2016 Individual Exchange Premiums updated November 4, 2015

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1 2016 Individual Exchange Premiums updated November 4, 2015 Within the document, you'll find insights across 50 states and DC with available findings (i.e., carrier participation, price leadership, gross and net premium changes) and carrier participation trends across all states. The following findings are informed by publicly available 2016 individual market exchange data as of November 4, 2015, with carrier participation and premium information for all 50 states and DC. Please note the following when reviewing the findings: This report does not include off-exchange data. As health insurance is regulated at the state level, we count carriers by state. For instance, if a company offers health insurance in two states, we count that as two carriers. More detail on our methodology and how to read the graphics within are in the appendix. Please contact us at with any questions. You can also find us online at healthcare.mckinsey.com/reform. 1

2 By the numbers: nationwide 2016 filed carriers + Presence of new lowest-price silver carrier vs (of 333 total) 2 nd lowestprice increase in lowest- 64 price silver plan 36 decrease in lowestprice silver plan SOURCE: Publicly available product data on federal and state exchanges as of November 4, *Based on a weighted average net premium across all subsidy-eligible individuals; accounts for age, family size, income, and geography. Totals may not add up to 100 in cases where some individuals see no change. 2

3 : By carrier type and experience NEW ENTRANTS BY CARRIER TYPE NEW ENTRANTS BY EXPERIENCE 31 new entrants + across all 50 states and DC Medicaid 7 Provider 19 Regional / Local 19 New to all insurance 27 New to individual insurance 23 Blue 7 National 48 Incumbents off-exchange 50 counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times. SOURCE: Public individual market exchange carrier participation as of November 4,

4 Carrier participation over time EXCHANGE ENTRANT PARTICIPATION Number of carriers entering and exiting, counting participation at a state level carriers 2015 withdrawals 2015 new entrants 2015 carriers 2016 withdrawals 2016 new entrants 2016 carriers Type of carriers Incumbents off-exchange in state* New to individual insurance in state New to all insurance in state data represents carrier participation announced across 50 states and DC *2015/2016 new entrant incumbents represent carriers that already had a presence off-exchange in a given state, or on exchange in other states in the year prior to their joining. SOURCE: Publicly available individual exchange participation information, , as of November 4,

5 CO-OP trends as of November 3 CO-OP EXCHANGE PARTICIPATION CO-OP PARTICIPATION BY STATE Of the 42 of rating areas that had access to a CO-OP in 2014, 16 will still have access to a CO-OP CO-OPs funded in CO-OP exits to-date WA OR NV CA ID AZ UT MT WY CO NM ND MN SD WI IA NE IL KS MO OK AR MS TX LA VT NY MI PA OH IN WV VA KY NC TN SC AL GA ME NH MA RI CT NJ DE MD DC HI FL of consumers enrolled in the CO-OPs that have exited to-date AK No CO-OP ever present CO-OP withdrew CO-OP withdrew, another CO-OP still present CO-OP still present POPULATION WITH ACCESS TO CO-OPS QHP-eligible population across 50 states and DC PRICE CHANGES FOR CO-OPS Median change in lowest-price premiums Population with access to CO-OPs in 2014 or Population with access to CO-OPs CO-OPs ALL CARRIER TYPES SOURCE: Based on known CO-OP participation and announced withdrawals to date; premiums based on publicly available exchange data for 50 states and DC as of November 4,

6 State by state 2016 EXCHANGE CARRIER PARTICIPATION AND RATE DETAILS Click on a state for details about 2016 exchange rates WA VT ME MT ND OR CA NV ID AZ UT WY CO NM SD NE KS OK MN WI IA IL MO AR MS NY MI PA OH IN WV VA KY NC TN SC AL GA NH MA RI CT NJ DE MD DC TX LA HI FL AK SOURCE: Publicly available 2016 individual exchange participation information as of November 4,

7 Alabama Presence of new lowest-price silver carrier vs (of 3 total) > nd lowestprice income, and geography. Totals may not add up to 100 in cases where some individuals see no change. 7

8 Alaska Presence of new lowest-price silver carrier vs (of 2 total) nd lowestprice see net premium Will income, and geography. Totals may not add up to 100 in cases where some individuals see no change. 8

9 Arizona Presence of new lowest-price silver carrier vs (of 11 total) nd lowestprice see net premium Will income, and geography. Totals may not add up to 100 in cases where some individuals see no change. 9

