Individual and Small Group Health Insurance Segment Profitability as Reported by Mark Farrah Associates

Individual and Small Group Health Insurance Segment Profitability as Reported by Mark Farrah Associates
Individual and Small Group Health Insurance Segment Profitability as Reported by Mark Farrah Associates

MCMURRAY, Pa., June 17, 2024–(BUSINESS WIRE)–Mark Farrah Associates (MFA), www.markfarrah.com, examined trends in membership, claims incurred PMPM (per member per month), adjusted premiums PMPM, and MLRs (Medical Loss Ratios) for the Individual and Small Group comprehensive medical/health insurance markets and segment leaders. Based on an analysis of the National Association of Insurance Commissioners (NAIC) Supplemental Health Care Exhibit (SHCE), MFA also analyzed the profitability of both health insurance segments for the last five years.

  • Both Individual and Small Group segments were profitable for insurers in 2023, where underwriting gains have returned to pre-pandemic levels.

  • The Individual segment experienced enrollment growth of 28.7%, to 17.7 million members for 2023. Premiums PMPM increased 2%, to a segment average of $549 PMPM. The average medical claims PMPM of $482 in 2023 was an increase of 0.2% from 2022.

  • The Small Group segment continues to lose membership, down another 7.4% to 8.5 million in 2023. Small Group PMPM premiums have increased an average of 7.7% annually, since 2020.

To read the full text of “An Analysis of Profitability for the Individual and Small Group Health Insurance Markets in 2023” 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!

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Contacts

Mark Farrah Associates
Ann Marie Wolfe, [email protected]