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The
2005 New York Consumer Guide to Health Insurers, which allows New
Yorkers to compare commercial and non-profit health insurers as well as
health maintenance organizations (HMOs) based on a wide range of
factors, has been released.
Published
annually as a joint effort of the New York State Insurance and Health
Departments, the 2005 New York Consumer Guide to Health Insurers is
available online and in hard copy form.
“Whether New Yorkers obtain their health insurance coverage
through group plans or on their own, these guides are invaluable tools
that help families make educated choices about their health insurance
coverage,” Gov. George Pataki stated. “We have worked hard
to expand coverage and make health insurance more available to New
York's families and these publications provide families with another
tool they can use to get as much information as possible before making
these choices. In addition, the online Interactive Guide allows
consumers to immediately obtain information about competing insurers
and HMOs.”
The
Governor also announced that the 2005 New York Consumer Guide to HMOs
has been issued. The publication is especially helpful to New Yorkers
seeking health insurance separate and apart from an employer. New
York’s HMOs, unlike commercial and non-profit health insurers,
are required under state law to offer coverage to any New Yorker under
the age of 65 regardless of sex, occupation or health status, subject
to a waiting period for pre-existing conditions.
A special interactive version of the HMO Guide is also available through the Insurance Department’s Web site at http://www.ins.state.ny.us.
It gives New Yorkers a detailed summary of the characteristics,
complaint records and services provided by HMOs operating in the
counties where they live and work. The Interactive Guide can be
accessed directly online through www.nyshmoguide.org.
Both guides also provide descriptions of health insurance products
available, such as the Healthy NY program, information on how to choose
a health plan, and easy-to-read tables with comparisons of health
insurers that offer plans in New York State. Healthy NY is a
state-sponsored health insurance program which helps ensure affordable
health insurance benefits are accessible to New York State's small
business owners, sole proprietors, and the working uninsured. More
information on Healthy NY can be found online at http://www.healthyny.com.
The
guides also provide information about Child Health Plus, New York
State’s health insurance plan for children under age 19, as well
as Family Health Plus, aimed at families who have no health insurance
but whose incomes make them ineligible for Medicaid or other public
assistance programs. New Yorkers looking to enroll in Child Health Plus
or Family Health Plus must meet certain income guidelines in order to
qualify.
One
of the guide's most accessed online features is the annual complaint
ranking of health insurers and HMOs. The complaint ratio -- the number
of upheld complaints by the New York Insurance Department divided by a
health insurer’s or HMO’s total annual premiums --allows
for a direct comparison of complaint records. An HMO complaint ranking
for the past three years is also available through the HMO Interactive
Guide. The three-year history gives consumers the ability to evaluate
the year-to-year consistency of an HMO’s complaint record.
The
online version of the 2005 New York Consumer Guide to Health Insurers
is available at the Insurance Department's Web site and hard copies of
that guide, as well as the 2005 New York Consumer Guide to HMOs, can be
obtained by calling 1-800-342-3736. The National Committee for Quality
Assurance (NCQA) provided editorial and research support for both
guides and the interactive guide. NCQA is a private, non-profit
organization dedicated to improving health care quality and also
accredits managed care plans nationwide. 9-23-05
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