2023 Rate Changes

Rate Changes

I'm about 1/3 of the way through my Annual Individual & Small Group Market Rate Filing project, having analyzed & crunched the numbers for 18 states + DC. This seems like a good time to step back and see where things stand.

So far, I've compiled the preliminary unsubsidized average premium rate filings for both the ACA-compliant individual and small group markes in Akransas, Colorado, Connecticut, Delaware, DC, Georgia, Hawaii, Indiana, Kentucky, Maine, Maryland, Michigan, Minnesota, New York, Oregon, Rhode Island, Tennessee, Vermont and Washington State. It's important to remember that these are preliminary filings only--many of the carriers will have their final 2023 rate changes reduced, although in most cases they tend to be approved as is, and in some cases they're even increased beyond what the carrier originally requested.

It's also important to note that these 18 states + DC only represent around 30% of the total U.S. population...aside from New York, the other big states (California, Florida, Texas, Pennsylvania, etc.) haven't posted their 2023 filings yet.

Texas

Going forward, it looks like I'm going to have to do some educated guesses for a lot of carrier enrollment numbers for the states which haven't made their full 2023 rate filing data publicly available either on their own insurance dept. sites or even via the SERFF database.

The federal Rate Review site includes the average rate increases for each individual carrier, but most of the enrollment data is still redacted.

Texas' annual health insurance rate filings are kind of a mixed bag in terms of transparecy. Hardly any of the carriers have Uniform Rate Review Template (URRT) forms or Rate Filing Justification Form Part II available (these are the documents which generally include the actual number of people enrolled in the policies for each market for that insurance carrier), and the Actuarial Memorandum (Part III) is heavily redacted for most of them, making it very difficult to lock in the actual enrollment numbers.

South Dakota

Going forward, it looks like I'm going to have to do some educated guesses for a lot of carrier enrollment numbers for the states which haven't made their full 2023 rate filing data publicly available either on their own insurance dept. sites or even via the SERFF database.

The federal Rate Review site includes the average rate increases for each individual carrier, but most of the enrollment data is still redacted.

In South Dakota, there are only 2 carriers offering individual market coverage next year. I have hard enrollment numbers for one of them; for the other, I'm assuming equal enrollment for each based on a rough assumption of ~42,000 total indy market enrollees statewide.

Assuming this is fairly close, that would put the weighted average rate increases at roughly 10.5%. If not...well, the unweighted average would be 11.3%.

For the small group market, I don't even have a decent total market size to base an estimate off of, so I have to go with the unweighted average of 4.3%.

Montana

Going forward, it looks like I'm going to have to do some educated guesses for a lot of carrier enrollment numbers for the states which haven't made their full 2023 rate filing data publicly available either on their own insurance dept. sites or even via the SERFF database.

The federal Rate Review site includes the average rate increases for each individual carrier, but most of the enrollment data is still redacted.

In Montana, there are only 3 carriers offering individual market coverage next year. I have hard enrollment numbers for one of them; for the other two, I'm assuming equal enrollment for each based on a rough assumption of ~52,000 total indy market enrollees statewide.

Assuming this is fairly close, that would put the weighted average rate increases at roughly 8.8%. If not...well, the unweighted average would be 9.3%.

For the small group market, I don't even have a decent total market size to base an estimate off of, so I have to go with the unweighted average of 4.9%.

Oklahoma

Going forward, it looks like I'm going to have to do some educated guesses for a lot of carrier enrollment numbers for the states which haven't made their full 2023 rate filing data publicly available. The federal Rate Review site includes the average rate increases for each individual carrier, but most of the enrollment data is still redacted.

In Oklahoma, there are 7 carriers offering individual market coverage next year (it looks like Bright Health Insurance is dropping out). I have hard enrollment numbers for 4 of them; for the other three, I'm assuming equal enrollment for each based on a rough assumption of ~190,000 total indy market enrollees statewide.

Assuming this is fairly close, that would put the weighted average rate increases at roughly 8.8%. If not...well, the unweighted average would be 9.0% anyway, so this is at least somewhat more accurate.

For the small group market, I don't even have a decent total market size to base an estimate off of, so I have to go with the unweighted average of 8.1%.

Iowa

Here's the preliminary 2023 rate filings for Iowa's individual & small-group markets. Unfortunately, I only have the enrollment data for the two smaller carriers on the individual market (and none for the small group market), but based on my estimate of Iowa's total ACA-compliant individual market, I can make an educated guess as to the weighted average, which should be roughly 2.0%.

Unfortunately I can't do the same for the small group market; for that, the unweighted average rate increase is around 5.1%.

I should also note that Iowa also has 35,400 residents still enrolled in pre-ACA ("transitional" or "grandmothered") medical policies, with nearly all of them being via Wellmark: 

Illinois

Unfortuantely, Illinois is another state which doesn't make it easy to analyze annual health insurance premium rate filings.

There's no details on their insurance department website, their SERFF listings don't seem to include the actuarial memos or URRT forms, and even the federal Rate Review listings only include the average requested rate changes; the actuarial memos there are mostly heavily redacted.

Illinois' total individual market enrollment should be roughly 330,000 people. Fortunately, three of the carriers do reveal their 2022 enrollment, including the biggest one in the state (Blue Cross). This allows me to make an educated guess as the the enrollment of the other 7, which in turn means I can make an estimate of the weighted rate increase of roughly 6.9%. The unweighted average is 8.9%.

For the small group market I have to go with the fully unweighted average of 6.8%.

Wyoming

Wyoming is the smallest state and only has two carriers offering individual market policies (and just three offering small group plans). This makes it pretty simple for me.

Unfortunately, neither their insurance department website nor their SERFF filings give any indication of the enrollment numbers for any of the carriers. Fortunately, the federal rate review website does list enrollment for Blue Cross Blue Shield of Wyoming...which also has something like 95% of the individual market share in the state. By estimating the enrollment for the 2nd carrier (Montana Health Co-Op), I should be pretty close to the weighted average...a pretty ugly 18.5% average rate hike. Ouch.

It's no better on the small group side, although I don't have the actual enrollment for the other two carriers; the unweighted average is "only" an 11.9% increase, but it's over 20% for BCBSWY enrollees.

South Carolina

The South Carolina Insurance Dept. website isn't particularly helpful when it comes to getting the annual rate filing data for these analyses--they post a link to the federal Rate Review website and the SERFF database, but that's it...and most of the filings don't show up in SERFF, while many Rate Review database actuarial memos are all heavily redacted.

Fortunately, this year the Rate Review database has Consumer Justification Narratives for 4 of the 5 carriers participating in SC's individual market (Bright Health Co. appears to be dropping out of the state's indy market). While the fifth one is missing (Molina), I can make an educated guess as to their enrollment based on South Carolina's total individual market size, which should be roughly 300,000 people, give or take.

Based on that, it looks like SC carriers are asking for around a 10.4% average rate hike in 2023.

For the small group market, all of the actuarial memos are redacted, so all I have is the unweighted 2022 average rate changes, which comes in at +5.4%.

Utah

Utah's preliminary 2022 individual and small group market rate filings are listed below. They launched a handy new website specifically dedicated to insurance filings, which is nice to see.

Unless there's a change in the final/approved rates, unsubsidized individual market plan premiums are increasing by around 6.0% in 2023, while small group plans will go up 6.7% on average.

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