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 March 31, 2023, nearing the height of the market in early 2015, according to financial statements filed by insurers, and with estimates by Mark Farrah Associates (MFA). In the latest brief, MFA provides insights into enrollment and financial trends for the individual health insurance segment.
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, to March 31, 2023, Centene increased membership by over one million members. CVS Health (Aetna) and Cigna also experienced membership gains during the period.
- Florida and Texas have the highest number of people enrolled in the individual coverage marketplace, as of March 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 from December 31, 2022, to March 31, 2023, including Scott & White, more than tripling its individual enrollment.
To read the full text of “Harbingers of Change for Individual Health Insurance Marketplace” visit the MFA Briefs library on Mark Farrah Associates’ website. MFA will continue to monitor health plan performance and competitive shifts across all healthcare segments.
About Mark Farrah Associates (MFA)
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 Employer Health Plus. Follow us on LinkedIn!