10 Arkansas Presence of new lowest-price silver carrier vs (of 3 total) nd lowestprice see net premium Will income, and geography. Totals may not add up to 100 in cases where some individuals see no change. 10

11 California Presence of new lowest-price silver carrier vs (of 10 total) nd lowestprice income, and geography. Totals may not add up to 100 in cases where some individuals see no change. 11

12 Colorado Presence of new lowest-price silver carrier vs (of 10 total) nd lowestprice income, and geography. Totals may not add up to 100 in cases where some individuals see no change. 12

13 Connecticut Presence of new lowest-price silver carrier vs (of 4 total) -1 2nd lowestprice income, and geography. Totals may not add up to 100 in cases where some individuals see no change. 13

14 Delaware Presence of new lowest-price silver carrier vs (of 2 total) nd lowestprice see net premium Will +83 income, and geography. Totals may not add up to 100 in cases where some individuals see no change. 14

15 District of Columbia Presence of new lowest-price silver carrier vs (of 3 total) 2nd lowestprice see net premium Will increase in lowest price silver plan -63 income, and geography. Totals may not add up to 100 in cases where some individuals see no change. 15

16 Florida Presence of new lowest-price silver carrier vs (of 14 total) 2nd lowestprice see net premium Will income, and geography. Totals may not add up to 100 in cases where some individuals see no change. 16

17 Georgia Presence of new lowest-price silver carrier vs (of 9 total) -1 2 lowestprice nd see net premium Will income, and geography. Totals may not add up to 100 in cases where some individuals see no change. 17

18 Hawaii Presence of new lowest-price silver carrier vs (of 2 total) nd lowestprice see net premium Will increase in lowest price silver plan income, and geography. Totals may not add up to 100 in cases where some individuals see no change. 18

19 Idaho Presence of new lowest-price silver carrier vs (of 5 total) nd lowestprice see net premium Will income, and geography. Totals may not add up to 100 in cases where some individuals see no change. 19

20 Illinois Presence of new lowest-price silver carrier vs (of 8 total) nd lowestprice income, and geography. Totals may not add up to 100 in cases where some individuals see no change. 20

21 Indiana Presence of new lowest-price silver carrier vs (of 9 total) nd lowestprice income, and geography. Totals may not add up to 100 in cases where some individuals see no change. 21

22 Iowa Presence of new lowest-price silver carrier vs (of 3 total) nd lowestprice income, and geography. Totals may not add up to 100 in cases where some individuals see no change. 22

23 Kansas Presence of new lowest-price silver carrier vs (of 5 total) nd lowestprice income, and geography. Totals may not add up to 100 in cases where some individuals see no change. 23

24 Kentucky 2016 filed carriers + Presence of new lowest-price silver carrier vs (of 5 total) 2 nd lowestprice increase in lowest- 71 price silver plan 29 decrease in lowestprice silver plan SOURCE: Publicly available product data on federal and state exchanges as of November 4, Last updated November 4, 2015 income, and geography. Totals may not add up to 100 in cases where some individuals see no change. 24

25 Louisiana Presence of new lowest-price silver carrier vs (of 6 total) 2nd lowestprice income, and geography. Totals may not add up to 100 in cases where some individuals see no change. 25

26 Maine Presence of new lowest-price silver carrier vs (of 3 total) 2 lowestprice nd see net premium Will increase in lowest price silver plan -56 income, and geography. Totals may not add up to 100 in cases where some individuals see no change. 26

27 Maryland Presence of new lowest-price silver carrier vs (of 7 total) nd lowestprice income, and geography. Totals may not add up to 100 in cases where some individuals see no change. 27

28 Massachusetts 2016 filed carriers + Presence of new lowest-price silver carrier vs (of 11 total) increase in lowest- 54 price silver plan nd lowestprice decrease in lowestprice silver plan -149 income, and geography. Totals may not add up to 100 in cases where some individuals see no change. 28

29 Michigan 2016 filed carriers + Presence of new lowest-price silver carrier vs (of 14 total) 2 nd lowestprice increase in lowest- 46 price silver plan 54 decrease in lowestprice silver plan SOURCE: Publicly available product data on federal and state exchanges as of November 3, Last updated November 3, income, and geography. Totals may not add up to 100 in cases where some individuals see no change. 29

30 Minnesota Presence of new lowest-price silver carrier vs (of 4 total) nd lowestprice income, and geography. Totals may not add up to 100 in cases where some individuals see no change. 30

