Every year I pore over hundreds of annual health insurance policy rate filings from carriers participating in the individual and small group markets, attempting to run weighted average rate changes on a state-by-state level. I then compile all 50 states (+DC) into a national weighted average rate change table.
I generally do this twice for every state: First, over the spring and summer, I crunch the numbers for the carriers preliminary rate change requests. These are submitted to the state regulatory authorities (or in a few cases, federal regulators), who run their own actuarial analysis and then either approve the requests as is, lower the requested rates or (in a few cases) even raise rates more than requested, since part of the regulators job is to ensure that the insurance carriers have enough cash flow to actually pay their claims over the upcoming year.
In some cases, the carriers actually resubmit revised filings later on in the summer if there's some material change to their finances, the marketplace or other policies which change their analysis.
I debated how to word the headline for this blog post. On the one hand, the press release itself includes some important information and some genuinely good news re. cost savings for Colorado residents. On the other hand, I couldn't get past how hilariously misleading the headline itself is, so I decided to use the sublede instead.
Gov. Polis and DOI Announce 80% of Health Insurers to Decrease Premium Requests for 2024 and Increases Reinsurance Savings to $411M for Colorado Consumers
Nearly 20,000 more Coloradans could reduce deductibles to as low as $100.
DENVER - When it comes to health insurance, the Colorado Division of Insurance (DOI), part of the Department of Regulatory Agencies (DORA), makes sure that insurance companies are complying with the Affordable Care Act (ACA), as well as State law and our specific insurance regulations. Today, Governor Polis and the Division of Insurance announced 80% of health insurers will decrease premium requests for 2024.
The most noteworthy developments below are that in addition to Friday, Oscar and Bright Health Plans all leaving the Colorado market (as documented/reported on several times earlier this year), Aetna and Humana both appear to be dropping out of the states small group market.
In any event, the weighted average increase being requested is 9.2% on the individual market and 8.4% for the small group market.
The good news is that the federal Rate Review database has now posted the preliminary avg. 2024 rate filings for the individual and small group markets for every state. This makes it very easy to plug in the average requested rate changes in 2024 for every carrier participating in both markets.
The bad news is that most of the underlying filing forms are heavily redacted, meaning I can't use the RR database to acquire the other critical data I need in order to run a proper weighted average: The number of people actually enrolled in the policies for each carrier.
This means that in cases where this data isn't available elsewhere (either the state's insurance department website, the SERFF database or otherwise), I'm limited to running an unweighted average. This can make a huge difference...if one carrier is requesting a 10% increase and the other is keeping prices flat, that's a 5.0% unweighted average rate hike...but if the first carrier has 99,000 enrollees and the second only has 1,000, that means the weighted average is actually 9.9%.
BISMARCK, N.D. – Insurance Commissioner Jon Godfread has approved the rates for individual and small group health insurance plans compliant with the Affordable Care Act (ACA).
Individual and small-group health insurance plans that are ACA-compliant are purchased through the Healthcare.gov exchange or licensed agents. Three statewide insurance carriers operate on the individual market, available via Healthcare.gov and through insurance agents. Five major carriers exist in the small group market, primarily purchased by employers of small businesses.
“We’re releasing these rates to give consumers who purchase their health insurance on the individual or small group markets an idea of what’s to come for 2024,” said Godfread. “The changes in rates this year are on par with previous years, with no big jumps or decreases in rates. When purchasing health insurance, or any insurance policy, shop around and look at different coverage options and find one that best fits your and your family's needs.”
The good news is that RateReview.HealthCare.Gov has posted the preliminary 2024 rate filing summaries for every state, making it much easier to pin down which carriers are actually participating in the individual & small group markets next year, as well as what the carriers average requested rate changes are in states which don't publish that data publicly (or which make it difficult to track down if they do).
The bad news is that in many of those states, acquiring the actual enrollment data is even more difficult, as their rate filings tend to be heavily redacted. Alabama falls into this category.
Utah's preliminary 2024 individual and small group market rate filings are listed below. They launched a handy new website specifically dedicated to insurance filings, which is nice to see.
Unless there's a change in the final/approved rates, unsubsidized individual market plan premiums are increasing by around 11.4% in 2023, while small group plans will go up 10.5% on average (caveat: I had to estimate the actual enrollment numbers for two of the small group carriers, so the weighted average may be slightly off). Both market hikes are significantly higher rate increases than they were last year.
I should note that both Aetna and Imperial Health appear to be newly entering the Utah individual market next year.
UPDATE 10/04/23: The Utah Insurance Dept. has published approved rates for all individual & small group market carriers with one exception (Molina is still listed as "submitted," but they only have 0.6% of the total market anyway so any dramatic change to their final rates would be a rounding error at most statewide).
Overall most of the filings were accepted as is, although a couple saw significant changes: BridgeSpan had their 6.7% increase nearly doubled to 12.1%, while Regence BCBS was shaved down slightly, from 9.2% to 8.8%.
Not a whole lot to report in the smallest (physically) state of the Union. Rhode Island only has two insurance carriers participating in the individual health insurance market, while six of them compete in the small group market. Thankfully, the SERFF database not only has all eight of these filings, each of them has at least one document which includes the actual number of RI residents enrolled in the carriers policies.
As a result, I can run a fully weighted average for both markets: In the individual market, carriers are requesting an average rate hike of 6.6%, while small group market insurers want to bump up premiums by 6.8% overall.
UPDATE 10/03/23: The Rhode Island Insurance Commissioner has issued a press release with the final, approved 2024 rates; the table has been updated below. In the end, individual market policies are going up 5.8% while small group plans are only going up 4.0% on average.
In August, I posted an unweighted average of the preliminary rate filings for Nevada's individual & small group markets; it was unweighted at the time because I was unable to find the actual unredacted rate filing forms on the SERFF database, federal Rate Review website or even Nevada's own insurance filing database site.
Fortunately, now that the approved 2024 filings have been published, the NV DOI has added the Rate Change Justification forms to their database, making it easy to plug in the number of enrollees for every carrier in both markets. It's also important to note that there are two new carriers joining Nevada's individual market: Molina Healthcare and Imperial Insurance Co.
Overall, the weighted average rate increases are 3.8% for unsubsidized individual market plans and 6.4% for small group market enrollees.
Each year, the Idaho Department of Insurance posts rate changes of individual and small group health insurance products so consumers can review and provide comments on the proposed increases. Insurance companies submit proposed rates for the upcoming calendar year to the Department, along with descriptions and justifications for why the rates are reasonable and not excessive.
The Department of Insurance is seeking public input for rate changes of individual and small group health insurance products to improve insurer accountability and transparency. By following the links below, the public can access a summary of the increase amounts and the carrier justifications for the rates. Please submit any comments to the Department for consideration.
