Health Insurance Regulatory Responsibilities of the Office of Insurance Regulation
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1 Health Insurance Regulatory Responsibilities of the Office of Insurance Regulation Health Innovation Subcommittee Florida House of Representatives January 21, 2015 Rich Robleto, Deputy Commissioner of Life & Health
2 Office Mission Promote a stable and competitive insurance market for consumers. 2
3 Office Goals Promote markets with products providing fair coverage at adequate prices Protect public from illegal/unethical acts and practices Monitor/address insurer financial issues Operate efficiently and transparently 3
4 Health Insurance Regulatory Framework Statutory Authority Chapter 20, Florida Statutes - Organizational Structure: Ch Financial Services Commission Authority Chapters , Florida Statutes - Insurance Code: Ch OIR and DFS General Powers Ch Licensing Ch Form and Rate Filing Ch Financial Reporting 4
5 Life & Health Regulatory Structure Deputy Commissioner Financial Oversight Unit Product Review Unit 5
6 Florida Health Insurance Market: Products Major Medical Other Pre-Paid Health Services Accident and Sickness Dental/Vision Disability Income Excess/Stop Loss Long-Term Care Medicare Supplement Other 6
7 Florida Health Insurance Market Regulated Entities (Authority Category) Authorities Health Insurers 448 Third Party Administrators 310 Continuing Care Retirement Communities 61 Discount Medical Plan Organizations 40 Health Maintenance Organizations 38 Fraternal Benefit Societies 36 Prepaid Limited Health Service Organizations/Prepaid Health Clinics 28 Source: Data used in CY 2013 NAIC Insurance Department Resources Report (compiled on 3/21/2014) 7
8 Florida Health Insurance Market Major Medical Total Covered Lives ,531 1,575,859 Individual (26%) Small Group (24%) Large Group (50%) Total - 3,136, ,408 Source: Florida Office of Insurance Regulation CY 2013 Accident & Health Markets Gross Annual Premium & Enrollment Report 8
9 Florida Health Insurance Market Major Medical Covered Lives: Individual Market Market Segment Covered Lives Individual In Individually Underwritten 795,593 Conversion 11,313 Market, 2013 Guarantee Issue 7,625 Total 814,531 Source: Florida Office of Insurance Regulation CY 2013 Accident & Health Markets Gross Annual Premium & Enrollment Report 9
10 Major Medical Covered Lives: Group Market Small Group Market Segment In Market, 2013 Total Groups Covered Lives Self-Employed/Sole Proprietor 6,902 10, Member Group 79, ,452 Total 86, ,408 Large Group Florida Health Insurance Market Member Group 6, ,980 >100 Member Group 12,429 1,312,879 Total 19,321 1,575,859 Source: Florida Office of Insurance Regulation CY 2013 Accident & Health Markets Gross Annual Premium & Enrollment Report 10
11 Florida Health Insurance Market Major Medical Direct Earned Premium 2013 $2,327,233,094 $6,575,115,677 $3,674,719,298 Total- $12,577,068,069 Individual (19%) Small Group (29%) Large Group (52%) Source: Florida Office of Insurance Regulation CY 2013 Accident & Health Markets Gross Annual Premium & Enrollment Report 11
12 Florida Health Insurance Market Major Medical Premium & Loss Ratio Individual Market Individual Market Segment In Market, 2013 Earned Premium Loss Ratio Individually Underwritten $2,150,210, % Conversion $113,604, % Guarantee Issue $63,418, % Source: Florida Office of Insurance Regulation CY 2013 Accident & Health Markets Gross Annual Premium & Enrollment Report 12
13 Florida Health Insurance Market Major Medical Premium & Loss Ratio Group Market Market Segment In Earned Premium Loss Ratio Small Group Self-Employed/Sole Proprietor $90,869, % 2-50 Member Group $3,583,849, % Large Group Market, Member Group $1,122,851, % 101+ Member Group $5,452,263, % Source: Florida Office of Insurance Regulation CY 2013 Accident & Health Markets Gross Annual Premium & Enrollment Report 13
14 Florida Health Insurance Market Concentration Total Accident and Health (CY 2013) Market Share: Top Writer 22.9% Top 5 Writers 50.8% Top 10 Writers 64.2% Herfindahl-Hirschmann Index: 846 (Competitive) Number of Companies: 396 Source: Data used in the Florida Office of Insurance Regulation s CY 2013 Accident & Health Markets Gross Annual Premium & Enrollment Report 14
15 Florida Health Insurance Market Concentration Major Medical Only (CY 2013) Market Share: Top Writer 30.8% Top 5 Writers 64.1% Top 10 Writers 82.0% Herfindahl-Hirschmann Index: 1354 (Moderately concentrated) Number of Companies: 117 Source: Data used in the Florida Office of Insurance Regulation s CY 2013 Accident & Health Markets Gross Annual Premium & Enrollment Report 15
16 Life & Health Financial Oversight: Primary Duties Review license applications Review expansions into additional lines Monitor financial solvency Identify/address financial issues/trends Inter-state coordination 16
17 Life & Health Financial Oversight: Filings Monthly, quarterly, and annual financial statements Audited financial statements Actuarial certifications 17
18 Life & Health Financial Oversight: Reviews Types of Review: Financial Analysis ( desk review ) Financial Examination ( on-site review ) Scope/Process: Confirm assets and liabilities Interview corporate level officers Review internal control process Identify risks regarding business plan 18
19 Life & Health Financial Oversight: Financial Examinations Location: On-site Frequency: At least once every five years Timeframe: Up to 18 months Period Covered: Preceding five fiscal years Number Completed: 31 (2014) Source: Data compiled from the Financial Services Commission 2014 Calendar Year - In Review Report 19
20 Life & Health Financial Oversight: Financial Analysis Location: OIR ( desk reviews) Frequency: Every quarter Timeframe: Based on priority level Period Covered: Period covered by statement Number Completed: 2,776 (2014) Source: Data compiled from the Financial Services Commission 2014 C- In Review Report 20
21 Life & Health Financial Oversight: Financially Troubled Companies Increase review priority Monthly reporting Corrective action plan Increase insolvency deposit Target exam Multistate coordination Administrative supervision Suspend or revoke license 21
22 Life & Health Financial Oversight: Additional Reviews Dividend distributions Acquisitions or mergers New officers, directors or shareholders Service agreements and amendments 22
23 Life & Health Product Review: Primary Duties Review rates Review forms 23
24 Life & Health Product Review: Rate Review Florida is a Prior Approval State Approval required prior to use Small group and individual policies only Actuarial review of rates Compliance with Florida statutes/rules Rating factors Analysis factors 24
25 Life & Health Product Review: Form Review Florida is a Prior Approval State Approval required prior to use All policy forms subject to prior approval Compliance with Florida statutes/rules 25
26 Life & Health Product Review: 2014 Filings Processed Forms Rates Total Filings 4,090 1,875 Lowest Monthly Count (Nov) 292 (Nov) 107 Highest Monthly Count (Jan) 399 (Apr) 185 Source: Data compiled from the Financial Services Commission 2014 Calendar Year - In Review Report 26
27 Questions? Rich Robleto (850)
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