2021 Rate Changes

Every year, I spend months painstakingly tracking every insurance carrier rate filing for the following year to determine just how much average insurance policy premiums on the individual market are projected to increase or decrease, and over the years I have a pretty good track record of nailing the average unsubsidized premium changes in each state.

However, it's never going to be dead on target, for a number of reasons: Rounding errors in the rate filings, missing enrollment data, outdated enrollment data, last-minute filing changes and so forth. In some states I'm only able to find on-exchange enrollments and have to estimate the corresponding off-exchange number for each carrier; in some cases the percent changes being approved don't match from the official Uniform Rate Review Template (URRT) form to the Actuarial Filing Memo, and sometimes neither of them match up with what shows up at RateReview.HealthCare.Gov!

OK, right after saying I was putting a lid on my 2021 Rate Change project, I'm slipping in one more: The District of Columbia posted their approved rate changes a few weeks back:

Information About Approved Rates for January 2021 Health Plan Offerings on DC Health Link

Open Enrollment for Plan Year 2021 DC Health Link’s open enrollment begins November 1, 2020 through January 31, 2021. DC Health Link is an online marketplace created for individuals, families, and small business owners in the District of Columbia to shop, compare, and select health insurance that meets their health needs and budgets. For more information, visit dchealthlink.com or call (855) 532-5465.

This page contains approved health plan rate information for the District of Columbia’s health insurance marketplace, DC Health Link, for plan year 2021.

My 2021 Rate Change project still isn't complete yet for two reasons: First, I only have the final/approved 2021 rate filings for 28 states as of today (vs. preliminary rates for all 50 states + DC). Second, a higher-than-usual number of carriers have made it impossible (or at least highly difficult) to dig up their effectuated enrollment data for 2020.

Without that number, I have no way of running weighted averages for that state's individual market; those are listed in grey below. In a few cases (like Florida), the state insurance dept. actually provided the weighted average but I still had to guess at the total enrollment number (also in grey).

This is a bigger problem than you might think. Let's say a state has 3 carriers requesting a 5% rate reduction, a 2% increase and a 15% increase. The unweighted average would be +4%....but if it turns out that the first carrier holds 90% of the market share this year, the weighted average would be more like -4%. You see the problem here.

New Mexico Superintendent of Insurance Announces Premium Decreases for 2021

Santa Fe, NM –New Mexico Superintendent of Insurance Russell Toal announced today that health insurance premiums will decrease significantly for individuals and families purchasing their own coverage through beWellnm (New Mexico’s Health Insurance Exchange). Average plan prices dropped in the Bronze, Silver, and Gold plan categories across the state. Silver plans, the most common plan purchased on the individual Exchange, will decrease between 8.1 and 13.5 percent on average. Small businesses will experience a 6.7 percent average premium decrease on beWellnm.

The Office of Superintendent of Insurance (OSI) reviews health insurance filings annually to determine whether rates are reasonable and fair.

“After a rigorous review of health insurance filings, our office is pleased to report that premiums are going down in 2021,” said Superintendent Toal. “Not only are rates decreasing, but New Mexico will have more health plans competing in the marketplace than ever before”

Way back in July (a lifetime ago!), Michigan's Dept. of Financial Services posted the state's preliminary 2021 individual & small group rate filings. At the time, the average premium changes being asked for were around a 1.3% increase on the individual market and 1.4% on the small group market.

Last week, a few days ahead of the launch of the 2021 Open Enrollment Period, they posted the approved 2021 rates...and there's almost no changes at all. The only significant change was to Meridian's request, which was dropped from a 2.7% increase to a 5.6% decrease. Also, National Health Insurance dropped out of the Small Group market, but they don't appear to have anyone enrolled this year anyway:

A couple of weeks ago I posted North Dakota's preliminary 2021 individual & small group policy premium rate filings, which averaged a 7.4% increase on the individual market and a 4.1% unweighted average increase for the small group market.

A few days ago, the North Dakota Insurance Dept. posted the final/approved rate hikes, including several significant reductions over those requested:

BISMARCK, N.D. – Insurance Commissioner Jon Godfread today released the approved health insurance rates for both individual and small group plans for 2021, and encourages consumers to start early, stay informed and shop around.

Back in early August, the Pennsylvania Insurance Dept. issued the preliminary rate filings for PA's individual and small group market carriers. At the time, the weighted average rate change being requested on the individual market came to a 2.6% reduction in unsubsidized premiums, while the average small group plan was set to increase by 2.3%.

Last week, the PA DOI issued their final decisions for the long list of carriers on each market, and the changes were...minimal, really. In fact, there was no change at all made to most requested rate filings--only two of the 17 indy market carriers saw a change (reductions for each), and only four of the 21 small group carriers did...and even then, the changes aren't terribly dramatic, just a few percentage points in most cases.

Here's the press release:

Insurance Department Announces Lower ACA Individual Plan Health Insurance Rates, Attributes Them To New State-Based Exchange And Reinsurance Program

Back in late July, the Rhode Island insurance dept. issued a press release with the preliminary 2021 rate filings for the state's individual and small group markets. At the time, the weighted statewide average increases being requested were around +5.0% and +2.2% respectively.

A month later, the RI DOI issued their approved 2021 rate decisions, and made some small tweaks to each. In fact, it looks like there was at least one revision in between, as the new press release lists slightly different numbers for the "preliminary" requests.

In any event, Rhode Island indy & sm. group enrollees will be looking at roughly 4.2% increases on the individual market and 2.6% increases for small group plans:

Way back in June, the Washington Insurance Dept. posted the state's preliminary 2021 preliminary individual & small group market premium rate filings. At the time, the weighted average across all carriers was a 1.8% drop in individual market premiums and a 3.4% increase in small group rates. They also announced the addition of two new carriers to the individual market: Community Health Network and UnitedHealthcare of Oregon. It's important to note that both of these new carriers will only be providing WA's new (quasi) Public Option plans.

Last month, however, the WA DOI announced the approved 2021 rates...for the individual market only, and even then it's missing two carriers which are still under review (Asuris and Health Alliance NW). The missing carriers only have 1,200 enrollees between them, however, so any changes to their requested rates won't move the needle noticeably:

Back in late August, the Florida Office of Insurance Regulation posted preliminary 2021 individual & small group market rate filings. At the time, the weighted average increases were around 1.8% on the individual market and 3.3% for small group plans. Unfortunately, the actual enrollment data for each carrier is protected as a trade secret in Florida, but the FLOIR did post those weighted statewide averages.

Last month (I'm a bit behind) they posted the approved, final rate filings. The average individual market increases actually went up a bit, which is unusual (usually they're whittled down a few points), while the small group market average is exactly the same (oddly, they had it as 3.3% in August but say that the preliminary average was 3.4% now):