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Market Snapshot - Small Group Health

Company (State of Domicile) NAIC# Number Insured3 Market Share
  12/31/12 12/31/13 12/31/12 12/31/13
HMO (Including Standardized and POS):
Harvard Pilgrim (MA) 96911 6,334 13,967 7% 16%
Aetna Health (Maine) 95517 3,997 8,581 4% 10%
HMO Maine (Anthem BC/BS)152618 4,133 3,024 5% 3%
Subtotal 14,464 25,572 16% 29%
Indemnity (Including Standardized) and PPO:
Anthem BC/BS (Maine) - PPO 52618 41,030 31,172 45% 36%
HPHC (MA) 18975 14,424 19,417 16% 22%
Aetna Life (CT) 60054 18,703 9,100 21% 10%
Excellus (NY) 551072 1,059 1,102 1% 1%
MEGA Life & Health (OK) 97055 1,127 877 1% 1%
United Healthcare (CT) 79413 143 153 0% 0%
Transamerica Life (IA) 79413 3 3 0% 0%
Subtotal 76,489 61,824 84% 71%
Total 90,953 87,396 100% 100%
1 HMO Maine is a line of business of Anthem Blue Cross and Blue Shield.
2 Excellus is not licensed in Maine but covers some small employers through a group plan issued to Dairylea, an agricultural cooperative.
3 Figures for the number of insured come from the two most recent 940 reports.

 

 

Average Rate Increases
Following are the average small group rate increases weighted by premium across the entire market by calendar year. Figures for 2001 and for the current year are based on a partial year's data, but represent an annual increase.
Year Average
2001
33%
2002
29%
2003
16%
2004
6%
2005
13%
2006
8%
2007
14%
2008
10%
2009
15%
2010
21%
2011
16%
2012
10%
2013
10%

 

Recent Rate Increases
Company Annual Average
Increase
Number of Lives
Affected
Coverage Type Effective Date SERFF Tracking Number1
Aetna Health
5.5% 362 HMO 1/1/2014 AETN-129221052
-1.4% 2,678 HMO 7/1/2013 AETN-128963095
0.4% 564 HMO 3/1/2013 AETN-128825754
6.8% 790 HMO 1/1/2013 AETN-128750679
Aetna Life
3.2% 1,450 PPO 1/1/2014 AETN-129221257
-0.4% 5,471 PPO 7/1/2013 AETN-128963143
8.3% 4,946 PPO 3/1/2013 AETN-128825746
17.4% 8,600 PPO 1/1/2013 AETN-128751190
Anthem BC/BS (HMO and PPO)
1.8% 1,187 CDHP Only 12/1/2013 AWLP-129215740
13.7% 6,479   10/1/2013 AWLP-129141029
14.6% 8,717 All 7/1/2013 AWLP-128963859
10.7% 511 CDHP Only 5/1/2013 AWLP-128917465
11.4% 7,280 All 4/1/2013 AWLP-128874654
15.0% 15,975 All 1/1/2013 AWLP-128753210
Harvard Pilgrim
5.4% 2,147 HMO & POS 10/1/2013 HPHC-129114724
6.3% 1,173 HMO & POS 7/1/2013 HPHC-129005226
1.9% 878 HMO & POS 4/1/2013 HPHC-128878768
2.1% 1,961 HMO & POS 1/1/2013 HPHC-128747251
8.2% 861 HMO & POS 12/1/2012 HPHC-128714646
HPHC Ins Co
5.4% 2,389 PPO 10/1/2013 HPHC-129114727
6.3% 1,869 PPO 7/1/2013 HPHC-129005159
2% 5,471 PPO 4/1/2013 HPHC-128880536
2.1% 4,296 PPO 1/1/2013 HPHC-128747263
8.2% 1,324 PPO 12/1/2012 HPHC-128714782
HPHC Ins Co (DirigoChoice)
3.3% 877 DirigoChoice 7/1/2013 HPHC-128999343
9.8% 1,577 DirigoChoice 1/1/2013 HPHC-128747030
7.25% 808 DirigoChoice 10/1/2012 HPHC-128588680
United Healthcare
7.5% 197 POS & PPO 10/1/2012 UHLC-128572021
1 To link to SERFF to view filings, go to .http://www.maine.gov/pfr/insurance/PPACA/HFAI.htm#. Under The Health Filing Access Interface (HFAI), select "Click here to Search Public Filings." You must first agree to the terms of use. Then on the search screen enter a SERFF Tracking Number (displayed above) in the Tracking Number field and click on the Search button. Details about the filing will appear and you can click on the "View Filing" link on left side to see the actual filing.

 

Pending Rate Increases
Company Average
Increase
Number
Affected
Coverage Type
Effective date
SERFF Tracking Number1
Anthem
9.0% 19,508   7/1/2014  
Harvard Pilgrim
10.0% 10,060   8/1/2014  
HPHC Ins Co
10.0% 12,470   8/1/2014  
1 To link to SERFF to view filings, go to .http://www.maine.gov/pfr/insurance/PPACA/HFAI.htm#. Under The Health Filing Access Interface (HFAI), select "Click here to Search Public Filings." You must first agree to the terms of use. Then on the search screen enter a SERFF Tracking Number (displayed above) in the Tracking Number field and click on the Search button. Details about the filing will appear and you can click on the "View Filing" link on left side to see the actual filing.

 

Source: Bureau of Insurance

Last Updated: May 23, 2014