Trends in Premiums in the Small Group and Individual Insurance Markets, 2008-2011. Trends in Data Collection

11/06/2012

The number of filings nationally for the individual market increased dramatically from 2008 to 2010, and then declined in 2011 (see Table 9), from 365 in 2008, to 540 in 2009, 573 in 2010, and 446 in 2011. In the small group market, filings grew dramatically from 2008 to 2011, from 139 in 2008, to 175 in 2009, 263 in 2010, and 309 in 2011.23 As previously noted, many carriers had not submitted their 2011 filings by the time Perr & Knight visited state insurance departments in the winter and spring of 2011 to photocopy filings. Although NovaRest and NORC did add to the 2011 filings as data became available on state websites, the 2011 data are still incomplete. This is a likely explanation for the decline in filings in the individual market in 2011, which was concentrated in (in order of magnitude) Wisconsin, Illinois, Indiana, Virginia, North Carolina, Ohio, Arkansas, Iowa, and Kentucky.

Table 9: Number of Filings by State and Nationally for Individual and Small Group Markets, 2008-2011

State Individual / Conversion 2008 Individual / Conversion 2009 Individual / Conversion 2010 Individual / Conversion 2011† State Small group 2008 Small group 2009 Small group 2010 Small group 2011†
TOTAL US 365 540 573 446 TOTAL US 139 175 263 309
AL . 2 4 4 AL 2 1 3 7
AR 13 16 21 9 AR . . . .
CA . 1 30 19 CA . 4 3 28
CO 15 27 45 54 CO 15 25 30 26
CT . 5 6 9 CT 2 . 6 2
FL 42 74 62 72 FL 44 31 52 45
HI . 1 . . HI 3 2 . 1
IA 56 58 32 21 IA 1 . . 1
ID 8 4 3 1 ID 1 6 2 1
IL 48 81 32 . IL . . . .
IN 52 47 29 6 IN 6 10 23 12
KS . 2 1 . KS   6 8 7
KY 8 2 18 6 KY 9 8 10 14
MA . . . . MA . . . 3
MD 2 1 2 13 MD 5 9 6 8
ME 3 5 10 8 ME . 2 4 40
MI 3 3 1 2 MI . . . .
MN 2 8 11 5 MN 3 1 4 2
NC 9 18 27 16 NC 8 5 2 16
NE . 1 3 18 NE . . 1 14
NJ . 23 38 54 NJ 27 32 39 28
OH 1 3 21 8 OH . 2 15 11
OK 1 2 4 7 OK . . . .
OR 20 33 21 26 OR 10 28 20 15
PA 16 30 24 35 PA 3 1 1 2
RI 1 2 1 1 RI . . 5 3
SD 1 5 7 . SD . . . .
VA . 6 19 2 VA . 1 20 8
WA 2 7 20 11 WA . 1 9 6
WI 62 73 81 39 WI . . . 9

† Data for 2011 are incomplete.


Carriers with filings in the database constituted a substantial percentage of the member-months in both the individual and small group market in their state. In the individual market, filings from carriers were 51.1 percent of member-months in 2008, 70.6 percent in 2009, 70.3 percent in 2010, and 63.9 percent in 2011 (Table 10). In the small group market, the percentage of member-months of carriers submitting rate increase filings were 31.2 percent in 2008, 46.1 percent in 2009, 47.8 percent in 2010, and 55.8 percent in 2011.

For the individual market, only one state (Kentucky) had more than 90 percent of its member-months represented in the sample each year. Oregon had 90 percent of its member-months represented for three of four years. Kentucky and Alabama were the only states to have more than 90 percent of membermonths represented in all years in the small group market. Oregon had more than 99 percent of membermonths rated for three of the four study years (Table 10). States with “HMO-only rate approval” tend to have a low percentage of earned premiums in the state with carrier filings. Due to the high concentration of enrollment in the largest plans (generally a Blue Cross/Blue Shield plan), our data for some file and use states such as Alabama represented a very high percentage of enrollments for some years simply because the Blue Cross/Blue Shield plan filed that year.

