As previously disclosed, in the fourth quarter of 2015 the company recorded a PDR associated with its 2016 individual commercial ACA‐compliant offerings. Historically, this business has reported a profit in the first quarter of the year due to the related benefit designs. Because the company continues to anticipate a loss associated with this business for the full year 2016, the seasonal earnings generated in 1Q 2016 are offset by an increase in the PDR, resulting in a higher benefit ratio year over year. This first quarter seasonality was anticipated as the company developed its estimate of the full‐year PDR recorded in the fourth quarter of 2015.
Financial results associated with the wind‐down of the non‐ACA compliant (legacy) business, including the related release of policy reserves, as well as indirect administrative costs associated with ACA‐compliant offerings are included in the company’s 1Q 2016 financial results.
Thanks to Adam Cancryn for calling my attention to Molina's quarterly earnings report, which has this rather eye-opening section:
I've used Molina's Q1 2016 report, along with the Q4 2015 reports of Cigna and Humana, to further fill in the "Major Insurer" table I've been working on all this week; here's what it looks like now:
Humana Group is one of the largest health insurance companies in the country. As such, their enrollment data being made available is extremely helpful in seeing where things stand and how they've changed nationally.
Today, Bob Herman of Modern Healthcare provided me with a link to Humana's latest SEC filing. In addition to a whole mess of financial info which is of little interest to me, there's also all sorts of year-over-year data about their enrollment numbers...including a very handy section about their individual market, broken out by ACA exchange-based, Off Exchange and even their non-ACA compliant enrollments (ie, "grandfathered" and/or "transitional" enrollees).
