Updated: New York Health Insurers To Dividend More than $1.2 Billion to Out-of-State Corporate Parents

NEW YORK, NY (12/10/2009)(readMedia)-- Governor David A. Paterson today announced that the Insurance Department has received requests from three New York State insurers or their subsidiaries to issue dividends of more than $1.2 billion, which will be sent to out-of-state corporate parents. The requests follow initial dividend actions from the same three insurers last year that totaled $948 million.

"The fact that health insurers take such large amounts of money out of the health care system while individual New Yorkers and small businesses struggle with skyrocketing health insurance premiums is deeply troubling," Governor Paterson said. "While rising unemployment is swelling the ranks of uninsured, the health insurance industry is making record dividends. State law allows them to issue these dividends to their out-of-state corporate parents, and there is nothing New York State regulators can do about it; they need the authority to protect consumers."

Insurance Superintendent James J. Wrynn said: "This is yet another reason the Legislature should reinstate the Insurance Department's authority to prior approve premium rate increases. Under the current 'file and use' methodology, the Department has little if any ability to review whether rate increases are excessive or consider the financial health of the insurer when it files for a rate increase. This year we received file and use applications for rate increases up to 33 percent. Prior approval would allow us to consider the insurer's overall financial condition when we review a proposed premium increase."

The following dividend requests were made to the Insurance Department and the Department of Health (dividend applications from HMOs are reviewed by the Department of Health, upon consultation with the Insurance Department):

Oxford: $800 Million. The total includes a request to dividend $400 million from Oxford Health Insurance, Inc. (OHI) to its sole shareholder and parent, Oxford Health Plans (OHP) and a request by OHP to dividend $800 million to its parent corporation, Oxford Health Plans, LLC. (The $800 million includes the $400 million from OHI, plus another $400 million from OHP's existing surplus).

Empire: $200 million. The total includes a request to dividend $90 million from Empire HealthChoice HMO, Inc. to its parent corporation, Empire HealthChoice Assurance Inc. and a request to dividend another $110 million from Empire HealthChoice Assurance, Inc. (for a total of $200 million) to its parent corporation, WellPoint Holding Corp.

Aetna: $134 million. Aetna Health, Inc. to its parent corporation, Aetna Health Holdings, LLC.

United Healthcare: $75 million. United Healthcare of N.Y. Inc. HMO to its parent corporation, AmeriChoice Corporation.

The dividends requested ranged as high as 18.7 percent of premiums:

* Includes $2,149,038,993 in OHI premium revenue.

** Includes $2,642,361,151 in Empire Healthchoice HMO premium revenue.

Last year, insurers released almost $1 billion in dividends:

$500 million. Oxford Health Plans (NY) to its parent corporation, Oxford Health Plans, LLC.

$48 million. Aetna Health Plan to its parent corporation, Aetna Health Holdings, LLC.

$400 million. Empire HealthChoice Assurance, Inc. to its parent corporation, WellPoint Holding Corp. Empire notes that these funds were primarily repayment of a capital loan from the parent WellPoint for the New York State employee drug benefit contract.

Since 1999, more than $5 billion in dividends have been issued industry wide, for a total of $5.4 million from that year through 2008.

Governor Paterson and the Insurance Department have urged the Legislature to restore its ability to approve health insurance rates for several years. Under current law, the Department is only allowed to review rate increases after they have gone into effect. Unfortunately, by the time the Department learns that the health plan increased their rates excessively; many consumers have already been priced out of the market due to the increase.

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A previous version of this release incorrectly stated that the following statements were given in support of reinstating the Department of Insurance's authority to approve premium rates. This is not correct. The following statements are not meant to reflect a position on this policy.

Kenneth E. Raske, President of the Greater New York Hospital Association, said: "While insurers seek to distribute $1.2 billion in dividends to out-of-state corporate parents a staggering 25 percent increase over last year hospitals on the frontline of patient care are struggling just to break even. That disparity should outrage all New Yorkers."

Daniel Sisto, President of the Healthcare Association of New York State, said: "This is a wake-up call to New York's businesses that for-profit HMOs are an ally to no one. These plans have established an astounding business model: saddle businesses with huge annual premium increases, complicate service delivery to patients and payments to providers, ship billions in profits out of state, and all the while blame everyone else for increased health care costs. At a time when sacrifice is requested from all health care sectors, these for-profit HMOs have instead responded with self interested protectionism. Now we know what these plans were really protecting -- their ability to transfer billions of dollars to out-of-state corporate parents, instead of using a fraction of these New York-derived profits to help protect health services for the very New Yorkers who are footing the bill."

Dr. David T. Hannan, President of the Medical Society of the State of New York, said: "The enormous dividend to be paid to corporate parents and shareholders demonstrates the need to return to the State Insurance Department the authority to review and approve health insurance rate requests. Returning this authority will not only better control health insurance premium increases, it will assure that health plan profits are reasonable and that companies are not allowed to extract excessive amounts of resources from the health care system in New York State and divert such resources to company dividends and profits."

Mark Scherzer, Legislative Counsel for New Yorkers for Accessible Health Coverage, said: "The very healthy profits being generated in our very unhealthy insurance market suggest the need not only for additional regulatory authority for the Insurance Department, but also for laws imposing greater limits on insurers' administrative expenses and requiring higher medical loss ratios for individual and small group health coverage."

Elisabeth Benjamin, Vice President for Health Initiatives at the Community Service Society and a leader of the Health Care for All New York Campaign said: "Our polling shows that New Yorkers understand that insurers are over-zealously hiking premiums, this practice underscores the need for the State lawmakers to reassert their ability to approve premium increases before they go into effect. In fact, 67% of New Yorkers believe that State insurance regulators should have the power to prevent these excessive rate increases."

Todd L. Shimkus, President and CEO of the Adirondack Regional Chamber of Commerce, said: "It's deeply offensive to see such excessive dividends paid to these insurers while we're seeing a record number of small businesses and sole proprietors forced to go without health insurance because of skyrocketing rates. Beyond going without, many of our family owned businesses are being forced to shift to high deductible plans or to pay their premiums with high interest credit cards. The small business community or what's left of it needs the legislature to authorize the Insurance Superintendent to be our consumer advocate by reinstituting prior approval."

Paul Muoio, on behalf of Benefit Specialists of NY, a wholly owned subsidiary of the Greater Syracuse Chamber of Commerce, said: "Health care reform, as well as health insurance reform, is not an easy fix. An appropriate prior approval process is only one of the many avenues required to address reform. We believe that to be an effective process that benefits the public and the business community, aspects of 'prior approval' must address the early release of rates, adequate stop-loss levels, an effective and time sensitive review process, and penalties for providing misleading or erroneous information during the review process."

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