Every year around this time I start my annual individual & small group market rate filing analysis project. This involves spending months painstakingly tracking every insurance carrier rate filing for the upcoming year to determine just how much average insurance policy premiums on the individual market are projected to change.
Carriers tendency to jump in and out of the market, repeatedly revise their requests, and the confusing blizzard of actual filing forms sometimes make it next to impossible to find the specific data I need.
The actual data I need to compile my estimates are actually fairly simple, however. I really only need three pieces of information for each carrier:
How many effectuated enrollees they have in ACA-compliant policies this year;
The average projected rate change for those policies;
Ideally, a breakout of the reasons behind the changes.
Usually the reasons given are fairly vague things like "increased morbidity" (ie, a sicker risk pool) or the like. Sometimes, however, there's a very specific reason given for some or all of the premium changes. Major examples of this include:
...Providence will stop offering most plans through Providence Health Plan,including individual, family and employer coverage, as it seeks to strengthen its financial footing and refocus on delivering care rather than operating an insurance arm.
...Providence Health Plan, based in Portland, is Oregon’s third-largest health insurer, covering more than 421,000 Oregonians. It also covers over 13,000 members in Washington and 4,800 in California.
Medicare Advantage (technically "Medicare Part C" & originally called "Medicare+Choice") is a type of health plan in the United States offered by private companies as part of the original Social Security Act of 1965 that created Medicare. It permits a private insurance option that wraps around traditional Medicare. Medicare Advantage plans attempt to fill some coverage gaps and offer alternative coverage options.
Under Part C, Medicare pays a plan operator a fixed payment for each enrollee. The operator then pays for their medical expenses. Traditional Medicare directly compensates providers on a fee-for-service basis. Plans are offered by integrated health delivery systems, labor unions, non profit charities, and health insurance companies, which may limit enrollment to specific groups of people (such as union members).
