Health Insurance Issuer Participation and New Entrants in the Health Insurance Marketplace in 2015. Conclusion

09/23/2014

Given that the number of new entrants is expected to be more than five times the number of exiting issuers among the 44 states included in this analysis, the Marketplaces will offer consumers significantly more choice for coverage in 2015 and appear to offer an increasingly attractive business opportunity for issuers.

Previous research has found that the number of issuers in a rating area is associated with more affordable premiums for benchmark plans (a four percent decrease in the premium of the second-lowest cost silver plan) for individuals and reduced costs for the federal government. Additionally, in 2014, areas with a larger number of issuers were found to offer a wider range of choices among plan types, such as preferred provider organizations (PPOs), health maintenance organizations (HMOs), and consumer-operated and oriented plans (CO-OPS).8 Furthermore, reports indicate that some of the largest insurers in the nation are increasing their participation in the Marketplaces in 2015.9 Independent research has found that participation by a large issuer could significantly reduce benchmark premiums.10

TABLE 1. Number of QHP Issuers in 2014 Federally-facilitated Marketplace States (1)

State Number of Issuers (2) (preliminary)* Issuers Exiting in 2015 (preliminary)** New Entrants in 2015 (preliminary)***
2014 2015 Net Change from 2014 to 2015
FFM Total (36 states) 191 248 57 10 67
Alabama 2 3 1 0 1
Alaska 2 2 0 0 0
Arizona 10 13 3 0 3
Arkansas (3) 3 4 1 0 1
Delaware (3) 3 3 0 2 2
Florida 11 14 3 1 4
Georgia 5 9 4 0 4
Idaho (4) 4 5 1 0 1
Illinois (3) 8 10 2 1 2
Indiana 4 9 5 1 6
Iowa (3) 4 4 0 0 0
Kansas 4 5 1 0 1
Louisiana 5 6 1 0 1
Maine 2 3 1 0 1
Michigan (3) 12 16 4 0 4
Mississippi 2 3 1 0 1
Missouri 4 8 4 0 4
Montana 3 4 1 0 1
Nebraska 4 4 0 1 1
New Hampshire (3) 1 5 4 0 4
New Jersey 4 6 2 0 2
New Mexico (4) 4 5 1 0 1
North Carolina 2 3 1 0 1
North Dakota 3 3 0 0 0
Ohio 12 16 4 1 5
Oklahoma 6 7 1 0 1
Pennsylvania 14 15 1 3 4
South Carolina 4 5 1 0 1
South Dakota 3 3 0 0 0
Tennessee 4 5 1 0 1
Texas 12 16 4 0 4
Utah 6 6 0 0 0
Virginia 8 9 1 0 1
West Virginia (4) 1 2 1 0 1
Wisconsin 13 15 2 0 2
Wyoming 2 2 0 0 0
Number of QHP Issuers in 2014 Federally-facilitated Marketplace States


Number of QHP Issuers in 2014 Federally-facilitated Marketplace States

State20142015
Alabama23
Alaska22
Arizona1013
Arkansas34
Delaware33
Florida1114
Georgia59
Idaho45
Illinois810
Indiana49
Iowa44
Kansas45
Louisiana56
Maine23
Michigan1216
Mississippi23
Missouri48
Montana34
Nebraska44
New Hampshire15
New Jersey46
New Mexico45
North Carolina23
North Dakota33
Ohio1216
Oklahoma67
Pennsylvania1415
South Carolina45
South Dakota33
Tennessee45
Texas1216
Utah66
Virginia89
West Virginia12
Wisconsin1315
Wyoming22

 

* Counts are from issuer filings in HIOS as of September 4, 2014. The number of issuers may not include issuers offering only multi-state plans.

** Exiting issuers represent issuers that offered a QHP through the Marketplace in a given State in 2014, but have not filed for participation in 2015.

*** New entrants represent 2015 issuers that did not offer QHPs through the Marketplace in a given State in 2014.

Source: Preliminary rate filings from the Center for Consumer Information and Insurance Oversight.

(1) Includes data for 36 states collectively known as the Federally-facilitated Marketplace. These 36 states include 27 states that have Marketplaces fully run by the federal government, 7 that have State Partnership Marketplaces, and 2 that have federally supported State-based Marketplaces in 2014.

(2) For the purposes of this analysis, an issuer represents a unique issuer identification number in the CMS Health Insurance Oversight System (HIOS). Because an entity’s HIOS code is specific to each state, for purposes of this analysis, no issuer is counted as being active in more than one state.

(3) Arkansas, Delaware, Illinois, Iowa, Michigan, New Hampshire, and West Virginia are State Partnership Marketplaces for 2014.

(4) Idaho and New Mexico are federally supported SBMs for 2014 and utilize the FFM eligibility and enrollment platform.

