TriState | Fall | 2008 | Health Plan Analysis

Ground zero for job losses is the financial sector in New York, and insurers are bracing for membership declines. The jobless may have a difficult time finding low-cost individual policies in New York, although legislators are working on reforms to allow more people into the Healthy New York program. Both New York and New Jersey have community ratings on policies, meaning that an individual does not have to be medically underwritten-that is not the case in Connecticut. The stock market downturn will affect two large initial public offerings for TriState companies. EmblemHealth in New York and Horizon Blue Cross Blue Shield of New Jersey are still pursuing conversions to for-profit status, but it could be months before those happen. Meanwhile, Horizon is trying out a value-based pharmacy benefit design on its own employees who have diabetes. They will get free generics and half-off the cost of brand-name drugs in exchange for participating in the company's wellness program and filling out health risk assessments. In Connecticut, Aetna Better Health and AmeriChoice, a UnitedHealthcare company, are preparing to enroll Medicaid members in February of 2009 as they scramble to assemble adequate networks in the state. The Medicare Part D landscape will be altered in 2009 with a new line-up of insurers serving the low-income market. And in New Jersey, AmeriHealth is offering its PPO and point-of-service-plus members access to a national network of physicians and hospitals.