Cost Sharing in New York's Health Insurance Market

Author/Editor: Bela Gorman, Don Gorman, and Peter Newell

This report examines the impact of cost sharing—deductibles, copayments, and coinsurance—on group health insurance premiums in New York, and the resulting out-of-pocket costs for enrollees. Based on an analysis of cost-sharing elements in small group market products, the report creates typical benefit designs showing how premiums vary with different types of cost sharing. Among its highlights, the report notes that the trend toward increased out-of-pocket costs for employees degrades the value of group insurance, especially for persons with the highest health care needs. In addition, it includes a discussion of possible ways to simplify and standardize benefit options, make cost-sharing elements more uniform and easier to understand, and better align cost-sharing elements with quality goals.

Support for the creation of this report was provided by the New York State Health Foundation and the New York Community Trust.

Copyright: 2010
Published: 03.03.2010

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