Charles Gaba's blog

Not a whole lot to report in the smallest (physically) state of the Union. Rhode Island only has two insurance carriers participating in the individual health insurance market, while six of them compete in the small group market. Thankfully, the SERFF database not only has all eight of these filings, each of them has at least one document which includes the actual number of RI residents enrolled in the carriers policies.

As a result, I can run a fully weighted average for both markets: In the individual market, carriers are requesting an average rate hike of 6.6%, while small group market insurers want to bump up premiums by 6.8% overall.

via the Pennsylvania Insurance Dept:

Shapiro Administration Announces Public Comment Period On Proposed 2024 Health Insurance Rate Increases

​Harrisburg, PA – Pennsylvania Insurance Commissioner Michael Humphreys today welcomed public comment on the requested rate changes insurance companies currently operating in Pennsylvania's individual and small group market filed for 2024. The comment period on the proposed rate increases will close on September 8.

"The Shapiro Administration is committed to raising awareness about the importance of health insurance and providing increased access to affordable, comprehensive health coverage," said Humphreys. "We strongly encourage individual market consumers to shop for coverage on Pennie® where they may qualify for financial assistance that, as we consistently hear from Pennsylvanians, makes coverage more affordable than they thought might be possible." 

Oklahoma is another state where I have no access to the actual enrollment data--all I have to go by are the average requested rate changes for each carrier on the individual and small group markets. As a result, the averages for each market are unweighted.

For individual market plans, that unweighted average is just 2.2%, though the carriers range from as low as a 3.5% drop to as high as a 6.1% increase. It's also worth noting that Friday Health Plans are kaput.

Similarly, for the small group market, average requested rate hikes range from as little as 0.8% for CommunityCare to as much as a 9.3% for Aetna. The unweighted average is 4.9%.

The Ohio Insurance Department does this weird thing where they list all of the carriers offering policies on the individual market and list the weighted average year over year premium change...but they don't list the actual rate increases for each carrier. Fortunately, federal Rate Review site includes the rate changes, and the SERFF database for Ohio includes the actual enrollment numbers for all of the individual market carriers except one.

As a result, I've been able to put together a weighted average requested rate increase for the individual market (I estimated the one missing enrollment number based on the overall Ohio indy market total); it comes in at 7.6%.

For the small group market, I have to go with an unweighted average of +10.8%. It's also worth noting that, once again, Humana appears to be bailing on the entire small group market nationally from what I can tell.

Not much to report about the 2024 individual and small group market rate filings. I could only find current enrollment numbers for two of the three indy market carriers and for three of the five small group market carriers. However, based on last year's total enrollment, I'm estimating ND's total indy market at being roughly 50,000 people, which means I was able to make an educated guess at how many are enrolled in Sanford Health Plan policies.

Based on this, I have a (mostly) weighted requested average rate increase of 4.4% for individual market plans and an unweighted average of 6.5% for small group market plans.

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.


This one is particularly frustrating. In addition to the filings being listed at the federal Rate Review website, every individual & small group market carrier also has their filings listed via the SERFF database and via New Mexico's own internal, searchable rate filing database...and yet I still can't run a weighted average rate change for either market because almost none of the filings at any of these three databases includes the actual enrollment data (Presbyterian on the individual market is the exception).

As a result, I have to once again settle for unweighted averages, which come to +5.6% on the individual market and +7.7% for small group plans.

New Jersey individual & small group market carriers are asking for unweighted average rate increases of 6.7% and 13.0% respectively for 2024. However, the unweighted averages don't tell the whole story--the carriers are asking for rate hikes ranging from as low as 3.8% to as high as 13.8% on the individual market, and from as low as 2.3% to a stunning 25.9% for small group plans.

As is the case with far too many states these days, most of the rate filing memorandums are heavily redacted in New Jersey, making it nearly impossible to get ahold of the actual enrollment numbers, which means I have no way of running a weighted average on either market.

Earlier this afternoon, the Centers for Medicare & Medicaid Services (CMS, which should really be CMMS) released a much-awaited (by healthcare wonks) Effectuated Enrollment Report for Affordable Care Act on-exchange enrollment.

While nearly 16.4 million Americans selected Qualified Health Plans (QHPs) via the federal and state ACA exchanges/marketplaces during the official 2023 Open Enrollment Period (along with an additional 1.2 million signing up for a Basic Health Plan (BHP) program in New York & Minnesota, which CMS continues to inexplicably treat as an afterthought in such reports), not all of them actually pay their first monthly premium (for January) for various reasons:

The good news about New Hampshire's health insurance market is that they're the only state without its own ACA exchange which produces publicly-accessible monthly reports on individual on-exchange market enrollment. The bad news is that they don't seem to publish the actual rate filings in an easy-to-read format, which means I'm left with the federal rate review website, which sometimes posts average rate requests which don't match up with the actual filings...but it's gonna have to do here. 

With these two data sources in hand, New Hampshire's individual market carriers are asking for a weighted average increase of 3.1%. It's important to note that Anthem Health Plans and Matthew Thornton Health Plan are listed as separate carriers on the federal Rate Review website (with separate average rate requests), but on the state's monthly report, they're merged into a single listing.