U.S. Department of Health and Human Services: Rate Review Annual Report September 2013. Small Group Market


In the small group market, analysis of the information from 35 states indicates that the implemented rate increases are approximately 19 percent lower than the rates originally requested by insurance companies.6  This difference equates to approximately $866 million in savings to consumers based on 2012 small group market premium data.  For the 35 states, 18.7 percent of total covered lives had rate requests reduced or denied.  Extrapolating to the total number of 18.1 million covered lives in the small group market, an estimated 3.4 million individuals had rate requests reduced or denied.

As with the individual market data, the small group premium data are based on MLR data from 50 states and the District of Columbia,7 whereas the average difference between rate changes requested and rate changes implemented is taken from ASPE’s analysis of 35 states in the small group market using RRG data and data from Florida, a non-grant state.  Again, the results were extrapolated to approximate a national savings total for the small group market as a result of rate review.

Figure 2: Rate Change Requested Versus Rate Change Implemented in the Small Group Market
Small Group Market Rate Change, 2012 Requested Implemented
Sources:  Revised State Rate Review Grant (RRG) data and data from state websites plus data from Florida (non-grant state)
Number of rate filings in 35 states 772 772
Number of covered lives affected by these rate filings 10,938,053 10,938,053
Average rate change for 35 states 5.8% 4.7%
Average rate change when request >=10% for 35 states 16.3% 9.7%
% filings with rate change requested >=10% for 35 states 14.0% 11.7%
% covered lives with rate change requested >=10% for 35 states 14.7% 9.3%
% covered lives with rate change request reduced or denied   18.7%
Total covered lives with rate change request reduced or denied based on 18.1 million total covered lives for all states   3.4 million
Total U.S. savings based on $78.7 billion total premiums for all states   $866 million

Total premiums in the individual and small group markets were lower by an estimated $1.2 billion compared to the total premiums initially requested.

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