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Chartbook Section 7

Chartbook Section 7. Health Plans. Section 7: Health Plans. Health plan market shares Fully-insured market in total Small group and individual market HMO financial statistics Net income & margins Reserves Health Plan Medical Loss Ratios HMO enrollment statistics

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Chartbook Section 7

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  1. Chartbook Section 7 Health Plans

  2. Section 7: Health Plans • Health plan market shares • Fully-insured market in total • Small group and individual market • HMO financial statistics • Net income & margins • Reserves • Health Plan Medical Loss Ratios • HMO enrollment statistics A summary of the charts and graphs contained within is provided at Chartbook Summaries - Section 7. Direct links are listed on each page. Please contact the Health Economics Program at 651-201-3550 or health.hep@state.mn.us if additional assistance is needed for accessing this information.

  3. Health Plan Market Shares(includes HMO and non-HMO plans)

  4. Health Plan Market Shares:Total Fully Insured Private Market, 2016 Companies with common ownership were treated as one entity. For example, Blue Cross Blue Shield of Minnesota includes BCBSMN and Blue Plus. Fully insured market only, market share based on premium volume. Source: MDH Health Economics Program, analysis of Health Plan Financial and Statistical Reports which covers health plans with over $3 million in annual premium revenue. Summary of Graph

  5. Health Plan Market Shares: Individual Market, 2016 Note: Companies with common ownership were treated as one entity. Market shares based on premium volume; fully insured market only. Source: Minnesota Department of Commerce, "Report of 2016 Loss Ratio Experience Health Plan Companies“, June 2017. Summary of Graph

  6. Health Plan Market Shares: Small Group Market, 2016 Note: Companies with common ownership were treated as one entity. Market shares based on premium volume; fully insured market only. Source: Minnesota Department of Commerce, "Report of 2016 Loss Ratio Experience Health Plan Companies“, June 2017. Summary of Graph

  7. Market Share of Minnesota Non-Profit Health Plans 2011 to 2016 Fully insured market only, market share based on premium volume. Source: MDH Health Economics Program, analysis of Health Plan Financial and Statistical Reports which covers health plans with over $3 million in annual premium revenue. Summary of Graph

  8. Health Plan Medical Loss Ratios(HMO and Non-HMO Carriers with $2 million or more in premium revenue)

  9. Medical Loss Ratio in the Individual Market, 2016 (Carriers with $2 million or more in Premium Revenue) 1 Premiums exclude taxes and fees. 2 Medical Loss Ratio. Beginning in 2012, federal law requires most insurance companies to issue rebates to consumers for an MLR under 80% in the individual market for the prior year. Firms are ordered by net premiums in decreasing order. Source: MDH Health Economics Program analysis of data from National Association of Insurance Commissioners (NAIC), Supplementary Health Care Exhibit—Part 1.

  10. Medical Loss Ratio in the Small Group Market, 2016 (Carriers with $2 million or more in Premium Revenue) 1 Premiums exclude taxes and fees. 2 Medical Loss Ratio. Beginning in 2012, federal law requires most insurance companies to issue rebates to consumers for an MLR under 80% in the small group market for the prior year. Firms are ordered by net premiums in decreasing order. Source: MDH Health Economics Program analysis of data from National Association of Insurance Commissioners (NAIC), Supplementary Health Care Exhibit—Part 1.

  11. Medical Loss Ratio in the Large Group Market, 2016 (Carriers with $2 million or more in Premium Revenue) 1 Premiums exclude taxes and fees. 2 Medical Loss Ratio. Beginning in 2012, federal law requires most insurance companies to issue rebates to consumers for an MLR under 85% in the large group market for the prior year. Firms are ordered by net premiums in decreasing order. Source: MDH Health Economics Program analysis of data from National Association of Insurance Commissioners (NAIC), Supplementary Health Care Exhibit—Part 1.

  12. HMO Financial Statistics Health Maintenance Organizations (HMO) are non-profit corporations which provide comprehensive health insurance coverage to Minnesotans. They also provide health care to state public programs enrollees through contracts with the Minnesota Department of Human Services and to Medicare beneficiaries through contracts with the Center for Medicare and Medicaid Services. HMOs are licensed pursuant to Minnesota Statutes, chapter 62D and Minnesota Rules, part 4685.

  13. Summary of HMO Financial Trends, Total Business Minnesota products only. Source: MDH Health Economics Program analysis of HMO annual reports.

  14. Net Income and Profitability by HMO, 2016 Minnesota products only. Prior to 2016 Hennepin Health was known as Metropolitan Health Plan. Source: MDH Health Economics Program analysis of HMO annual reports.

