Health Insurance Survey Report

Health Insurance Survey Report

Idaho Lives Covered-End of Survey Year

2 Year Comparison

Compiled 8/02/2016

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Health Insurance Survey Report-Idaho Lives Covered EOY-2 yr comparison 2014-2015.docx

Table of Contents

Report Introduction ........................................................................................................... 3

Section 1 - Individual Health Benefit Plans ............................................................... 4-5

Section 2 - Individual - Non-renewable Short Term plans, Medicare, Etc. .................... 6

Section 3 - Group – Small, Mid & Large Employer Health Benefit Plans .............. 7-8

Section 4 - Group – Non-renewable Short Term plans, Medicare, Etc. ...................... 9-10

Section 5 – Population Data ..................................................................................... 11-13

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This report highlights the annual Health Insurance Survey data supplied by carriers that

are licensed in Idaho and provide services or products to Idahoans. The report contains

information acquired via carrier data submissions through the annual online Idaho Health

Insurance Survey portal 2014 & 2015. Furthermore, the compiled data in this report is shown in

the aggregate reflecting a 2 year period and the primary focus is on the number of Idaho lives

covered at the end of the survey years.

The report is separated into five sections; the first section shows the Individual Major

Medical health benefit plan categories; the second is reflective of other Individual Health

Insurance Products such as; Non-renewable short term, Medicare, limited benefits and other

misc. categories; the third section highlights the Group Major Medical-Small (2-50), Midsize

(51-100), and Large Employer (101+) health benefit plans; the fourth section shows other Group

Health Insurance Products such as: Non-renewable short term, Medicare, limited benefits and

other misc. categories; the fifth section highlights the Estimated Idaho population data and

aggregate categorical data. Graphs are included to provide visual references and theoretically to

offer support in the analysis for this volume of data.

It is noteworthy to remember that this Health Insurance Survey report is a historical data

composition or “snapshots” in time and adjustments/data editing can still take place; albeit more

likely on a very small scale. Any large scale data adjustments initiated by the carriers or this

department will be communicated and a revised report will be assembled and submitted.

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Section 1 Individual Major Medical Health Benefit Plans

2014 Individual Major Med.-Idaho Lives Covered End of Year

Association or Trusts 682

ACA-Compliant 94,012

Grandfathered Individual Major Med 7,059

Transitional Individual Major Med 17,814

HRP-All 408

2015 Individual Major Med.-Idaho Lives Covered End of Year

Association or Trusts 9


Grandfathered Individual Major Med 4,599

Transitional Individual Major Med 12,762

HRP-All 100

Type 2014 2015

Association or Trusts 682 9

ACA-Compliant 94,012 110,754

Grandfathered Individual Major Med 7,059 4,599

Transitional Individual Major Med 17,814 12,762

HRP-All 408 100

Totals 119,975 128,224

Carrier Reported Data

Year to year % of Change 2014-2015

Association or Trusts -98.7%

ACA-Compliant 17.8%

Grandfathered Individual Major Med -34.8%

Transitional Individual Major Med -28.4%

HRP-All -75.5%

Total 6.9%

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- 10,000 20,000 30,000 40,000 50,000 60,000 70,000 80,000 90,000

100,000 110,000 120,000 130,000 140,000

Association orTrusts

ACA-Compliant GrandfatheredIndividual Major

Med

TransitionalIndividual Major

Med

HRP-All Totals

2014 682 94,012 7,059 17,814 408 119,975

2015 9 110,754 4,599 12,762 100 128,224

Individual Major Medical-Idaho Lives Covered EOY

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Section 2 Other Individual Health Insurance Products - Non-renewable Short Term plans, Medicare, Etc.

Type 2014 2015 Year to year % of Change 2014-2015

Accident AD &D 378,793 381,442 Accident AD &D 0.7%

Dental Benefit 308,886 342,081 Dental Benefit 10.7%

Disability Income 24,740 24,031 Disability Income -2.9%

Hospital Indemnity 8,824 8,435 Hospital Indemnity -4.4%

Limited Benefit 34,317 29,141 Limited Benefit -15.1%

Long-Term Care 22,236 21,414 Long-Term Care -3.7%

Medicare Adv (Title XVIII) 85,629 81,688 Medicare Adv (Title XVIII) -4.6%

Medicare Part D 69,329 83,446 Medicare Part D 20.4%

Medicare Supplement 48,797 54,250 Medicare Supplement 11.2%

Other-Specific Products 10,238 10,512 Other-Specific Products 2.7%

Short-Term Medical 4,071 4,345 Short-Term Medical 6.7%

Specified Disease 78,765 80,277 Specified Disease 1.9%

Vision 8,243 7,064 Vision -14.3%


- 40,000 80,000

120,000 160,000 200,000 240,000 280,000 320,000 360,000 400,000 440,000 480,000 520,000

AccidentAD &D

DentalBenefit

DisabilityIncome

HospitalIndemn.

LimitedBenefit

Long-TermCare

MedicareAdv (Title

XVIII)

MedicarePart D

MedicareSup.

