Rate Increases

A couple of weeks ago, my post on Indiana's average 2016 rate increases on the individual market would likely be very close to flat, based on partial enrollment data (i.e., they provided the rate data for every insurance company, but enrollment data for only one of them). The one company they provided enrollment information for, Physicians Health Plan, also happens to have the highest average rate hike, 13.5%.

However, I noted that since a) Physicians only holds around 4% of Indiana's market, and b) several of the other companies were approved for rate decreases (up to -19% for Mdwise Marketplace), it's entirely possible that the state could be looking at an overall rate decrease, or a very low increase at worst. I decided to split the difference and go with a flat zero percent change until further notice.

Today, Louise Norris has come through again:

Louise Norris has again done some of the heavy lifting for me over at healthinsurance.org, this time for New Hampshire:

In 2015, New Hampshire’s exchange had five carriers, up from just one in 2014.  There will still be five carriers in 2016, although there’s one swap:  Assurant/Time is exiting the market (nationwide), but Ambetter (offered by Celtic) is joining the exchange in New Hampshire.

...Two carriers in the exchange – Minuteman Health and Community Health Options – have requested double digit rate increases, although they have not yet been approved.  Both carriers are CO-OPs created under the ACA, and both expanded into New Hampshire at the start of 2015, so their claims data for the state is very limited. 

As we head into the final batch of states, it looks like the national weighted average rate increases, which had been hovering in the 11-12% range up until a week or so ago, are unfortunately starting to inch upwards, slammed by 20%+ averages out of South Dakota, Montana, West Virginia, Oklahoma and Utah. Lower average rate hikes out of Connecticut and Wyoming have also been announced, but the other 5 states more than cancelled those two out.

And now you can add Tennessee to the mix. Starting with Louise Norris' exchange-only data (which comes in at a 33% average hike), I've also plugged in additional off-exchange individual market numbers to come up with what looks like an overall average rate hike of around 28.3%:

Wyoming's total individual health insurance market in 2014 was just 27,000 people. While the total market likely increased somewhat this year, those gains are likely offset by perhaps 15% being either "grandfathered" or "transitional" policies.

Just over 18,000 were enrolled in effectuated exchange-based policies as of June 30 of this year, leaving perhaps 9,000 more enrolled in off-exchange plans.

According to Louise Norris of HealthInsurance.org, there's only two companies operating on the exchange in Wyoming this year: WINhealth Partners and BCBS of WY. WINhealth is asking for a 13.37% average rate hike; Blue Cross is asking for an uknown increase...except that it's under 10%.

Over at HealthInsurance.org, Louise Norris has done her usual excellent job of summarizing the enrollment/rate/exchange participation situation for another state, Utah. As she notes, in addition to the companies which operated on the Utah ACA exchange this year, one more "mystery" company is expected to join in 2016. Of course, Louise only focuses on the companies actually operating on the exchange, while I'm looking at the entire ACA-compliant individual market state-wide (because the risk pool includes off-exchange policies as well).

Fortunately, Utah has a fairly comprehensive rate review database with an easy-to-use lookup feature. Unfortunately, a few of the entries don't quite jibe with HHS's RateReview website. Most notably, the HHS site claims that Arches Mutual Insurance has 2 filings from the same date: One requesting a jaw-dropping 58% hike, the other for a slightly less-insane 46.65% increase, neither of which includes the actual number of covered lives:

The Kaiser Family Foundation has posted an updated analysis of the average rate hikes for the benchmark Silver plans (ie, the 2nd-lowest cost policies) and the lowest-cost Silver plans in each market.

"Benchmark" in this case refers to the plans which are used as the basis for the ACA's Advance Premium Tax Credit (APTC) formula. How much/little these particular rates change is even more important than the change in other policy rates, because these are the ones which the federal tax credit amounts are based on.

This is really important, because if the benchmark policy rate in your area changes, it can seriously impact how you receive in tax credits...even if nothing has changed at your end.

Maryland was one of the first states to release their list of requested 2016 rate hikes, and caused quite a stir at the time due to the largest player in the state, CareFirst, asking for a whopping 30% rate hike. At the time, I didn't have much to go on in terms of hard enrollment numbers, but it looked like the weighted average request would be somewhat lower, perhaps around 22-23%.

Today, the Maryland Dept. of Insurance has released the final, approved rate changes, and while 5 of the 8 companies on the individual exchange saw reductions in their rate change (2 others were approved as is, and one, Kaiser Health Plan was actually increased from 4.8% to 10%), it's still difficult to lock down a fully weighted average due to some crucial enrollment data missing.

I was able to track down the "covered lives" data for 5 of the eight companies.