Table 10: Percentage of Member-Months Included in the Sample, by State and Nationally, in Individual and Small Group Markets

State Individual / Conversion 2008 Individual / Conversion 2009 Individual / Conversion 2010 Individual / Conversion 2011† State Small Group 2008 Small Group 2009 Small Group 2010 Small Group 2011†
Mean US 51.1% 70.6% 70.3% 63.9% Mean US 31.2% 46.1% 47.8% 55.8%
AL . **85.7% **85.7% **85.9% AL **95.7% **95.7% **96.3% **99.3%
AR 1.3% 11.8% 10.9% **81.0% AR . . . .
CA . 7.6% **91.3% **100.0% CA . 10.1% 10.1% **100.0%
CO 16.9% 46.1% **57.8% **54.8% CO 41.8% **94.5% **88.8% **94.0%
CT . **71.7% 35.6% **74.8% CT 8.5% . **64.3% 39.0%
FL **67.2% **67.7% **78.0% **64.6% FL **65.3% **70.3% **72.0% **55.3%
HI . 46.8% . . HI **82.3% 14.8% . 67.5%
IA **91.9% **89.9% **84.8% **87.1% IA 0.1% . . 0.3%
ID 37.1% **71.5% **72.3% 33.9% ID 42.6% **87.7% 43.0% 42.6%
IL **72.4% **72.5% **72.1% . IL . . . .
IN **92.9% **86.4% **73.8% 8.1% IN 0.8% **58.5% **62.4% **74.7%
KS . 19.1% 0.0% . KS . 1.5% 1.4% 8.8%
KY **94.5% **94.5% **94.5% **95.1% KY **90.3% **95.5% **90.7% **95.4%
MA . . . . MA . . . 26.5%
MD 1.9% 3.7% 27.6% **72.2% MD 6.0% **61.5% **77.7% **68.5%
ME 49.9% 50.2% 98.4% **98.6% ME . 0.0% 7.5% **71.4%
MI 1.8% 1.8% 0.0% 1.0% MI . . . .
MN 9.6% **83.3% **83.4% **83.3% MN 7.1% 0.4% **84.4% **54.8%
NC 9.7% 12.1% **84.6% **89.7% NC **63.4% **63.9% **63.3% **69.5%
NE . 62.7% **62.8% **69.5% NE . . 42.0% 37.3%
NJ . **80.9% **81.8% **81.8% NJ **86.2% **84.0% **86.2% **79.5%
OH 1.8% 1.8% 41.8% 39.2% OH . 6.5% **66.4% **68.6%
OK 4.2% **62.8% **62.8% **62.8% OK . . . .
OR **83.0% **99.2% **96.0% **89.7% OR **65.0% **100.0% **99.9% **99.5%
PA 39.5% 47.7% **62.3% **54.7% PA 12.9% 1.1% 1.1% 6.8%
RI 0.5% 47.8% 47.3% 47.3% RI . . **70.7% **71.2%
SD 5.1% **86.3% **87.6% . SD . . . .
VA . **73.2% **77.0% 0.5% VA . 0.0% **54.9% **57.6%
WA 43.2% 9.7% **100.0% **87.2% WA . 13.0% **71.0% 24.1%
WI **80.8% **79.3% **77.4% **50.3% WI . . . 0.0%

† Data for 2011 are incomplete.
Note: State estimates highlighted in blue** are reportable. State estimates containing only one filing, no matter its enrollment, are not considered reportable.


Figures 1 and 2 present the percent of national member-months that our filings constitute by state regulatory review authority. Prior approval states accounted for the greatest share of national enrollment from our filings. Thus, in 2011, filings in our database in prior approval states constituted 46.8 percent of the national member-months in the individual market and 34.8 percent in the small group market, whereas filings from file and use states accounted for 15.6 percent of national enrollment.

Figure 1: Percent of National Member-Months for Individual/Conversion Policies Represented by the Sample, by Rate Regulatory Review, by Year

Figure 1: Percent of National Member-Months for Individual/Conversion Policies Represented by the Sample, by Rate Regulatory Review, by Year

† Data for 2011 are incomplete.
Prior approval – Rates are reviewed for HMO, PPO, and other plans and do not go into effect immediately.
HMO Prior Approval – Rates are reviewed for HMO plans only.
PPO and other plans have file and use requirements only. File and Use – Carriers file rates and the rates go into effect immediately. In some cases, there may be retrospective review.


Figure 2: Percent of National Member-Months for Small Group Coverage Represented by the Sample, by Rate Regulatory Review, by Year

Figure 2: Percent of National Member-Months for Small Group Coverage Represented by the Sample, by Rate Regulatory Review, by Year

† Data for 2011 are incomplete.
Prior approval – Rates are reviewed for HMO, PPO, and other plans and do not go into effect immediately.
HMO Prior Approval – Rates are reviewed for HMO plans only. PPO and other plans have file and use requirements only.
File and Use – Carriers file rates and the rates go into effect immediately. In some cases, there may be retrospective review.


23 Three filings in the database did not include information on the proposed or approved rate changes – one was disapproved, the second withdrawn, and the third closed. They are included in the database for purposes of tracking the frequency of regulatory approvals, for example, but no values are imputed in analyses of rate increases.

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