New Hampshire Insurance Department Study Commission on the Future - - PowerPoint PPT Presentation
New Hampshire Insurance Department Study Commission on the Future of the NH Premium Assistance Program Tyler Brannen Health Care Policy Analyst January 9, 2017 Agenda Role of the NH Insurance Department NH Insurance Markets
Tyler Brannen Health Care Policy Analyst January 9, 2017
– The ACA is a federal law
– NHID enforces compliance with state laws and makes recommendations to CMS for products on the exchange
Source: NHID 2015 Medical Cost Drivers report, November 2016
Source: NHID 2015 Medical Cost Drivers report, November 2016
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2014 2015 2016 2017
Anthem/Matthew Thornton Celtic/Ambetter Assurant/Time Harvard Pilgrim Minuteman Community Health Options
New Hampshire Individual Market
Off Exchange Only On and Off Exchange
Prepared by Gorman Actuarial, Inc.
newborn care
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– Substantial subsidies are available through the exchange for those at 100%-400% of federal poverty (FPL) – 2014:
– Those under 100% FPL are not eligible for subsidies
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1.0 3.0 27.0 0.0 5.0 10.0 15.0 20.0 25.0 30.0 Individual Market State High Risk Pool PCIP Axis Title
PCIP = Federal Pre-existing Condition Insurance Plan (temporary) Source: New Hampshire Market Study Key Findings, Gorman Actuarial, Inc. September 2012
Source: New Hampshire Market Study Key Findings, Gorman Actuarial, Inc. September 2012
December 31, 2013 2014 1 Change from 12/31 % Change Individual Market 34,817 60,795 25,978 75% Federal and State High Risk Pools 2,613 802
Fully Insured Group 188,913 178,909
Self Insured 293,009 291,338
Medicaid 118,537 127,968 9,431 8% Total Membership 637,889 659,812 21,923 3%
12014 membership is based on updated enrollment as of May 1, 2014 received from Anthem. Federal High Risk Pool Enrollment is as of
January 31, 2014. All other 2014 enrollment is as of April 1, 2014. Source: New Hampshire Health Insurance Market Analysis, Wakely Consulting Group, August 2014
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Data Source: NHID Annual Hearing data 2015 and 2016, Gorman Actuarial, Inc.
Individual Exchange NH PAP Individual Non-Exchange Indiviudal Exchange Small Group Large Group
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Data Source: NHID Supplemental Data Request 2014, 2015 and 2016; Gorman Actuarial, Inc.
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*Information shown prior to any federal MLR rebate payments Data Source: 2015 federal MLR reports provided by insurers. Anthem provided additional information for FEHBP to make necessary adjustments to exclude from Large Group. Gorman Actuarial, Inc.
Individual Small Group Large Group
Medical & Pharmacy Claims ACA Charges Other State & Federal Taxes Profit (Positive) Admin Expenses & Fees Profit (Negative)
Company/Product Rate Increase Ambetter 1% HPHC ElevateHealth HMO 10% HPHC NH Network HMO 9% MTHP/Anthem HMO 13-17% Minuteman 2-10%
ACA compliant individual plans in NH with effective dates of 1/1/17, from healthcare.gov.
Contact Information New Hampshire Insurance Department
21 South Fruit Street, Suite #14 Concord, NH 03301 requests@ins.nh.gov Phone: (603) 271-2261 Fax: (603) 271-1406 TTY/TDD: 1 (800) 735-2964 www.nh.gov/insurance
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Tyler Brannen
Health Care Policy Analyst NH Insurance Department Tyler.Brannen@ins.nh.gov