As always, the Texas individual and small group markets are pretty messy. For starters, they have up to 20 individual market carriers depending on the year, along with over a dozen small group market carriers some years (this year they're at 17 and 8 respectively).
On top of that, as is also the case in some other states, some of the names of the insurance carriers can be confusing as hell. There's the "Insurance company of Scott & White" which seems to have changed its name to "Baylor Scott & White Insurance Co.," which isn't to be confused with "Scott & White Health Plans" and so on.
I was only able to acquire hard enrollment data for five of the carriers on the individual market this year, and one of those doesn't really count since they're brand new and don't have any (Wellpoint Insurance Co.). For another 11 of them the rate filings include the number of policyholders but not the actual number of covered lives; for those I'm using an average 1.4x multiplier, based on the actual multiplier found in the carriers I have both numbers available for.
Tennessee's preliminary 2025 individual & small group market health insurance rate filings are now available. Unfortunately, I can't find any unredacted filing forms for any of them (and in fact most of the rate filings aren't showing up in the SERFF database at all).
For the most part there's not much to see at first glance: Requested rate changes range from a 1.3% drop to a 3.9% increase on the individual market and from a 9.7% to 11.2% increase for small group plans. The unweighted averages are +1.4% and +10.6% respectively.
However, it also looks like several carriers are dropping out of each market in Tennessee: Alliant and US Health & Life (Ascension) don't show up on the federal Rate Review database for the individual market, while Aetna and CIGNA are missing for small group listings.
Assuming the exchange-based market makes up roughly 85% of total individual market enrollment in Tennessee, the total indy market should be around 628,000 people.
Pretty straightforward in the Mount Rushmore state. Three carriers on the individual market; around 56.4K enrollees total. The weighted average rate change across all three is +2.3% if approved as is.
Note that I've added a new feature to my rate change spreadsheet this year: I've started including the on exchange effectuated enrollmentas well as the subsidized on exchange enrollment as of February for every state. This will allow me to calculate the percent of the total individual market which is receiving ACA subsidies...at least in states where I'm able to figure out what total off-exchange enrollment is (typically only around half of them).
In South Dakota, for instance:
95.7% of on exchange enrollees are subsidized (49,250 / 51,416)
87.2% of the total market is subsidized (49,250 / 56,457)
On exchange enrollment makes up around 91% of the total individual market
For the small group market, there are five carriers this year; Medica Insurance Co. appears to be pulling out of the state. The weighted requested average rate change is a 2.8% increase.
Unfortunately, South Carolina is another state where they don't make unredacted rate filings available, either on the state insurance dept website, the federal Rate Review websiteor the SERFF database.
As a result, I'm limited to unweighted averages for both the individual and small group markets:
It's worth noting that Cigna Healthcare is dropping out of the South Carolina individual market next year, while Aetna is pulling out of the small group market (see below).
I got so far behind on my annual rate filing project that some of the states have started issuing their APPROVED changes before I got around to analyzing the REQUESTED rate changes. Ah, well...
PID is working with insurers to review proposed changes to ensure rates are adequate and fair.
Harrisburg, PA – The Pennsylvania Insurance Department (PID) today announced that 2025 rate changes requested by insurance companies currently operating in Pennsylvania's individual and small group markets are now available online. This initiative upholds the Shapiro Administration's commitment to providing consumers with the information they need when shopping for health insurance.
Rate filings for 2025 health insurance plans were submitted to PID on May 15, 2024. Ever since, PID has been working with insurers to review these insurance companies' proposed rate changes, as rates vary by plan and region and are subject to change by the Department to ensure rates are adequate and fair. Final approved rates will be made public in the fall.
As a result, I've been able to put together a weighted average requested rate increase for the individual market, which comes in at +3.9%.
For the small group market, I have to go with an unweighted average of +12.0%. It's also worth noting that it looks like one of Aetna's divisions is pulling out of the OH small group market, as are two fof the 4 (!) UnitedHealthcare divisions and possibly AultCare, although I'm not sure about that one.
North Dakota only has 3 carriers participating in their individual health insurance market and four in their small group market, since it appears that Health Partners will be pulling out of the latter next year.
For the indy market, the weighted average premium increase being requested is a painful 16.7%, although this may be off slightly due to Medica's enrollment number being a rough estimate (last year's total ND market was only 45,000 people; I'm assuming Medica only has around 2,000 enrollees this year).
For the small group market, I only have the unweighted average rate hikes, which come in at 10.8%.
Ah, at last, another state which includes both the average requested rate changes for 2024 as well as the number of enrollees each carrier has for both the individual and small group markets in clear, transparent language!
Generally, according to NC Insurance laws, health insurance rates must not be excessive, inadequate, or unfairly discriminatory, and must exhibit a reasonable relationship to the benefits provided in the policy.
Overall, individual market carriers in North Carolina are requesting 7% rate increases in 2025 for unsubsidized policies, while small group market carriers are asking for a 6.5% bump. It's worth noting that one of the three (!) UnitedHealthcare divisions is pulling out of the NC small group market next year for whatever reason.
The bad news is that I was only able to acquire effectuated enrollment for 3 of New Mexico's 4 individual market carriers participating in 2025 (a fifth carrier, Western Sky, is dropping out of the market entirely).
The good news is that I'm able to roughly estimate the enrollment of the remaining carrier (BCBS NM) if I look at on-exchange effectuated enrollment as of February and assume that another 10% or so is off-exchange. That gives me an estimated weighted average increase of 10.6%.
Even if that estimate is wrong, it doesn't make much difference since the unweighted average is around 10.1% anyway.
As for the small group market, I only have an unweighted average there of 8.6%.
