Baseline Information for Evaluating the Implementation of the Health Insurance Portability and Accountability Act of 1996: Final Report. Insurer Databases

10/01/1998

1. AM Best

Organization A.M. Best
Contact (908) 439-2200
Type proprietary
Availability/Cost $375 for 1st year, see dfa.risknet.com/insurance/ambest/ambest.htm
Time Period annual
Scope of coverage health insurers included in NAIC annual financial report
Analysis unit accident and health insurers 
Sample size over 1,200 companies reviewed 

provides detail for up to 80 leading companies by line (the remainder are grouped together as "other")

Response rate not applicable
Geography presented by state.

States can be identified.

Design NAIC annual statement
Data collection mode information extracted from statements
Content aggregate premiums (accident AND health) attributable to each principal line of coverage

market share

number of carriers by line of insurance and state

Note: The Accident and Health lines are broken down by

  • Group
  • Credit
  • Collectively Renewable
  • Non-cancelable
  • Guaranteed Renewable
  • All Other

2. ALPHA

Organization Alpha Center
Contact Deborah Chollet (202) 296-1818 
Type public-use
Availability/Cost an overview of the findings are reported in the monograph "Mapping Insurance Markets: The Group and Individual Health Insurance Markets in 26 States" which can be dowloaded from docs.ac.org/shopping_cart/FMPro
Time Period calendar year 1995
Scope of coverage group and nongroup major medical health insurance markets where insurers wrote at least $500,000 of comprehensive major medical business in 1995.

Does not include self-insured employers.

Analysis unit insurance plan 
Sample size 1,022 group health insurers

518 individual

Response rate not applicable
Geography 25 states (AL,CA,CT,FL,IA,ID,IL,KY,LA,MA,MD,MN,MS,MT

ND,NH,NY,OR,PA,RI,SC,TX,UT,VT,WA) for group and individual plus MI for individual only.

States can be identified.

Design include states in which at least 85% of total group health-related market and individual market are understood.
Data collection mode compiled from financial reports filed from HMOs, commercial insurers and BC/BS.

Also searched websites and telephoned company headquarters and states’ department of insurance.

Content premiums (aggregate)

market share

number of carriers by market (group and individual broken down by BC/BS, HMOs, and Commercial)

Note: They occasionally had to impute major medical coverage to multi-state insurers and impute the proportion of major medical coverage to multiple-line insurers.

Citation: Chollet, D. J., Kirk, A. M., Ermann, R. D. "Mapping Insurance Markets: The Group and Individual Health Insurance Markets in 26 States," State Initiatives in Health Care Reform monograph. Alpha Center, October, 1997.


3. HIAA

Organization Health Insurance Association of America
Contact (202) 824-1600
Type proprietary database
Availability/Cost no set fee
Time Period annual
Scope of coverage HIAA member companies (commercial insurers)
Analysis unit commercial insurer 
Sample size 200+ insurers
Response rate not applicable
Geography state level
Design survey
Data collection mode survey
Content number of commercial carriers active in small group market

4. Comprehensive Health Insurance for High-risk Individuals

Organization Communicating for Agriculture 
Contact Bruce Abbe (612) 854-9005 or www.cainc.org/insurance/riskpool.html
Type publication
Availability/Cost $29.95 per copy
Time Period annual; 1998 will be available in October.
Reference Period operating statistics are for year end of previous year
Scope of coverage state comprehensive health insurance programs (risk-sharing pools)
Analysis unit state 
Sample size 28 programs (see note)
Response rate 100%
Geography state level for 28 states with risk pools (AL,AK,AR,CA,CO,CT,FL,IL,IN,IO,KS, LA,MN,MS,MO,MT,NE,NM,ND,OK,OR, SC,TN,TX,UT,WA,WI,WY)
Design survey
Data collection mode information supplied by state health plan administrators and obtained through research conducted by Communicating for Agriculture.
Content summary of plan composition

eligibility requirements

benefits design

waiting period and pre-existing conditions

number of participants (overall and by plan type)

premiums collected

premiums paid 

Note: Alabama and Texas are included in the survey though their comprehensive health insurance programs were not yet operational at the time of data collection.


5. Interstudy

Organization Interstudy
Contact (800) 844-3351 or www.hmodata.com/index.html
Type publications and proprietary databases
Availability/Cost varies ($200-$12,000)
Time Period annual and semi-annual; most recent - reporting date of July 1, 1997 (reporting date as of January 1, 1998 expected to be available in Fall 1998).
Reference Period Competitive Edge Database includes information for current year as well as for two previous years
Scope of coverage target all HMOs nationwide
Analysis unit HMOs 
Sample size varies
Geography nationally, by region, state and metro area
Design contact all HMOs
Data collection mode information extracted from surveys and regulatory data
Content premium

market share

enrollment

financial indicators

competitive indicators

Note: "The Competitive Edge" database contains HMO industry data and enrollment and utilization information.

"The Regional Market Analysis" publication maps marketplaces for all MSAs and identifies HMO penetration, cost and premium information.


Glossary

AHCPR Agency for Health Care Policy and Research

BC/BS Blue Cross and Blue Shield

BLS Bureau of Labor Statistics

CA Communicating for Agriculture

CDC Center for Disease Control

COG Census of Governments - a list of government firms maintained by the Census Bureau.

D&B Dun and Bradstreet. Their Marker Identifier file is a national census of employment establishments.

GPO Government Printing Office

HIAA Health Insurance Association of America

HMO Health Maintenance Organization

ICPSR Inter-university Consortium for Political and Social Research

NAIC National Association of Insurance Commissioners

NCHS National Center for Health Statistics

NTIS National Technical Information Service

POS Point-of-service health plan

PPO Preferred Provider Organization

SSEL Standard Statistical Establishment List - a list of private sector business establishments maintained by the Census Bureau.