Health Plans Project 5.6% Growth For Group Plans, 2.8% For Individual Plans

For Individual plans, growth expectations are higher by 5.0 percentage points. Individual members include all who purchase insurance individually who are not eligible for Medicare or Medicaid.

After the effect of buy-downs, plans anticipate premium increases for Group plans of 4.3% and 1.8% for Individual plans. A buy-down is a change in a product’s benefit design to secure a lower premium.

For plans participating in this survey, we infer that they project medical cost increases of 4.7% for Group plans and 3.1% for Individual plans. This is based on their anticipated MLR decrease for Groups of 0.7 percentage points and an increase of 0.3 percentage points for Individual plans. Similarly, we estimate an increase in consumer cost sharing of 8.4% for Group plans and 4.9% for Individuals.

There were 54 respondents to our survey. The plans serve approximately 22 million members with Fully-Insured commercial group and non-group products, or 22.6% of the United States total. This is Sherlock Company’s twenty-seventh consecutive annual survey of premium pricing trends.

Additional information concerning the survey results, including region-specific trend breakouts, is available through our newsletter PULSE.

Sherlock Company (www.sherlockco.com), based in North Wales, Pennsylvania, provides informed solutions for health plan financial management. Since its founding in 1987, Sherlock Company has been known for its impartiality and technical competence in service to its clients.