South Carolina: *Final* avg. unsubsidized 2025 #ACA rate changes: -1.3%; Cigna leaving, Celtic/InStil joining (updated)

Originally posted 9/12/24

Unfortunately, South Carolina is another state where they don't make unredacted rate filings available, either on the state insurance dept website, the federal Rate Review website or the SERFF database.

As a result, I'm limited to unweighted averages for both the individual and small group markets:

• Individual Market: FLAT
• Small Group Market: +6.7%

I'm estimating the total individual market at perhaps 700,000 people, based on an assumption that 80% are enrolled in on-exchange plans.

It's worth noting that Cigna Healthcare is dropping out of the South Carolina individual market next year, while Aetna is pulling out of the small group market (see below).

UPDATE 10/22/24: OK, the South Carolina Insurance Dept. has published the final, approved rate changes for the 2025 individual market; this, combined with having access to the number of policyholders (though not the actual number of covered lives) has allowed me to run a weighted average as well. 

According to the 2024 Open Enrollment Public Use File, there were around 1.3 individuals included in every enrollment application statewide this year. Assuming 1.3x covered lives per policyholder, that works out to around 568,000 total covered lives on the SC individual market when done on a per-carrier basis.

This also lines up pretty closely with the weighted average based on market premium provided by the SC DOI, and it's also slightly higher than the number of on-exchange effectuated enrollees as of February (562,000), so I should be pretty close.

It's also worth noting that in addition to Cigna Healthcare dropping out of the SC market, two other carriers are jumping in: Celtic (Ambetter) and InStil Health.

Overall I get a 1.35% average reduction, very close to the 1.29% average drop calculated by SC DOI.

Unfortunately I don't have any final data available for the SC small group market, however.