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Life Health > Health Insurance

N.Y. Health Insurers Irk Regulator

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NU Online News Service, March 8, 2004, 4:45 p.m. EST – A New York insurance regulator says his state’s health insurers are doing a lousy job of supplying risk-adjustment data.[@@]

Carriers in New York’s individual and small group market are supposed to share the risk of insuring “high cost persons” by participating in an industrywide risk-adjustment pool.

The state set up the risk pool to replace an older system that put more emphasis on members’ age and other demographic factors than on members’ health status.

The New York State Insurance Department used letters, face-to-face meetings and Web postings to explain the new pool data requirements.

“Despite the information provided by the Insurance Department, almost all of the 74 companies subject to the pools failed to meet the initial filing deadline of Jan. 31, 2003, for the 6 submissions covering years July 1, 1999 – Jan. 1, 2003,” Thomas Zyra, New York’s health bureau co-chief, writes in a circular letter.

“In addition,” Zyra writes, “half of the companies were required to send in revised submissions due to errors.”

The pool administrator needs complete, accurate data from all 74 companies before it can tell the companies how much they can collect from the pool or how much they owe the pool, Zyra writes.

The New York department will take disciplinary action against all companies that failed to submit complete, accurate data by Feb. 27, Zyra writes.

The New York department has posted a copy of the circular letter at


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