Mark Farrah Associates Assessed Individual Health Insurance Enrollment Trends
The individual market has seen numerous changes in the last fifteen years. Enrollment in individual medical plans, both on and off the exchange, totaled approximately 19.5 million as of
Key highlights include:
-
The individual segment has been profitable, overall, for health plans since 2017, however, premium growth has, once again, been outpaced by medical expense growth, leading to increasing medical loss ratios (MLRs). Traditional MLRs for 1Q23 are like those experienced during the first quarters in the years leading up to the ACA, with an average aggregated traditional MLR of 79.3%, at premiums per member per month (PMPM) of
$528 and claims PMPM of$419 . -
Bright Health and
Friday Health Plans withdrew from individual markets in multiple states during the early part of 2023, which could bring change for the segment. -
Between
December 31, 2022 , toMarch 31, 2023 , Centene increased membership by over one million members. CVS Health (Aetna ) and Cigna also experienced membership gains during the period. -
Florida andTexas have the highest number of people enrolled in the individual coverage marketplace, as ofMarch 31, 2023 , with nearly 4 million and 3.6 million, respectively. Five health insurance plans in each state reported changes of greater than 100,000 enrollees fromDecember 31, 2022 , toMarch 31, 2023 , includingScott & White , more than tripling its individual enrollment.
To read the full text of "Harbingers of Change for
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MFA is a leading data aggregator and publisher providing health plan market data and analysis tools for the healthcare industry. Committed to simplifying analysis of health insurance business, our products include: Health Coverage Portal™, Medicare Business Online™, Medicare Benefits Analyzer™, County Health Coverage™, Health Plans USA™ and 5500
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