Cost Sharing in New York’s Health Insurance Market

This United Hospital Fund report outlines the intricacy of cost-sharing devices applied in New York’s insurance market. As the cost of health coverage has increased, cost sharing has become a tool health plans commonly use to reduce annual premium increases but it also raises out-of-pocket costs.

The report analyzed common benefit designs in New York’s health insurance market, and modeled the premium reductions to be obtained through imposing various levels and combinations of co-pays, co-insurance and deductibles, and out-of-pocket maximums. Results showed premium reductions ranging from 3% to more than 60% for products with cost sharing when compared to baseline products with no or limited cost sharing. To reduce the complexity of cost sharing, this report presents recommendations on how to simplify, standardize, and rationalize cost sharing devices.