Other-Specific

Products

Short-Term

Medical

SpecifiedDisease

Vision

2014 378,793 308,886 24,740 8,824 34,317 22,236 85,629 69,329 48,797 10,238 4,071 78,765 8,243

2015 381,442 342,081 24,031 8,435 29,141 21,414 81,688 83,446 54,250 10,512 4,345 80,277 7,064

Other Individual Health Insurance Products

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Section 3

Small, Midsize & Large Employer Health Benefit Plans

2014 Group Major Med.-Idaho Lives Covered End of Year

Small Employer (2-50) *Combined Sm. Emp. Basic, Stnd, Cata, ACA, Grandfathered, and Trans line items* 80,270

Small Employer Basic or (MCO) -

Small Employer Standard or (MCO) 14

Small Employer Catastrophic or (MCO) -

Large Employer (101+) 165,179

Midsize Employer (51-100) 35,570

Multiple Employer Association or trust 1,804

Federal Government Benefit Plans 41,374


Grandfathered Sm. Employer. Major Med 14,769

Transitional Sm. Employer. Major Med 47,243

Grandfathered Midsize Employer. Major Med 4,754

Non-Grandfathered Midsize Employer. Major Med 30,816

Grandfathered Large Employer. Major Med 54,004

Non-Grandfathered Large Employer. Major Med 111,175

2015 Group Major Med.-Idaho Lives Covered End of Year

Small Employer (2-50) *Combined Sm. Emp. Basic, Stnd, Cata, ACA, Grandfathered, and Trans line items* 78,906

Small Employer Basic or (MCO) -

Small Employer Standard or (MCO) 14

Small Employer Catastrophic or (MCO) -

Large Employer (101+) 141,859

Midsize Employer (51-100) 35,237

Multiple Employer Association or trust 951

Federal Government Benefit Plans 42,024


Grandfathered Sm. Employer. Major Med 12,700

Transitional Sm. Employer. Major Med 32,670

Grandfathered Midsize Employer. Major Med 2,837

Non-Grandfathered Midsize Employer. Major Med 32,400

Grandfathered Large Employer. Major Med 53,571

Non-Grandfathered Large Employer. Major Med 87,337

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Small Employer (2-50) 80,270 78,906 Small Employer (2-50) -1.7%

Large Employer (101+) 165,179 141,859 Large Employer (101+) -14.1%

Midsize Employer (51-100) 35,570 35,237 Midsize Employer (51-100) -0.9%

Multiple Employer Association or trust 1,804 951 Multiple Employer Association or trust -47.3%

Federal Government Benefit Plans 41,374 42,024 Federal Government Benefit Plans 1.6%

Totals 324,197 298,977 Total -7.8%


- 40,000 80,000

120,000 160,000 200,000 240,000 280,000 320,000 360,000 400,000

Small Employer (2-50)

Large Employer(101+)

Midsize Employer(51-100)

Multiple EmployerAssociation or trust

FederalGovernmentBenefit Plans

Totals

2014 80,270 165,179 35,570 1,804 41,374 324,197

2015 78,906 141,859 35,237 951 42,024 298,977

Group Major Medical-Small, Midsize & Large Employer-Idaho Lives Covered EOY

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Section 4 Other Group Health Insurance Products - Non-renewable Short Term plans, Medicare, Etc.

Accident or AD&D 622,139

Blanket / Student Plan 28,295

Dental Benefit 108,986

Hospital Indemnity 6,153

Limited Benefit 6,983

Long Term Care 5,929

Long Term Disability 153,919

Medicare Part D 20,745

Medicare Supplement 15,526

Short Term Disability 84,372

Specified Disease 19,076

Stop Loss-Excess Loss 120,376

Vision 194,676

Other-Specific Products 83,879

2014 Idaho Lives Covered End of Year

Accident or AD&D 670,735

Blanket / Student Plan 54,803

Dental Benefit 127,186

Hospital Indemnity 8,474

Limited Benefit 9,344

Long Term Care 5,894

Long Term Disability 164,602

Medicare Part D 20,370

Medicare Supplement 16,909

Short Term Disability 88,838

Specified Disease 19,474

Stop Loss-Excess Loss 160,421

Vision 159,574

Other: Specific Misc. Group Products 66,166

2015 Idaho Lives Covered End of Year

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Accident or AD&D 622,139 670,735 Accident or AD&D 8%

Blanket / Student Plan 28,295 54,803 Blanket / Student Plan 94%

Dental Benefit 108,986 127,186 Dental Benefit 17%

Hospital Indemnity 6,153 8,474 Hospital Indemnity 38%

Limited Benefit 6,983 9,344 Limited Benefit 34%

Long Term Care 5,929 5,894 Long Term Care -1%

Long Term Disability 153,919 164,602 Long Term Disability 7%

Medicare Part D 20,745 20,370 Medicare Part D -2%

Medicare Supplement 15,526 16,909 Medicare Supplement 9%

Short Term Disability 84,372 88,838 Short Term Disability 5%

Specified Disease 19,076 19,474 Specified Disease 2%

Stop loss-Excess Loss 120,376 160,421 Stop loss-Excess Loss 33%

Vision 194,676 159,574 Vision -18%

Other-Specific Products 83,879 66,166 Other-Specific Products -21%


- 50,000

100,000 150,000 200,000 250,000 300,000 350,000 400,000 450,000 500,000 550,000 600,000 650,000 700,000

Accidentor AD&D

Blanket /Student

Plan

DentalBenefit

HospitalIndemn.

