Health Insurance Premium Increases in the Individual Market Since the Passage of the Affordable Care Act. Appendix

02/22/2013

This issue brief analyzes health insurance premium rate increases for comprehensive major medical policies and HMOs in the individual market. States were included in the analysis if data were available on rate change requests, rate changes implemented, and the number of policyholders or members affected by the rate change for at least 2 full years. Requests that were submitted for new state or federal coverage mandates were not included. Most of the data were collected from state insurance websites. Data from Minnesota, New Jersey, and Washington State were obtained directly from state officials for 2009 to 2011. The analysis includes data from 9 states in 2009, 11 states in 2010, 15 states in 2011 and 2012, and 10 states in 2013 (see Table A-1). A number of states have data available from 2012 on but not complete data for earlier years so trends over time could not be analyzed. Most of these states are prior approval states for the individual market except California, New Jersey, and Wisconsin, which are file and use states.

Most states now use the National Association of Insurance Commissioners’ (NAIC) System of Electronic Rate and Form Filing (SERFF). The disposition page on SERFF has the implementation date, insurance company name, overall percentage rate impact (requested), the number of policyholders affected, and the overall percentage rate change approved. The overall percentage rate approved is the statewide average percentage change approved to the current rates for the benefit plans included in the rate filing. The rate filing may include different rate changes by age category, geographic area, and/or benefit coverage (deductibles, cost-sharing, and specific benefits such as prescription drugs).

Results regarding average premium increases are a weighted average, where the weights are proportional to the number of policyholders covered by each rate filing. Although insurers were instructed to provide information on the number of policyholders, some insurers submitted information on the number of members, which includes dependents. We used a number of methods to identify instances where members were substituted for policyholders, and to correct the data to get a consistent count of policyholders. The insurers may not have labeled the number of members correctly on the disposition page, but we were able to ascertain from other parts of the rate filing whether the number was for members or policyholders. Some state insurance websites did not post actual rate filings but summarized the data which may include the number of policyholders or the number of members.

Information on the number of policyholders and members is provided for most rate filings in four states. The number of members per policyholder was 1.44 for California major medical policies, 1.51 for California HMOs, 1.66 for Minnesota, 1.55 for Rhode Island, and 1.61 for Washington State, for an average of 1.48 overall (or 0.67 policyholders for each member) across these states. Where it was necessary to estimate the number of policyholders, the state-specific factor was used (California major medical policies, some California HMOs, some Minnesota policies, and some Washington State rate filings) . The overall factor of 0.67 was used to estimate the number of policyholders for Delaware, New Jersey, and Oregon. The state insurance websites are shown in Table A-2.

Table A-1 Number of Policyholders and Rate Filings Included in the Analysis
Policyholders
State 2009 2010 2011 2012 2013
1States without prior approval authority
Source: State insurance websites except directly from MN, NJ, and Washington State for 2009-2011
AR 61,594 52,894 46,654 38,357 41,162
CA1 no data no data 879,031 1,056,924 166,485
CT no data no data 76,600 60,371 34,783
DE no data no data 7,935 1,481 no data
FL 402,708 366,011 379,540 397,064 no data
IN no data no data 162,967 130,214 172,275
ME 11,028 17,259 17,387 9,615 no data
MN no data 150,097 147,679 154,543 102,244
NC 145,465 225,038 246,685 264,120 238,635
NJ1 74,624 78,973 83,871 72,668 no data
OR 130,995 119,808 139,568 112,140 21,341
PA no data 118,288 125,175 183,664 93,411
RI 9,100 9,425 9,425 9,808 no data
WA 178,711 184,371 176,863 172,477 71,403
WI1 105,843 124,541 88,683 51,486 5,020
Total 1,120,068 1,446,704 2,588,062 2,714,932 946,759
Table A-1 Number of Policyholders and Rate Filings Included in the Analysis (cont.)
Filings
State 2009 2010 2011 2012 2013
1States without prior approval authority
Source: State insurance websites except directly from MN, NJ, and Washington State for 2009-2011
AR 19 19 10 8 5
CA1 no data no data 23 25 4
CT no data no data 12 15 7
DE no data no data 6 5 no data
FL 68 52 58 48 no data
IN no data no data 42 23 10
ME 5 8 4 5 no data
MN no data 11 9 15 5
NC 21 20 9 18 4
NJ1 17 21 17 11 no data
OR 33 25 30 26 6
PA no data 21 27 40 25
RI 1 1 1 1 no data
WA 14 14 13 9 3
WI1 35 46 46 34 8
Total 213 238 307 283 77

 

Table A-2 State Insurance Websites with Rate Change Information
State Rate Filings
AR http://www.insurance.arkansas.gov/LH/FlgShpage/Filings.htm
CA http://www.insurance.ca.gov/0250-insurers/HlthRateFilings/index.cfm
http://wpso.dmhc.ca.gov/RateReview/
CT www.catalog.state.ct.us/cid/portalApps/RateFilingDefault.aspx
DE http://www.delawareinsurance.gov/departments/rates/MedWebRate2011_2012.pdf
http://delawareinsurance.gov/departments/rates/ratefilings.shtml
FL http://www.floir.com/Office/DataReports.aspx
http://www.floir.com/edms/
IN http://www.in.gov/idoi/files/SerffReportIDOI113010_(4).pdf
http://www.in.gov/idoi/ratewatch/
ME http://www.maine.gov/pfr/insurance/PPACA/HFAI.htm#
MN http://mn.gov/commerce/insurance/topics/medical/Access-Filing/access-filings-overview.jsp#
NC http://infoportal.ncdoi.net/filelookup.jsp?divtype=3
NJ http://www.state.nj.us/dobi/lifehealthactuarial/rateinfo/ratefilings_ihc.html
OR http://www.oregoninsurance.org/insurer/rates_forms/health_rate_filings/health-rate-filing-search.html
PA http://www.portal.state.pa.us/portal/server.pt/community/industry_activity/9276
RI http://www.ohic.ri.gov/Insurers_RegulatoryActions.php
WA https://fortress.wa.gov/oic/onlinefilingsearch/
WI https://ociaccess.oci.wi.gov/Companyfilings/jsp/rfsearch.oci

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