31 Mississippi Presence of new lowest-price silver carrier vs (of 3 total) <+1 2nd lowestprice income, and geography. Totals may not add up to 100 in cases where some individuals see no change. 31

32 Missouri Presence of new lowest-price silver carrier vs (of 7 total) nd lowestprice income, and geography. Totals may not add up to 100 in cases where some individuals see no change. 32

33 Montana Presence of new lowest-price silver carrier vs (of 4 total) nd lowestprice income, and geography. Totals may not add up to 100 in cases where some individuals see no change. 33

34 Nebraska Presence of new lowest-price silver carrier vs (of 3 total) > nd lowestprice > income, and geography. Totals may not add up to 100 in cases where some individuals see no change. 34

35 Nevada Presence of new lowest-price silver carrier vs (of 5 total) 2 lowestprice nd > income, and geography. Totals may not add up to 100 in cases where some individuals see no change. 35

36 New Hampshire Presence of new lowest-price silver carrier vs (of 5 total) nd lowestprice see net premium Will +177 income, and geography. Totals may not add up to 100 in cases where some individuals see no change. 36

37 New Jersey Presence of new lowest-price silver carrier vs (of 5 total) nd lowestprice see net premium Will income, and geography. Totals may not add up to 100 in cases where some individuals see no change. 37

38 New Mexico 2016 filed carriers + Presence of new lowest-price silver carrier vs (of 5 total) 2 nd lowestprice > increase in lowest- 19 price silver plan 81 decrease in lowestprice silver plan income, and geography. Totals may not add up to 100 in cases where some individuals see no change. 38

39 New York 2016 filed carriers + Presence of new lowest-price silver carrier vs (of 19 total) 2 nd lowestprice increase in lowest- 96 price silver plan 04 decrease in lowestprice silver plan NOTE: Currently we do not account for age 29 dependent plans in our premium changes nor impact of premium changes sections. Rate filings for new entrants in New York are not made public and therefore not reflected in this summary.source: Publicly available product data on federal and state exchanges as of November 1, income, and geography. Totals may not add up to 100 in cases where some individuals see no change. 39

40 North Carolina Presence of new lowest-price silver carrier vs (of 3 total) nd lowestprice income, and geography. Totals may not add up to 100 in cases where some individuals see no change. 40

41 North Dakota Presence of new lowest-price silver carrier vs (of 3 total) nd lowestprice income, and geography. Totals may not add up to 100 in cases where some individuals see no change. 41

42 Ohio Presence of new lowest-price silver carrier vs (of 16 total) 2nd lowestprice see net premium Will income, and geography. Totals may not add up to 100 in cases where some individuals see no change. 42

43 Oklahoma Presence of new lowest-price silver carrier vs (of 4 total) nd lowestprice see net premium Will increase in lowest price silver plan -5 income, and geography. Totals may not add up to 100 in cases where some individuals see no change. 43

44 Oregon Presence of new lowest-price silver carrier vs (of 10 total) nd lowestprice income, and geography. Totals may not add up to 100 in cases where some individuals see no change. 44

45 Pennsylvania Presence of new lowest-price silver carrier vs (of 13 total) nd lowestprice see net premium Will income, and geography. Totals may not add up to 100 in cases where some individuals see no change. 45

46 Rhode Island Presence of new lowest-price silver carrier vs (of 3 total) 2nd lowestprice income, and geography. Totals may not add up to 100 in cases where some individuals see no change. 46

47 South Carolina Presence of new lowest-price silver carrier vs (of 5 total) nd lowestprice see net premium Will increase in lowest price silver plan -8 income, and geography. Totals may not add up to 100 in cases where some individuals see no change. 47

48 South Dakota Presence of new lowest-price silver carrier vs (of 3 total) nd lowestprice income, and geography. Totals may not add up to 100 in cases where some individuals see no change. 48

49 Tennessee Presence of new lowest-price silver carrier vs (of 5 total) nd lowestprice see net premium Will increase in lowest price silver plan -84 income, and geography. Totals may not add up to 100 in cases where some individuals see no change. 49

50 Texas Presence of new lowest-price silver carrier vs (of 14 total) -8 2nd lowestprice > see net premium Will income, and geography. Totals may not add up to 100 in cases where some individuals see no change. 50