LimitedBenefit

LongTermCare

LongTerm

Disability

Medicare Part D

Medicare Sup.

ShortTerm

Disability

SpecifiedDisease

Stoploss-

ExcessLoss

Vision Other-Specific

Products

2014 622,139 28,295 108,986 6,153 6,983 5,929 153,919 20,745 15,526 84,372 19,076 120,376 194,676 83,879

2015 670,735 54,803 127,186 8,474 9,344 5,894 164,602 20,370 16,909 88,838 19,474 160,421 159,574 66,166

Other Group Health Insurance Products

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Section 5

Population Data

2014 Idaho Population (Est.)* 1,634,806

2014 Idaho Uninsured Lives (Est.)** 245,221

2014 Idaho Insured Lives (Est.) 1,389,585

*Census and DOL estimates as of July 1, 2014.

**Kaiser Family Foundation estimates 2014

Idaho uninsured rate of 15% based on Census

Bureau's March 2014 CPS (Current Population

Survey).

2015 Idaho Population (Est.)* 1,654,930

2015 Idaho Uninsured Lives (Est.)** 182,042

2015 Idaho Insured Lives (Est.) 1,472,888

*Census and DOL estimates as of July 1, 2015.

**Kaiser Family Foundation estimates 2015

Idaho uninsured rate of 11% based on Census

Bureau's March 2015 CPS (Current Population

Survey).

2014 Idaho Insured Lives EOY

Individual Major Med* 119,975

Sm. Gr. Major Med* 80,270

Mid. Gr. Major Med* 35,583

Lrg. Gr. Major Med* 165,179

Fed. Gov. Benefits* 41,374

Mult. Emp. Assoc. and Trusts.* 1,804

Self-Funded H P-Major Med** 328,432

Medicare*** 170,694

Medicare Advantage (XVIII)* 85,629

Medicaid**** 51,609

Medicaid-Child**** 189,768

CHIP**** 30,615

Tricare***** 50,750

VA Care****** 41,266

1,392,948


Individual Major Med* 128,224

Sm. Gr. Major Med* 78,906

Mid. Gr. Major Med* 35,237

Lrg. Gr. Major Med* 141,859

Fed. Gov. Benefits* 42,024

Mult. Emp. Assoc. and Trusts.* 951

Self-Funded H P-Major Med** 417,791

Medicare*** 175,191

Medicare Advantage (XVIII)* 81,688

Medicaid**** 45,737

Medicaid-Child**** 202,190

CHIP**** 34,513

Tricare***** 50,455

VA Care****** 42,592

1,477,358

*2014 Idaho Health Insurance Survey

**2014 Idaho Self-Funded Health Plan Survey

***CMS.gov Medicare Enrollment Dashboard

Data file

****Medicaid.gov December 2014 enrollment

numbers less Child and CHIP data

****From Medicaid.gov based on FFY (Federal

Fiscal Year 10/1/2013 thru 9/30/2014)


Fiscal Year 10/1/2013 thru 9/30/2014)

*****Evaluation -TRICARE Program FY2015

Report to Congress-data for FY2014 MHS

(Health.mil)

******Estimates by the Allocation Resource

Center (ARC) for FY14 (ending 9/30/2014)

*2015 Idaho Health Insurance Survey

**2015 Idaho Self-Funded Health Plan Survey

***CMS.gov Medicare Enrollment Dashboard

Data file

****Medicaid.gov December 2015 enrollment

numbers less Child and CHIP data


Fiscal Year 10/1/2014 thru 9/30/2015)


Fiscal Year 10/1/2014thru 9/30/2015)

*****Evaluation - TRICARE Program FY2015

Report to Congress-data for FY2015 MHS

(Health.mil)

******Estimates by the Allocation Resource

Center (ARC) for FY15 (ending 9/30/2015)

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8.6%

5.8%2.6%

11.9%

3.0%

0.13%23.6%

12.3%

6.1%

3.7%

13.6%

2.2%3.6% 3.0%


Individual Major Med

Sm. Gr. Major Med

Mid. Gr. Major Med

Lrg. Gr. Major Med

Fed. Gov. Benefits

Mult. Emp. Assoc. and Trusts.

Self-Funded H P-Major Med

Medicare

Medicare Advantage (XVIII)

Medicaid

Medicaid-Child

CHIP

Tricare

VA Care

8.7%5.3%

2.4%

9.6%

2.8%

0.06%28.3%

11.9%

5.5%

3.1%

13.7%

2.3%3.4% 2.9%


Individual Major Med

Sm. Gr. Major Med

Mid. Gr. Major Med

Lrg. Gr. Major Med

Fed. Gov. Benefits

Mult. Emp. Assoc. and Trusts.

Self-Funded H P-Major Med

Medicare

Medicare Advantage (XVIII)

Medicaid

Medicaid-Child

CHIP

Tricare

VA Care

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