Based on financial statements filed by insurers, Mark Farrah Associates reported Dec. 27 that enrollment in individual medical plans—both on and off the exchange—totaled approximately 20.4 million as of September 2023, representing a 15.8% increase from the 17.6 million members in September 2022.
This is the largest number of participants this segment has seen as redeterminations have removed millions from Medicaid roles, causing some individuals to take advantage of the increased Marketplace subsidies, and to seek health insurance coverage from the Individual segment.
Open enrollment for 2024 coverage started on Nov. 1st and runs through Jan. 15th.
In the latest brief, MFA provides insights into third quarter individual health insurance market trends and market developments with state-by-state membership comparisons.
Featured highlights include:
- Centene, Guidewell Mutual Holding Group (the parent company of Blue Cross Blue Shield affiliates operating in Florida), Elevance Health, and CVS all reported more than 1 million individual medical covered lives as of third quarter 2023.
- CVS experienced a year-over-year enrollment increase of 648.5%, in its Individual business.
- Florida, California, and Texas had the highest number of enrollees, with Florida covering nearly 3.6 million members as of 3Q23 compared to 2.8 million in Texas and California’s 2.3 million.
- For 3Q23, plans with individual business reported a 1.8% year-over-year increase overall in premiums per member per month (PMPM).
As MFA reported in August 2023 in its business strategy brief titled, “An Analysis of Profitability for the Individual and Small Group Health Insurance Markets in 2022 ,” while segment membership is trending up, segment profitability for health insurance companies is marginal, at $0.5 billion underwriting gain or 0.5% of adjusted premium revenues for 2022. For 3Q23, plans in the individual segment reported a 1.8% year-over-year increase overall in premiums per member per month (PMPM), from $69.1 billion to $79.5 billion in premiums earned.
To read the full text of “Record Breaking Enrollment for the Individual Health Insurance Market“, visit the Analysis Briefs library on Mark Farrah Associates’ website.
McMurray, Pa.-based MFA is a leading data aggregator and publisher providing health plan market data and analysis tools for the healthcare industry.