New York: NYSoH releases market share breakout by carrier

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.

*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.

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.

*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.