Press Release: NY State of Health Releases 2019 Enrollment Data by Insurer

Mar 12, 2019

New Yorkers Value Choice of Plans

2019 Enrollment is Spread Across NY State of Health’s 12 Qualified Health Plan Insurers and 16 Essential Plan Insurers

 

ALBANY, N.Y. (March 12, 2019) - NY State of Health, the state’s official health plan Marketplace today released 2019 health plan enrollment by insurer. Twelve insurers offer Qualified Health Plans (QHP) and sixteen insurers offer the Essential Plan (EP) statewide in 2019. Most consumers have a choice of at least four QHP and EP insurers in every county of the state. 

“We are pleased to once again offer consumers a broad choice of high-quality, affordable health plan options in every county of the state,” said NY State of Health Executive Director, Donna Frescatore. “And the wide distribution of enrollment across insurers shows us that consumers value this choice.”

Marketplace enrollment is at its highest point ever. More than 1 million (1,062,025) people enrolled in QHPs and EP as of January 31, 2019, an increase of 70,072 from 2018. 

 

2019 Enrollment by Insurer

Qualified Health Plans

The 12 insurers offering individual QHP coverage in 2019 each participate in five to 56 counties.  Fidelis, which offers QHP coverage in 56 counties of the state, has the largest share (39 percent) of total statewide QHP enrollment followed by Healthfirst (15 percent), which offers coverage in seven counties including New York City; MVP (seven percent), which offers coverage in 48 counties; and Empire BCBS (seven percent), which participates in 17 counties.  The balance of statewide enrollment was spread across the remaining insurers, as shown in the table below.  

 

2019 QHP Individual Enrollment by Insurer

Issuer

% of QHP Enrollees

Fidelis Care

39%

Healthfirst

15%

MVP Health Care

7%

Empire Blue Cross Blue Shield (Medical Downstate)

7%

Oscar

6%

Emblem Health

6%

MetroPlus Health Plan

5%

Excellus BlueCross BlueShield

5%

UnitedHealthcare

3%

CDPHP

2%

BlueCross BlueShield of Western New York

1%

Independent Health

1%

BlueShield of Northeastern New York

1%

Univera Healthcare

<1%

Empire Blue Cross (Medical Upstate)

<1%

Total

100%

Note:  In this table, insurers are shown by their d/b/a (doing business as) and sum to more than 12.

 

Marketplace insurers each have different service areas comprising specific counties. Comparing enrollment by insurers’ respective service areas shows significant distribution of enrollment across plans. No one insurer has more than half of the enrollment in their service area and similar to 2018, most insurers have between five and 25 percent of the enrollment in their respective service areas.  Fidelis enrolled 40 percent of QHP consumers in its service area, followed by Excellus with 36 percent, HealthFirst with 25 percent, BCBS of Western NY with 23 percent, Independent Health with 22 percent, and MVP with 21 percent of enrollment in their respective service areas.  The remaining insurers each had less than 20 percent of enrollment in their respective service areas, as detailed below. 

 

2019 QHP Individual Market Share by Insurer

 

Insurer

% of QHP Enrollees in Service Area

Fidelis Care

40%

Excellus BlueCross BlueShield

36%

Healthfirst

25%

BlueCross BlueShield of Western New York

23%

Independent Health

22%

MVP Health Care

21%

BlueShield of Northeastern New York

19%

MetroPlus Health Plan

13%

CDPHP

11%

Oscar

9%

Empire Blue Cross Blue Shield (Medical Downstate)

9%

Emblem Health

7%

Univera Healthcare

5%

United Healthcare

4%

Empire Blue Cross (Medical Upstate)

<1%

Note:  In this table, insurers are shown by their d/b/a, or “doing business as,” since they may differ

depending on geographic region of the State, and sum to more than 12.

 

 

The Essential Plan

 

Sixteen insurers offered the Essential Plan (EP) in 2019 – the same 15 insurers that offered EP in 2018 with one addition, Capital District Physicians Health Plan (CDPHP) which offers EP in the Capital District. Statewide, 22 percent of EP enrollment was with Fidelis Care, 21 percent with Healthfirst, 15 percent with United Healthcare, 10 percent with MetroPlus, and the remaining 32 percent was spread across the remaining insurers.  

 

2019 Essential Plan Enrollment by Insurer

 

Issuer

 

% of EP Enrollees

Fidelis Care

 

22%

Healthfirst

 

21%

UnitedHealthcare Community Plan

 

15%

MetroPlus Health Plan

 

10%

Empire BlueCross BlueShield HealthPlus

 

8%

Affinity Health Plan

 

5%

Excellus BlueCross BlueShield

 

5%

WellCare of New York

 

4%

EmblemHealth Essential Plan - HMO

 

3%

MVP Health Care

 

3%

Independent Health

 

1%

Univera Healthcare

 

1%

BlueCross BlueShield of Western New York

 

1%

YourCare Health Plan a Monroe Plan Company

 

<1%

CDPHP

 

<1%

Molina Healthcare

 

<1%

Crystal Run Health Plan

 

<1%

TOTAL

 

100%

Note:  In this table, insurers are shown by their d/b/a (doing business as) since they may differ

depending on geographic region of the State, and sum to more than 16.

 

Comparing EP enrollment by insurers’ respective service areas likewise shows significant distribution of enrollment across plans. Excellus, which provides Essential Plan coverage in a 31-county service area serving the Southern Tier, Central New York, and the North Country, is the only insurer with more than 50 percent of EP enrollees in its respective service area. Four insurers – HealthFirst, Fidelis, Independent Health, and MVP – each have between 22 and 26 percent of enrollment in their respective service areas.  All other insurers have between four and 16 percent of EP enrollment in their respective service areas. 

 

2019 Essential Plan Market Share by Insurer

Issuer

% of EP Enrollees in Service area

Excellus BlueCross BlueShield

56%

Healthfirst

26%

Fidelis Care

22%

Independent Health

22%

MVP Health Care

22%

MetroPlus Health Plan

16%

Univera Healthcare

16%

UnitedHealthcare Community Plan

15%

BlueCross BlueShield of Western New York

13%

Empire BlueCross BlueShield HealthPlus

11%

Molina Healthcare

9%

YourCare Health Plan a Monroe Plan Company

9%

Crystal Run Health Plan

7%

CDPHP

7%

Affinity Health Plan

6%

WellCare of New York

5%

EmblemHealth Essential Plan - HMO

4%

Note:  In this table, insurers are shown by their d/b/a (doing business as) since they may differ depending on geographic region of the State, and sum to more than 16

 

 

Additional demographic and health plan specific information for the 2019 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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