Yorkers. ”
As compared to the first open enrollment period, enrollment in Qualified Health Plans (QHP), Medicaid, and Child Health Plus increased in every county in the state, with 86 percent of those eligible to renew their QHP in 2015 doing so. The high renewal rate is indicative of the high level of satisfaction with the Marketplace, as was similarly found in independent consumer surveys conducted by the NYS Health Foundation.
Below is a summary of the 2015 Open Enrollment Report. The complete 2015 Open Enrollment Report is available on the NYSOH website at: http://info.nystateofhealth.ny.gov/2015OpenEnrollmentReport
NY State of Health Enrollment as of February 28, 2015:
Total: 2,143,413
Qualified Health Plan: 415,352
Child Health Plus: 159,716
Medicaid: 1,568,345
Report Highlights:
Increase in Enrollment
More than 2.1 million people- over 10 percent of the state’s population- enrolled in health insurance coverage through the Marketplace as of February 28, 2015, the end of the second open enrollment. This represents a more than a two-fold increase from the first open enrollment period, when 960,762 were enrolled.
Financial Assistance
Consistent with year one, nearly three-quarters of individuals and families enrolled in a QHP received financial assistance to reduce the cost of their insurance. The average tax credit was $220 per month, up slightly from 2014.
Previously Uninsured
Overall, 89 percent of those enrolled as of February 28, 2015 reported that they were uninsured when they applied for coverage through the Marketplace, a nine percentage point increase from 2014.
Enrollment by Region and County
New Yorkers from every region and county in the state have enrolled in the Marketplace, with 56 percent of enrollees in New York City and 44 percent of enrollees in other areas of the state. Counties with the largest enrollment are Kings (Brooklyn), Queens, Bronx, New York, Suffolk, Nassau, Westchester, Erie, and Monroe, which are also the most populous counties in the state. Enrollment by county and program is included in the full report.
Enrollment by Age
Marketplace enrollees include a mix of New Yorkers across all age groups. 60 percent of individuals who enrolled in coverage through the Marketplace are under age 35. Thirty-two percent of individuals enrolled in a QHP are under age 35, 18 percent are between ages 35 and 44, 23 percent are between ages 45 and54, and 25 percent are between ages 55 and 64.
Enrollments by Gender
Enrollment remained nearly evenly split between males and females, with females comprising 52 percent of total enrollees across all programs.
Enrollment by Race and Ethnicity
The report includes data on enrollment by race and ethnicity, as self-reported by applicants. Across all programs, 36 percent of enrollees self-reported that they are white, non-Hispanic, 16 percent reported being black/African-American, 13 percent reported being Asian/Pacific Islander and seven percent reported race as “other”. Nearly one-third of applicants did not respond to the optional question about their race.
25 percent of Marketplace enrollees self-reported that they are Hispanic, an increase of four percentage points from the end of the 2014 open enrollment period. Twelve percent of applicants chose not to respond to the optional question about ethnicity.
Statewide Enrollment by Insurer – Individual Marketplace
All of the health insurers offering QHP coverage through NYSOH enrolled members into their plans. Nine health insurers enrolled five percent or more of total statewide QHP enrollees. The four insurers with the highest percentage of statewide enrollment are: Fidelis Care (20 percent), Health Republic (19 percent), Healthfirst (10 percent) and Empire Blue Cross Blue Shield (10 percent).
Service Area Enrollment by Insurer- Individual Marketplace
Insurers approved to participate in the Marketplace have county-level service areas ranging from four to 55 counties. Nine insurers have 13 percent or more of the enrollment in their respective service areas. The insurer with the highest share of enrollment in its service area – Excellus – has 28 percent of enrollment in the counties it serves. Compared to 2014, six insurers had an increase or decrease in total service area enrollment of five percentage points or more between 2014 and 2015. A closer look at market shifts in New York City suggests that significant premium changes from year to year are associated with changes in relative market share.
Qualified Health Plan Enrollment Level – Individual Marketplace
The Marketplace offers QHPs at four different metal levels: Platinum, Gold, Silver, and Bronze. Twelve percent of enrollees are enrolled in Platinum plans, 10 percent are in Gold plans, 58 percent are in Silver plans, 18 percent are in Bronze plans, and two percent are in Catastrophic plans. Fifty-five percent of enrollees are in health plans with no annual deductible or deductibles of $600 or less.
Plan Selection in the Individual Marketplace
- Standard versus Non-Standard Plans – The Marketplace offers standard and non-standard plans. Standard plans cover all Essential Health Benefits and have the same cost-sharing across insurers within each metal level. To increase consumer choice, insurers may also offer a limited number of non-standard plans on the Marketplace. Twelve insurers elected to offer both standard and non-standard plans on the individual Marketplace in 2015. Sixty-one percent of enrollees opted to enroll in a standard plan and 39 percent enrolled in a non-standard plan. The most popular non-standard plans covered services not covered by the standard plan, such as adult dental and/or vision care, acupuncture and a limited number of physician sick visits with no copayment.