Delaware's 2016 rate hike analysis is about as simple and straightforward as it gets: Two companies (Aetna and Highmark BCBS) for both the individual and small group market, both on- and off-exchange, period...and their website includes the actual affected enrollee tallies for each, giving weighted totals:

Ugh. Nearly 25% requested for the individual market, just under 10% for the small group market. Of course these are requests only, so they might be slashed somewhat by regulators yet.

Louisiana's Insurance Dept. website is refreshingly complete: It includes every company on the individual & small group market, lists both the requested and approved rate hikes, and includes direct links to the filings which list the actual total enrollment in a clear-cut, consistent fashion.

In fact, the only data missing is some of the approved rate hikes; they've only posted the approved numbers for 3 of the 5 small group listings and 1 of the 10 individual listings, making it impossible to plug in the approved weighted average. However, the requested average is complete: About 15.4% for the individual market and 9.4% for the small group market.

Last year, while most state-wide average premium rates increased somewhat (averaging around 5.5% overall nationally, give or take), there were a few states which actually saw rate decreases from the year before: Arkansas, Mississippi and New Mexico saw overall decreases on their individual markets, while the District of Columbia and Hawaii saw decreases on their Small Business markets.

Last week I estimated the overall weighted average rate increases for the Arkansas individual market at "between 4-5%", with a rough estimate of around 4.6%.

Today, Arkansas Times reporter David Ramsey has provided the exact market share numbers for Arkansas. When I plug these in, the weighted average comes in a bit higher, at 4.98%:

HOWEVER, according to Ramsey, the Arkansas Insurance Division says that the actual weighted average is only 4.4% overall.

There could be any number of reasons for the discrepancy; it's possible that there's a few additional minor off-exchange carriers who I've missed, or there could be rounding errors/etc. In any event, these are all just estimates anyway, so I'll go with AID's official 4.4% figure.

Nevada's insurance dept. rate filing website has an extremely user-friendly, interactive website which lets you drill down and find exactly what you're looking for: Individual or Small Group policies, HMO or PPO, Under Review or Reviewed. From what I can tell, there are 12 companies offering individual policies in 2016 (a 13th, the Nevada Health COOP, just announced that they've gone belly-up and are being dissolved, meaning a minimum of 16,000 Nevadans will have to switch to a different insurance carrier).

The requested rates were approved for 8 of the companies, but were reduced significantly for Aetna (from 21-24% down to 15%). Here's what it looks like in the end:

The Small Group market is faring somewhat better, with just a 5.3% overall weighted average increase:

When I last checked in on Rhode Island's 2016 rate increase status, the three companies operating in the state (BCBSRI, Neighborhood and UnitedHealthcare) had requested hikes of 7%, 8.6% and 11% respectively. There was no off-exchange enrollment data, but the exchange-based market share breakdown was roughly 48.5% / 48.5% / 3%. This meant a requested average hike of around 7.9%.

A week or so ago, the approved rate hikes were released for Neighborhood and UHC, along with total enrollments (on+off exchange) for BCBS:

Still unresolved is how much Blue Cross and Blue Shield of Rhode Island may raise rates for its individual plans, which cover about 25,000 people. The nonprofit insurer initially requested an 18-percent increase, but no decision has yet been made because, by law, its rate hike requests are reviewed in a separate process that reserves a key role for the state's attorney general.

NOTE: THIS POST HAS BEEN UPDATED WITH ALL 50 STATES HERE.

  • 10/15/15: Added Pennsylvania with approved rate average
  • 10/12/15: Updated South Carolina with approved rate average
  • 10/8/15: Added Nebraska (approved rates)

I spent most of July and August simply overwriting/updating the original version of this entry, but now that the approved 2016 premium rates are starting to pop up all over (the deadline for approval of exchange policy rates was a few days ago), I figured it was time to start fresh.

When I last checked in on the ongoing saga between the New Mexico Insurance Commissioner and Blue Cross Blue Shield of New Mexico, BCBS was threatening to take their ball and go home if NM Insurance Commish John Franchini didn't cave and agree to let them jack rates up by 51% on the individual market (Franchini had agreed to a 24% hike instead).

Well, Franchini called BCBS's bluff...but they weren't bluffing:

Thousands of New Mexicans will need to shop for new health insurance plans later this year after a decision by Blue Cross Blue Shield to stop offering individual insurance plans through the state health exchange beginning Jan. 1.

...The letter said Blue Cross Blue Shield of New Mexico lost $19.2 million in 2015 on the 35,000 individuals covered by plans they purchased on and off the exchange.

...Blue Cross will offer a basic-level insurance plan outside the exchange in 2016, which will be available to all consumers at the same rate as in 2015.

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