51 Utah 2016 filed carriers + Presence of new lowest-price silver carrier vs (of 6 total) 2 nd lowestprice > increase in lowestprice silver plan decrease in lowestprice silver plan income, and geography. Totals may not add up to 100 in cases where some individuals see no change. 51

52 Vermont Presence of new lowest-price silver carrier vs (of 2 total) nd lowestprice income, and geography. Totals may not add up to 100 in cases where some individuals see no change. 52

53 Virginia Presence of new lowest-price silver carrier vs (of 9 total) nd lowestprice income, and geography. Totals may not add up to 100 in cases where some individuals see no change. 53

54 Washington Presence of new lowest-price silver carrier vs (of 10 total) >-1-5 2nd lowestprice income, and geography. Totals may not add up to 100 in cases where some individuals see no change. 54

55 West Virginia Presence of new lowest-price silver carrier vs (of 1 total) nd lowestprice see net premium Will increase in lowest price silver plan -77 income, and geography. Totals may not add up to 100 in cases where some individuals see no change. SOURCE: Publicly available product data on federal and state exchanges as of November October 19,1, Last updated November October 19,1,

56 Wisconsin Presence of new lowest-price silver carrier vs (of 15 total) 2nd lowestprice see net premium Will increase in lowest price silver plan -223 income, and geography. Totals may not add up to 100 in cases where some individuals see no change. SOURCE: Publicly available product data on federal and state exchanges as of November October 19,1, Last updated November October 19,1,

57 Wyoming Presence of new lowest-price silver carrier vs (of 2 total) nd lowestprice income, and geography. Totals may not add up to 100 in cases where some individuals see no change. 57

58 Appendix How to read the charts To understand how carrier participation is changing exchange competitive dynamics, we compared the carriers competing on the exchanges in 2015 and The carrier count represents the number of unique carriers offering products in at least one county within a state. (Not all carriers offer products in every county within a state.) Carrier count is as it appears to consumers shopping on exchanges. Specifically, the count is the number of carriers that offer plans in each state, i.e., carrier that offers plans in 3 states is counted 3 times, and a carrier that offers plans under 2 different carrier names in one state is counted 2 times represents the number of carriers that filed exchange plans in a given state in both 2015 and Of XX total represents the number of 2015 exchange carriers in a given state. (If that number is greater than the number of incumbents filing, one or more incumbents left that state s exchange market in 2015.) How to read the charts 00 To understand the evolving competitive dynamics of price leadership changes, we compare the carrier offering the lowest-price silver plan vs within each county. When the carrier offering the lowest-price silver plan is different than in 2015, we define that as the 2015 price leader being. To determine the percent of 2015 price leaders being, we divide the number of 2015 price leaders by the total number of 2015 price leaders, at the county level. To determine the percent of consumers eligible for a qualified health plan (QHP) who will see a, we add up the total QHP-eligible population in every county with an price leader, and divide that by the total number consumers across all counties in states tracked to date. represents the number of carriers filing 2016 exchange plans that did not participate in

59 Appendix 2014 How to -19 read +14 the charts How to read the charts To understand how premium price changes impact affordability, we calculated the premium price change in the lowest-price bronze, lowest-price silver, and secondlowest-price available in every rating area within a given state between 2015 and / increase represents the maximum percentage change in premiums across all rating areas in a given state, for each specified price point (i.e., lowest-price bronze, lowest-price silver, and second-lowest-price silver plans). (On the summary slide, it represents the maximum change across all rating areas in all states analyzed.) Each percentage represents a premium price change in one specific rating area (whichever rating area has the maximum decrease or maximum increase across the entire state). It does not represent premium changes seen across the entire state. To understand the net premium changes that subsidy-eligible individuals will face, we calculated the weighted average change in net premiums between 2015 and 2016 for the lowest-price silver plan in each county. We assumed that all individuals will redetermine their subsidy eligibility in First, we established a distribution of subsidy-eligible individuals (at a household level) in each county, using public sources (Census Bureau, ACS, SAHIE). Next, we combined this population distribution with data about 2015 and 2016 lowest-price silver plan net premiums, calculating per member per month net premiums at a household level. To estimate net premiums, we used income level and household size to determine the relative premium cap for each household unit. Then, we calculated the second-lowest-price silver premium based on the median age for each age bucket combined with household size to determine relative subsidy, and applied that to the lowestprice silver to calculate net premium of the lowest-price silver plan. Finally, we used the 2015 and 2016 net premiums to calculate weighted average rate changes for the states with complete filings available to date. 59

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