- Plans with Out-of-Network Benefits- QHPs with out-of-network benefits were offered on the individual Marketplace in 11 counties of the state. Twenty-one percent of enrollees in those counties selected one of these plans. With a few exceptions, plans that included out-of-network benefits were more expensive than the most popular plan at the same metal level.
- Plan Cost- An analysis of enrollment in silver QHPs by county shows that relative premium cost is strongly associated with the most popular plan. In more than 80 percent of counties, the silver plan most often selected by consumers ranked in the bottom third in cost and, in every county, had an annual deductible equal to or less than the deductible in the standard plan and the lowest cost silver plan. This limited analysis suggests that consumers are selecting plans based on both premium and out-of-pocket costs.
Application Assistance
NY State of Health has trained and certified nearly 11,000 people to provide free, in-person enrollment assistance to New Yorkers applying for coverage through the Marketplace. Across all programs, more than two-thirds of people who were enrolled as of February 28, 2015 (including new enrollees and those who renewed their coverage for 2015) sought the assistance of an in-person assistor. Medicaid and Child Health Plus enrollees were the most likely to work with an in-person assistor. QHP enrollees were more likely to enroll through the website without in-person assistance. Thirty-three percent of QHP enrollees who received financial assistance applied through the website without assistance. That percentage doubled to 66 percent for QHP enrollees who did not qualify for or did not apply for financial assistance.
Website Activity
Between November 15, 2014 and February 28, 2015, there were 1,915,448 unique visitors to the NYSOH website. Visitors viewed 89,695,730 web pages. System response time averaged 2.5 seconds. Coincident with the start of the second open enrollment period, the Marketplace debuted a new website feature that allows individuals to anonymously shop for coverage before they begin their application. Over 2.4 million people used this new feature during the second open enrollment period. NYSOH also launched a Spanish version of its individual and families website in November 2014. More than 35,000 website sessions were conducted on the Spanish site.
Customer Service Center
Between November 15, 2014 and February 28, 2015, the NYSOH Customer Service Center answered 1,274,739 calls from New Yorkers, slightly more calls than were fielded during the six-month 2014 open enrollment period. Call volume reached more than 106,000 calls per week in the final days leading up to the January 1, 2015 enrollment deadline. The Marketplace’s social media channels also served as an important source of information and assistance to consumers providing responses to about 2,300 posted comments and questions.
Small Business Marketplace
Small businesses with 50 or fewer employees can enroll in the Small Business Marketplace (SBM) throughout the year. As of February 28, 2015, over 3,700 small businesses had offered coverage and nearly 15,000 employees and dependents had enrolled through the SBM. Eighty-seven percent of employers took advantage of the employee choice model, offering their employees the choice of two or more QHPs. On average, SBM employers contributed 70 percent towards the cost of the employee’s coverage. Sixty--two percent offered coverage to their employees’ dependents, up 14 percentage points from 2014. As projected, the average small business that enrolled through the SBM had three employees.
Each of the 10 insurers participating in the SBM enrolled one or more employer groups. The SBM covered workers in every county of the state with more than one-third of SBM employers located in NYC. Platinum plans were again the most popular plan selected in the SBM representing over one-third of total enrollment. Gold and silver plans had nearly equal shares of enrollment at 27 percent and 26 percent, respectively, and only 13 percent of SBM enrollees chose Bronze plans.
Stand-Alone Dental Plans
Stand-Alone Dental Plans (SADPs) are offered as an option for dental insurance on both the Individual and Small Business Marketplace. Eleven SADPs participate in the Individual Marketplace and eight participated in the SBM. Combined, the SADPs provided dental coverage to 41,334 people including 38,934 individuals and 2,400 SBM enrollees.
The next open enrollment period will begin on November 1, 2015 for coverage starting on January 1, 2016. Until that time, only those individuals and families who qualify for a Special Enrollment Period are able to enroll in a QHP. Special Enrollment Period qualifying events include getting married, gaining a dependent, losing employer insurance, or permanently moving into New York State.
During the next open enrollment period, NYSOH will add a new program called the Basic Health Program (BHP) to the suite of insurance coverage options available through the Marketplace. The BHP, which will be called the “Essential Plan,” will provide comprehensive coverage to qualified individuals based on income at even more affordable rates.
New Yorkers eligible for Medicaid and all children can enroll in coverage through NYSOH at any time during the year. NYSOH’s SBM is also open for enrollment throughout the year.
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NYSOH website, the NYSOH customer service center and certified in-person assistors statewide remain available to assist eligible New Yorkers with enrollment. Individuals and families can get information and enroll in a plan either online at https://nystateofhealth.ny.gov/ , by calling toll-free at 1-855-355-5777, or with in-person with a certified assistor. Lists of in-person assistors can be found on the NYSOH web site http://info.nystateofhealth.ny.gov/findassistor
Contact: New York State Department of Health
518 474 7354, ext. 1
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