 

TABLE 2. Number of QHP Issuers in 2014 Select State-based Marketplaces (1)

 

State Number of Issuers (2) Number of Issuers (2) Issuers Exiting in 2015 (preliminary)** New Entrants in 2015 (preliminary)***
2014 2015 Net Change from 2014 to 2015
SBM Total
(8 states)
61 67 6 4 10
California (3) 12 10 -2 2 0
Colorado (4) 10 12 2 0 2
Connecticut (5) 3 4 1 0 1
District of Columbia (6) 4 4 0 0 0
Maryland (7) 6 7 1 1 2
New York (8) 16 17 1 1 2
Rhode Island (9) 2 3 1 0 1
Washington (10) 8 10 2 0 2

 * Counts are from issuer filings and media reports as of August 2014. Data were unavailable for Hawaii, Kentucky Minnesota, Massachusetts, Nevada, Oregon, and Vermont.

** Exiting issuers represent issuers that offered at QHP through the Marketplace in a given State in 2014, but have not filed for participation in 2015.

*** New entrants represent 2015 issuers that did not offer QHPs through the Marketplace in a given State in 2014. Source: Preliminary rate filings from the Center for Consumer Information and Insurance Oversight and additional sources as noted below.

(1) Includes data for eight states that have State-based Marketplaces in 2014 (excluding states with State Partnership Marketplaces and federally supported SBMs).

(2) For the purposes of this analysis, an issuer represents a unique issuer identification number in the CMS Health Insurance Oversight System (HIOS). Because an entity’s HIOS code is specific to each state, for purposes of this analysis, no issuer is counted as being active in more than one state.

(3) “Covered California Announces Rates for 2015; Rigorous Negotiations with Health Insurance Companies Keep Rate Increases Low and Choices Robust.” Covered California. July 31, 2014. Retrieved from http://news.coveredca.com/2014/07/covered-california-announces-rates-for.html#more

(4) “Division of Insurance Releases Preliminary Look at 2015 Health Plans.” Colorado Division of Insurance. June 23, 2014. Retrieved from http://cdn.colorado.gov/cs/Satellite?blobcol=urldata&blobheadername1=Content-Disposition&blobheadername2=Content-Type&blobheadervalue1=inline%3B+filename%3D%22DOI+Release+Preliminary+Look+at+2015+Health+Plans.pdf%22&blobheadervalue2=application%2Fpdf&blobkey=id&blobtable=MungoBlobs&blobwhere=1252001286218&ssbinary=true

(5) “Connecticut Insurance Department – Current Rate Filings.” Connecticut Insurance Department. Retrieved from http://www.catalog.state.ct.us/cid/portalApps/RateFilingComment.aspx

(6) Preliminary rate filings from the Center for Consumer Information and Insurance Oversight.

(7) “Public Comment Sought on Carriers’ Proposed Health Rates for 2015.” Maryland Insurance Administration. June 6, 2014. Retrieved from http://www.mdinsurance.state.md.us/sa/news-center/2015-proposed-health-rates.html

(8) Prakash, N. “Behind New York’s 2015Health Insurance Rates.” Capital. August, 4, 2014. Retrieved from www.capitalnewyork.com/article/albany/2014/08/8549028/behind-new-yorks-2015-health-insurance-rates

(9) “State of Rhode Island Office of the Health Insurance Commissioner: Requested and Approved Summary for 2015 Rates in the Individual, Small Group, and Large Group Markets.” Rhode Island Health Insurance Commissioner. Retrieved from http://www.ohic.ri.gov/2014%20Rate%20Review%20Final%20Decision/2_2014%20Rate%20Review%20%20All%20Market%20Requested%20and%20Approved%20Summary.pdf

(10) Kreidler, M. “90 health plans approved for next year’s Exchange with a record low 1.9 percent rate change.” Washington State Office of the Commissioner. August 27, 2014. Retrieved from http://insurance.wa.gov/about-oic/news-media/news-releases/2014/8-27-2014.html


8 See http://aspe.hhs.gov/health/reports/2014/Premiums/2014MktPlacePremBrf.pdf

9 For example, see: Abelson, R., “Insurers Once on the Fence Plan to Join Health Exchanges in ’15”, The New York Times, May 25, 2014, available at http://www.nytimes.com/2014/05/26/your-money/health-insurance/insurers-once-on-the-fence-plan-to-join-health-exchanges-in-15.html

10 Leemore Dafny, Jonathan Gruber, and Christopher Ody, “More Insurers Lower Premiums: Evidence from Initial Pricing in the Health Insurance Marketplaces,” National Bureau of Economic Research working paper no. 20140, May 2014, available at http://www.nber.org/papers/w20140.

 

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