1. Overview of Enrollment and Premiums in New York’s Direct Pay, Healthy New York, and Small Group Markets James R. Tallon, Jr. President United Hospital Fund May 11, 2007

2. Enrollment in the Direct Pay, Healthy New York, and Small Group Markets, New York State 2000-2007 (numbers in thousands) Source: New York State Insurance Department, 2007.

3. Individual Enrollment in the Direct Pay and Healthy New York Markets, New York State 2000-2007 Source: New York State Insurance Department, 2007.

4. Direct Pay Market Enrollment, by Product New York State 2000-2007 111,000106,000102,00094,00057,00099,00090,00072,000 Source: New York State Insurance Department, 2007.

5. Healthy New York Enrollment, by Category New York State 2002-2007 4,00020,00043,00079,000109,000132,000 Source: New York State Insurance Department, 2007.

6. Healthy New York Enrollment, With and Without Prescription Drugs New York State 2002-2007 4,00020,00043,00079,000109,000132,000 Note: Healthy New York was first offered without prescription drugs in 2003. Numbers do not sum to totals because of rounding. Source: New York State Insurance Department, 2007.

7. Average Monthly Premium for Single HMO Coverage in the Direct Pay, Healthy New York, Small Group, and Large Group Markets, New York State 2001-2005 Note: Premium data are for Article 44 Health Maintenance Organizations (HMOs) and pertain to their in-network HMO and of out-of-network point of service products. Source: New York State Insurance Department, 2007.

8. Annual Percent Change in Average Monthly Premium for Single HMO Coverage in the Direct Pay, Healthy New York, Small Group, and Large Group Markets, New York State 2001-2005 Note: Premium data are for Article 44 Health Maintenance Organizations (HMOs) and pertain to their in-network HMO and out-of-network point of service products. Source: New York State Insurance Department, 2007.

9. Direct Pay Market Stop Loss Claims and Reimbursement, New York State 2006 32% 51% 39% Note: In 2006, an additional $16 million will be directed to HMOs based upon their claims experience in the direct pay market to provide additional premium relief. Source: New York State Insurance Department, 2007. # of persons for whom stop loss was claimed: 2,932 1,756 4,688

10. Healthy New York Stop Loss Claims and Reimbursement, New York State 2001-2006 *Note: Eight to ten percent of annual stop loss funds were spent on program marketing and advertising. Stop loss claims for 2006 are estimated. Source: New York State Insurance Department, 2007. Stop loss claims have been fully funded every year. $40m $106m $15.6m $49.2m $69.2m $109.6m Annual stop loss allotments:* *