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Press Release: NY State of Health Releases 2018 Enrollment by Insurer

Mar 14, 2018

Consumer Choice Continues to be a Hallmark of the Marketplace

ALBANY, N.Y(March 14, 2018) -- NY State of Health, the state’s official health plan Marketplace, today released data showing 2018 health plan enrollment by insurer. Statewide, 12 health insurers offer Qualified Health Plans (QHP) to individuals and 15 health insurers offer coverage to Essential Plan (EP) enrollees through the Marketplace. Ten health insurers participate in all individual market programs offered through NY State of Health allowing consumers a smooth transition if their program eligibility changes. Throughout the 2018 Open Enrollment Period, most consumers had a choice of at least four health insurer options in every county of the State. 

“NY State of Health is proud to offer consumers a robust menu of health plan choices to satisfy the unique, individual needs of our customers,” said NY State of Health Executive Director, Donna Frescatore. “We value our partnership with the health insurer community and appreciate their commitment to providing quality Marketplace products to New Yorkers.”

 

Qualified Health Plans

Fidelis Care, which offers Qualified Health Plans in all but six counties of the state, has the largest share (41 percent) of total statewide QHP enrollment in 2018 followed by Healthfirst (13 percent) which serves the counties of NYC and Long Island.  Four of the five insurers with the highest statewide enrollment in 2018 – Fidelis, Oscar, MVP, and Healthfirst – also had the highest statewide enrollment in 2017. EmblemHealth, which had a 53 percent increase in Qualified Health Plan enrollment this year, is also among the insurers with the highest statewide enrollment in 2018.

 

2018 QHP Individual  Enrollment by Insurer*

Issuer

% of QHP Enrollees

Fidelis Care

41%

Healthfirst

13%

Oscar

8%

EmblemHealth

8%

MVP Health Plan, Inc.

6%

MetroPlus Health Plan

6%

Excellus BlueCross BlueShield

5%

Empire Blue Cross Blue Shield (Medical Downstate)

5%

UnitedHealthcare

3%

CDPHP

2%

Independent Health

1%

BlueCross BlueShield of Western New York

1%

BlueShield of Northeastern New York

<1%

Univera Healthcare

<1%

Empire Blue Cross (Medical Upstate)

<1%

TOTAL

100%

*This chart shows insurers by their d/b/a, or “doing business as,” since they may differ depending on geographic region of the State.

 

Marketplace insurers each have an approved service area comprising specific counties. Comparing enrollment by insurers’ respective service areas shows significant dispersion of enrollment across plans. No one insurer has more than half of the enrollment in their service area and most insurers have between 6 and 23 percent of the enrollment in their respective service areas, reflecting broad consumer choice of insurers.

 

2018 QHP Individual Market Share  by Insurer *

Insurer

% of QHP Enrollees in Service Area

Fidelis Care

42%

Excellus BlueCross BlueShield

36%

Independent Health

23%

BlueCross BlueShield of Western New York

23%

Healthfirst

22%

MVP Health Plan, Inc.

19%

MetroPlus Health Plan

15%

Oscar

12%

CDPHP

11%

EmblemHealth

10%

BlueShield of Northeastern New York

6%

Empire Blue Cross Blue Shield (Medical Downstate)

6%

Univera Healthcare

4%

UnitedHealthcare

4%

Empire Blue Cross (Medical Upstate)

<1%

*This chart shows insurers by their d/b/a, or “doing business as,” since they may differ depending on geographic region of the State.

 

The Essential Plan

Fifteen insurers offered the Essential Plan (EP) in 2018 – the same 14 insurers that offered EP in 2017 and one addition, Molina Healthcare, which offers EP in Central NY. Statewide, 22 percent of EP enrollment was with Fidelis Care, 20 percent with Healthfirst, 15 percent with UnitedHealthcare Community Plan, 10 percent with MetroPlus, and the remaining 33 percent were spread across the remaining insurers.  

2018 Essential Plan  Enrollment by Insurer*

Issuer

% of EP Enrollees

Fidelis Care

22%

Healthfirst

20%

UnitedHealthcare Community Plan

15%

MetroPlus Health Plan

10%

Empire BlueCross BlueShield HealthPlus

8%

Affinity Health Plan

6%

Excellus BlueCross BlueShield

5%

WellCare of New York

4%

EmblemHealth Essential Plan - HMO

4%

MVP Health Care

3%

Independent Health

1%

Univera Healthcare

1%

YourCare Health Plan a Monroe Plan Company

<1%

BlueCross BlueShield of Western New York

<1%

Crystal Run Health Plans

<1%

Molina Healthcare

<1%

TOTAL

100%

*This chart shows insurers by their d/b/a, or “doing business as,” since they may differ depending on geographic region of the State.

 

Comparing EP enrollment by insurers’ respective service areas likewise shows significant dispersion of enrollment across plans. Excellus, which provides Essential Plan coverage in a 31-county service area, serving the Southern Tier, Central NY, and North Country is the only insurer with more than 50 percent of EP enrollees in their respective service area. All other insurers have between 4 and 27 percent of EP enrollment in their respective service areas. 

 

2018 Essential Plan Market  Share by Insurer *

 

Issuer

% of EP Enrollees in Service area

Excellus BlueCross BlueShield

57%

Healthfirst

27%

Independent Health

26%

MVP Health Care

23%

Fidelis Care

23%

MetroPlus Health Plan

16%

UnitedHealthcare Community Plan

15%

Univera Healthcare

15%

BlueCross BlueShield of Western New York

12%

Empire BlueCross BlueShield HealthPlus

12%

Crystal Run Health Plans

9%

YourCare Health Plan a Monroe Plan Company

8%

Affinity Health Plan

7%

EmblemHealth Essential Plan - HMO

5%

WellCare of New York

5%

Molina Healthcare

4%

*This chart shows insurers by their d/b/a, or “doing business as,” since they may differ depending on geographic region of the State.

 

Additional demographic and health plan specific information for the 2018 Open Enrollment Period will be available in the coming weeks.

 

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Contact: New York State Department of Health

518-474-7354, Ext. 1

press@health.ny.gov

 

About NY State of Health

New York opened its health plan Marketplace, NY State of Health in October 2013. The Marketplace’s one stop health insurance shopping experience offers high quality comprehensive health plans. NY State of Health is the only place where consumers can qualify to get help paying for coverage through premium discounts or tax credits. Eligible New Yorkers can also enroll in Medicaid, Child Health Plus and the Essential Plan through the Marketplace all year.  For more information about the NY State of Health Marketplace, please visit: https://nystateofhealth.ny.gov/   or call Customer Service at 1-855-355-5777, TTY: 1-800-662-1220 or find an enrollment assistor.

 

 

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Press Releases