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North Fork faces ‘extremely limited’ health insurance networks in 2018

10/06/2017 5:58 AM |

New York State of Health, the state’s official health plan marketplace, has announced its 2018 insurance options. Open enrollment begins Nov. 1 and ends Jan. 31.

Local insurance brokers say they don’t see any major changes in the offerings for 2018, except the absence of CareConnect, which announced Friday that it will stop renewing group policies as of Nov. 30 and will not renew individual policies for calendar year 2018, according to a press release. CareConnect was part of the Northwell Health network.

“We started CareConnect as a way to make it easier and more affordable for people to get the care they need, and to allow Northwell to move into prevention and population health,” said a statement from Richard Miller, Northwell Health senior vice president and deputy chief financial officer in a statement.

“Although an insurance company proved unsustainable under current conditions, we will wind down CareConnect in a way that protects New Yorkers as we continue to develop our strategy of population health and value-based care,” Mr. Miller said.

CareConnect originally announced it would exit the market in late August, leaving about 125,000 customers in New York State, including 31,500 in Suffolk County, without a plan. North Fork residents are still faced with limited options.

“Unfortunately for the East End, as far as the individual market goes, there’s extremely, extremely limited networks,” said Anthony Cardona, owner and president of Cardona & Company Insurance of East Hampton. “A lot of those plans on the exchange, whether it’s the individual or group plans, really don’t have great networks.”

Mr. Cardona said that the lack of networks is the biggest problem the North Fork faces.

Twelve insurance carriers will offer Qualified Health Plans on the individual marketplace. According to a press release from NY State of Health, consumers who select the most popular silver plan will see a 5 percent premium decrease.

“NY State of Health remains strong, offering consumers in every corner of the state a choice of health plan options in 2018. In many cases, after tax credits, many consumers will find that their premiums will be lower in 2018 than they are today,” NY State of Health executive director Donna Frescatore said. “As in past years, NY State of Health will have in-person enrollers and a staffed Customer Service Center ready to help consumers shop for the most affordable plan option.”

Insurance brokers on the East End aren’t as optimistic about price reductions.

“What it really comes down to is the pricing,” Mr. Cardona said. “The pricing just goes up every year. [With] the group plans, I’m starting to see plans that have high deductibles, so I’m definitely not seeing pricing go down.”

Karl Washwick of Washwick Agencies in Riverhead said that there wasn’t much change in the 2018 plans from the 2017 plans. He also said that the best option is to get insurance coverage through an employer, if possible.

“When dealing with the New York exchange, there is a very limited number of carriers,” Mr. Washwick said.

NY State of Health also announced that 15 insurers will carry the Essential Plan, which has premiums that cost about $20 or less per person. However, Mr. Washwick said he had trouble finding doctors who accepted that plan. The Essential Plan has a very high deductible and is designed for lower-income New Yorkers, according to the state press release.

It also announced a new service called NYS Provider & Health Plan Look-Up, an online tool that allows consumers to research provider networks and health plans.

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