Normally by early October I have the preliminary rate filings analyzed & posted for nearly every state and the approved rate changes for at least half of them. This year I'm lagging way behind for several reasons, some personal, some professional.

Having said that, I'm trying to play catch-up this week. Case in point, today I'm posting Iowa's preliminary individual and small group market filings for 2021.

Wellmark is dropping their premiums by a jaw-dropping 42% next year, which would normally be a huge story except that they only have around 3,000 Iowans enrolled to begin with (which may explain the massive rate drop, of course). Oscar Insurance appears to be expanding into the Iowa individual market, while Medica continues to hold nearly 95% of the market and is only raising premiums by around 2.5%. Overall, 2021 rates are essentially flat on averae.

The small group market is much the same...there's a bunch of carriers which only have a few dozen enrollees statewide, and four which hold over 90% of the market share (realistically more like 2-3 carriers depending on how you define UnitedHealthcare and Wellmark subsidiaries).

The Delaware Insurance Dept. has posted the approved 2021 individual market rates and it's about as unexciting as you can imagine: There's a single carrier in the state (Highmark BCBS), which asked for a 0.5% average premium reduction and was approved for...a 1.0% average premium reduction. Unsubsidized Delaware enrollees will average around $80 in savings per year.

In early August, the Arkansas Insurance Dept. posted the preliminary 2021 rate filings for the individual & small group market. At the time, the carriers were requesting average increases of 7.0% for ACA indy market plans and a slight drop of 0.3% for the small group market.

The approved rate filings have now been published, and the increases have been cut in half on the individual market to just 3.4%, while the small group market is slightly lower still (-0.4%) due to a revision in the estimated number of current enrollees:

2021 Minnesota health insurance rates continue to show stability for another year; expanded consumer choice across the state

ST. PAUL, Minn.—The Minnesota Department of Commerce announced final 2021 Minnesota health insurance rates today, which will remain stable across the state. For the 2021 plan year, 80 counties have three or more health insurance companies offering plans on the exchange, compared to just 31 counties with three or more in 2020. Ninety-seven percent of Minnesotans buying health insurance through MNsure will have an average of 30 different qualified health plans and three or more carriers to choose from.

Five health insurance companies are partnering with MNsure for the 2021 plan year: BluePlus, HealthPartners, Medica, UCare, and newly added Quartz, a Madison-based insurer offering plans in some southeastern Minnesota counties. Quartz will be offering 14 qualified health plans on the exchange. Additionally, dental plans will be available from Delta Dental and Dentegra.

It was a little over a year ago that New Jersey legislators passed, after some last-minute drama, a bill to follow in the footsteps of Nevada and split off from the federal ACA exchange, HealthCare.Gov (there's actually a dozen other states which also operate their own full state-based exchanges as well, but 11 of them were never hosted by the federal exchange in the first place. The exception is Idaho, which was hosted by HC.gov for one year before splitting off, but that was always their plan from the start).

New Jersey's ACA portal website, Get Covered NJ, has actually been live for two enrollment periods already, but until now it was just that--an information portal only. The actual healthcare policy shopping/enrollment process was still handled through HealthCare.Gov.

New Insurance Carrier Joins Idaho Exchange, Record Number of Plans Available in 2021

  • Preview plans and prices beginning Oct. 1 at YourHealthIdaho.org

BOISE, Idaho – Your Health Idaho, the state health insurance exchange, announced today that Idahoans will have a record number of medical and dental plans and a new insurance carrier to choose from in 2021.

Regence, which currently sells small group and individual plans off-exchange in Idaho, will offer medical coverage through Your Health Idaho for the first time in 2021. The addition of Regence brings the total number of insurance carriers on the Idaho exchange to seven.

“We are pleased to welcome Regence to Your Health Idaho,” said Pat Kelly, Your Health Idaho Executive Director. “Adding another regional insurance carrier means even more choice for Idahoans and continued local control for the Idaho marketplace.” 

Beginning Oct. 1, Idahoans can preview the 136 medical and 13 dental plans that will be available in 2021 online at www.YourHealthIdaho.org. 

I'm not sure what's going on with Bright Health Care in Nebraska. They entered the state's ACA market in 2020, but for whatever reason they aren't showing up in the HealthCare.Gov Rate Review database. The only carrier listed for the state's individual market is Medica, and the SERFF database for Nebraska doesn't bring up either one.

Even more curious, when I ran a search to make sure that Bright hadn't simply jumped in and then out again the following year, I found this article:

Bright Health Plan announced today its 2021 expansion plan. It will expand access to its Medicare Advantage, individual and family-plan products in select areas, and to add fully-insured small business plans to its available products in certain markets.

I don't know if this is an industry trend, a state regulator trend or new policies being implemented by CMS, but it seems that either more health insurance carriers have been redacting their Actuarial Memos and/or not uploading their URRT files to the publicly-accessible SERFF database or the state insurance departments, SERFF database and/or CMS's Rate Review database aren't posting as many of them publicly.

Case in point, Wisconsin: I have the average requested 2021 premium rate filings for every carrier on the individual and small group markets...but the actuarial memos are all redacted and none of the URRTs are available at all, making it impossible for me to run a weighted average since I don't know how many enrollees each carrier has. Also, for the second year running, Compcare Health Services doesn't appear in CMS's Rate Review database at all for reasons unknown.

Missouri's preliminary avg. 2021 unsubsidized premium rate changes have been posted. There's one new entrant into the individual market this year (Blue Cross Blue Shield of Kansas City, which actually mostly pulled out of MO a couple of years back). Nothing too noteworthy--the average requested 2021 premium is going up 4.7% on the individual market and 9.3% on the small group market.