MCMURRAY, Pa.--(BUSINESS WIRE)--Mark Farrah Associates (MFA), www.markfarrah.com, released an analysis brief providing insights into the current, uncertain state of the Individual segment and ACA Marketplace Exchange health insurance markets. According to the Centers for Medicare & Medicaid Services (CMS) reports combined with data from MFA’s Health Coverage Portal™, 63% of the 20.2 million individual medical members were enrolled through the Marketplace as of March 2016. The remaining 37% of this segment, or 7.5 million covered lives, were enrolled in off-exchange plans. However many insurers are turning their attention to off-exchange membership, as more and more are beginning to withdraw from the exchanges.
In "The Unpredictable Individual Health Insurance Market" Mark Farrah Associates reported that enrollment in individual, non-group medical plans totaled 20.2 million as of March 2016, according to financial statements filed by insurers, with the largest states commanding the highest membership totals. Although Marketplace reports indicate 4.9 million new members enrolled in 2016, year-over-year individual market enrollment actually declined slightly by about 1%. Total individual market enrollment, based on carrier reports, was 20.4 million a year ago in March 2015. Anthem, UnitedHealth, Aetna, Health Care Service Corporation (HCSC), Humana and Kaiser lead the industry in this segment, each reporting more than a million individual medical covered lives as of 1st quarter 2016.
Insurers collectively lost almost $6 billion in the segment last year and out of 194 companies that filed the 2015 Supplemental Health Care Exhibit (SHCE), sixty-nine percent, or 133, reported aggregate net losses in the individual, non-group segment. MFA cited key contributing factors resulting in significant losses on Marketplace business such as high medical claims, adverse selection, 3Rs program challenges, immature risk pools, and under-enrollment of younger, healthier individuals. Still, Marketplace advocates maintain that the ACA is in its formative years and new companies will enter markets as others exit.
This assessment is a summary of findings presented in “The Unpredictable Individual Health Insurance Market” the latest Healthcare Business Strategy™ release. Mark Farrah Associates regularly reports interesting updates about health insurance enrollment, performance and competition in this complimentary series. To access Healthcare Business Strategy™, visit the Analysis Briefs library on our website at www.markfarrah.com.
About Mark Farrah Associates (MFA)
Mark Farrah Associates is a leading business information provider in the health insurance sector. We provide health plan market data and analysis tools for the healthcare industry and our products include Health Coverage Portal™, County Health Coverage™, Health Insurer Insights™, Health Plans USA™, Medicare Business Online™, Medicare Benefits Analyzer™ and SHCE & MLR Annual Data™. To learn more about our products, access the product brochures and preview videos in the Products section of our website at www.markfarrah.com.
