The following section describes the data analysis processes of this report, including weighting and statistical testing.
As discussed in previous sections, NORC took multiple steps to ensure quality in the data collection phase of this project. Research analysts extracting and entering data on filings used an Access database for all steps of the data collection process, linking each step and creating meta-data on the process. Screen shot images were saved for every
Within the Microsoft Access relational database, each filing corresponds to a single data entry form. Analysts used this database of filings to capture the analytic variables from each PDF filing. Similar to the data extraction phase, NORC used pre-populated drop-down menus to reduce transcription error for quality control/quality assurance purpos
Effects of Implementing State Insurance Market Reform, 2011-2012. Querying of State Portals and Extraction of Filings
Having selected the states, NORC needed to identify carriers from those states operating in the small group and individual/conversion market. This began with obtaining the most current NAIC Supplement Health Exhibit from 2011, which lists the carriers operating in each state and market, as well as total premium dollars and enrollment. 27 We used
This section describes the steps take to extract and enter the rate increase filings analyzed for the study.
There were 29 states included in the study. All states had publicly available data posted on their state website. Of the 29 study states, 24 were also included in the Trends study. For this report, we excluded six states that were in the Trends study that did not have public websites (Hawaii, Idaho, Massachusetts, Maryland, Ohio, and South Dakota)
This study builds upon the research and methods of the 2012 Trends study report prepared for DHHS. Based on our experience with the data quality of maintained paper filings among many states in the Trends study, we relied exclusively on data from filings and summary information available electronically from public state websites for this study.
In September of 2012, the U.S. Department of Health & Human Services released their 2012 Annual Rate Review Report 20 and cited major savings for consumers in both the individual and small group markets. Their report examined important aspects of the Rate Review Program, including 1) lowering rate increases and saving consumers’ money; 2) i
Effects of Implementing State Insurance Market Reform, 2011-2012. Study Objectives and Research Questions
This study is, in many ways, a follow-up to a previous study, Trends in Premiums in the Small Group and Individual Insurance Markets, 2008-2011 , (referred to as Trends study), in which NORC used multiple modes of data collection to assess the state of the individual and small group insurance markets prior to implementation of the ACA. Data quali
The Affordable Care Act and associated regulatory changes may substantially affect the individual and small group markets for health insurance. This study uses public data obtained from websites of state insurance regulators to assess increases in the premium rates for major medical insurance policies in the individual and small group markets in 2
These limitations inform readers to view study findings with some caution. Nonetheless, we saw statistically significant differences in the levels of premium rate increases during different periods of time. Premium increases slowed substantially in the individual and small group markets after rate review went into effect. Results show that, on ave
While this report presents data from the current study alongside data from the Trends study, comparisons across the years should be made with caution. The Trends study included a different sample of states, employed different methods of data collection, and presented an incomplete picture of insurance filings in 2011 because data collection ended
Premium increases have slowed since 2011, the same year ACA rate regulations went into effect. In the individual market, the average premium increase effected declined from 11.7 percent in 2010 as estimated based on the sample of states included in the Trends study to 7.0 percent in 2011 and 7.1 percent in 2012 as estimated using the sample of sta
The assessment of premium rate increases follows on a prior study where NORC analyzed the same outcomes for the years 2008 to 2011. The findings from this prior study were presented in the report entitled “Trends in Premiums in the Small Group and Individual Insurance Markets, 2008-2011,” or the Trends study. The Trends study addressed similar
This study uses public data obtained from state insurance departments’ websites to assess premium increases of major medical insurance policies during the period 2011 to 2012. The study further examines modification of proposed premium rate increases by state regulators, possible determinant characteristics of state markets, and possible effects
Based on carrier rate filings with state regulatory agencies, this study built a nationally representative database and then examined trends in premiums prior to and immediately after the passage of the Affordable Care Act. Readers should view findings with caution – we found both the quantity and quality of filings wanting in many states. Some
Readers should be aware of several limitations of this study. First, in many states, filings were missing in some study years. Moreover, important data elements were sometimes absent from existing filings, or of questionable quality. Lack of consistent data on medical loss ratios (MLRs) required us to drop that analysis. Sometimes filings included
Trends in Premiums in the Small Group and Individual Insurance Markets, 2008-2011. Relationship of Carrier Size, Product Type, and Market Concentration on Approval Rates
We examined whether large carriers had higher approval rates than smaller carriers (Figures 15 and 16) using the same criteria for approval as in Figure 12. With the exception of the 2011 small group market, smaller carriers had significantly lower approval rates throughout the study period. Figure 15: Percentage of Premium Increases Approved