Univera And Health Insurance

Health-plan pricing data to be made public

Want an inside peek at how health insurers price your premiums? You’re about to get it.

State insurance regulators are planning to release all documents relating to health insurers’ applications for rate hikes, reversing a longstanding policy of treating them as confidential and triggering a howl of protests from the carriers.

The newly formed State Department of Financial Services notified health insurers last month that it would no longer exempt from public disclosure the details and supporting materials for their premiums. It would also release “all written determinations of the department in response.”

Last week, the department received 10 letters in response from insurers, including HealthNow New York, Independent Health Association and Excellus BlueCross BlueShield, parent of Univera Healthcare, and one from a trade group.

Unless insurers get a reversal or court injunction, the data would be public by late November, a department official said.

The action by State Superintendent of Financial Services Benjamin Lawsky marks a major turnabout in the department’s relationship with insurers and consumers.

Rather than err on the side of the carriers to preserve confidentiality and protect competitive information, the department will now err on the side of consumers and transparency.

That’s part of the new philosophy of Lawsky and his mentor, Gov. Andrew

M. Cuomo, toward more openness in government. It’s also designed to support the state’s new “prior approval” process for health insurance, under which insurers must submit their rate requests in advance to regulators, who can approve, modify or reject them before they go into effect.

The goal is to ensure consumers have enough information to make decisions for themselves. In particular, regulators believe that releasing the full supporting information about rate requests for consumers to read will enable the public to comment or object more appropriately and thoroughly on any proposed premium hikes.

Univera founder to direct UB office - UB Reporter

Arthur Goshin, BS ’66 & MD ’70, gets things done.

He spent the summer before starting medical school in Springfield, Mass., surveying the health of 400 families relocated by an urban renewal project with a physician who was later a celebrated New York City health commissioner. He also helped organize local field-training placements there for a hurried, two-week training program for 90 Peace Corps volunteers headed for India.

So he entered medical school at UB, at age 20, with an interest in public health and a newly discovered talent as an organizer. It was 1966.

Goshin was the leader of the Student Health Organization; he says they were “progressive.” The group responded to a plea for health care services from a community group in the First Ward in Lackawanna by starting a neighborhood clinic with medical school faculty and funds from the Erie County Board of Health. Goshin served as board chair and de facto executive director.

When he graduated from UB medical school in 1970, he became assistant health commissioner for Erie County and developed three comprehensive clinics to serve impoverished neighborhoods in Buffalo. In the meantime, he was studying the relatively new concept of HMOs. He eventually obtained a federal grant to start what became Univera Healthcare, a statewide $1 billion-a-year health care and health insurance program with a staff of 2,900 and more than half a million members.

Now he’s starting a new program at UB with the same kind of do-it-yourself idealism.

After discussing global health issues with public health students last year, Goshin, who has maintained adjunct faculty status in the Department of Social and Preventive Medicine throughout his career as a health care executive, offered to lead an effort to promote and coordinate global health opportunities at the School of Public Health and Health Professions (SPHHP). He had recently sponsored three occupational therapy student placements in India and Africa through his Healthy World Foundation.

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