  15. Minnesota HMO Net Income by Product Line, 2011 to 2016 PMAP is Prepaid Medical Assistance Program; GAMC is General Assistance Medical Care; SNBC is Special Needs Basic Care, and MSHO is Minnesota Senior Health Options; All Other includes: Medicare Supplemental, Dental. Source: MDH Health Economics Program analysis of HMO annual reports. Summary of Graph

  16. Minnesota HMO Net Income per Member Month by Product Line, 2011 to 2016 PMAP is Prepaid Medical Assistance Program; GAMC is General Assistance Medical Care; SNBC is Special Needs Basic Care, and MSHO is Minnesota Senior Health Options; All Other includes: Medicare Supplemental, Dental. Source: MDH Health Economics Program analysis of HMO annual reports. Summary of Graph

  17. Minnesota HMO Net Income by Product Line, 2016 PMAP is Prepaid Medical Assistance Program; MSHO is Minnesota Senior Health Options; SNBC is Special Needs Basic Care; All Other includes: Medicare Supplemental, and Dental. Source: MDH Health Economics Program analysis of HMO annual reports. Summary of Graph

  18. Minnesota HMO Net Income per Member Month by Product Line, 2016 PMAP is Prepaid Medical Assistance Program; MSHO is Minnesota Senior Health Options; SNBC is Special Needs Basic Care; All Other includes: Medicare Supplemental, and Dental. Source: MDH Health Economics Program analysis of HMO annual reports. Summary of Graph

  19. Minnesota HMO Profitability by Product Line, 2011 to 2016 PMAP is Prepaid Medical Assistance Program; GAMC is General Assistance Medical Care; SNBC is Special Needs Basic Care, and MSHO is Minnesota Senior Health Options; All Other includes: Medicare Supplemental, Dental. Source: MDH Health Economics Program analysis of HMO annual reports. Summary of Graph

  20. Sources of HMO Net Income, 2011 to 2016 1 Investment income as a percent of net income is not listed when HMOs have a negative net income and a positive investment income. Minnesota products only. Source: MDH Health Economics Program analysis of HMO annual reports.

  21. Investment Income as a Percent of Net Income by HMO, 2016 1Investment income as a percent of net income is not listed for HMOs that have a negative net income and a positive investment income. Prior to 2016 Hennepin Health was known as Metropolitan Health Plan. Source: MDH Health Economics Program analysis of HMO annual reports

  22. Reserves, Medical Expenses, and Regulatory Minimum Level by HMO, 2016 1 Fee-for-service revenue earned was subtracted from expenses to approximate member only expenses for these plans. 2“Regulatory level” is the authorized control level; total expenses is from line 16 of HMO Minnesota Supplement Report #1. Prior to 2016 Hennepin Health was known as Metropolitan Health Plan. Minnesota products only.Source: MDH Health Economics Program analysis of HMO annual reports.

  23. Total Minnesota HMO Reserves Relative to Regulatory Minimum Levels, 2006 to 2016 Source: MDH Health Economics Program analysis of HMO annual reports. Summary of Graph

  24. HMO Enrollment Statistics Health Maintenance Organizations (HMO) are non-profit corporations which provide comprehensive health insurance coverage to Minnesotans. They also provide health care to state public programs enrollees through contracts with the Minnesota Department of Human Services and to Medicare beneficiaries through contracts with the Center for Medicare and Medicaid Services. HMOs are licensed pursuant to Minnesota Statutes, chapter 62D and Minnesota Rules, part 4685.

  25. Minnesota HMO Member Months by Product Line, 2010 to 2016 Enrollment figures are as of December 31st of each year. PMAP is Prepaid Medical Assistance Program; MSHO is Minnesota Senior Health Options; SNBC is Special Needs Basic Care; All Other includes: Medicare Supplemental, and Dental. Source: MDH Health Economics Program analysis of HMO annual reports. Summary of Graph

  26. Distribution of Minnesota HMO Enrollment by Region, 2016 Enrollment figures are as of December 31st of each year. Prior to 2016 Hennepin Health was known as Metropolitan Health Plan. Source: MDH Health Economics Program analysis of HMO annual reports

  27. Minnesota HMO Enrollment as Percent of Regional Population, 2016 Enrollment figures are as of December 31st of each year. Prior to 2016 Hennepin Health was known as Metropolitan Health Plan. Source: MDH Health Economics Program analysis of HMO annual reports

  28. Minnesota HMO Enrollment as of December 31st as Percent of Regional Population, 2016 11.3 18.5% 13.6% 18.9% 24.5% 7.4% 11.1% 13.5% Source: MDH Health Economics Program analysis of HMO annual reports; U.S. Census Bureau Summary of Graph

  29. Minnesota HMO Member Months by Firm, 2016 Prior to 2016 Hennepin Health was known as Metropolitan Health Plan. Source: MDH Health Economics Program analysis of HMO annual reports Summary of Graph

  30. Minnesota HMO Member Months by Product Line, 2016 MSHO is Minnesota Senior Health Options; SNBC is Special Needs Basic Care. Source: MDH Health Economics Program analysis of HMO annual reports Summary of Graph

  31. Total Minnesota HMO Enrollment, 2011 to 2016 Enrollment figures are as of December 31st of each year. Source: MDH Health Economics Program analysis of HMO annual reports Summary of Graph

  32. Minnesota HMO Market Penetration, 2011 to 2016 Enrollment figures are as of December 31st of each year. Source: MDH Health Economics Program analysis of HMO annual reports, U.S. Census Bureau

  33. HMO Enrollment in Minnesota by Product Line, 2011 to 2016 Enrollment figures are as of December 31st of each year. 1Other Medicare includes Medicare Cost, Minnesota Senior Health Options, Medicare Supplement, and Special Needs Basic Care. PMAP is Prepaid Medical Assistance Program; GAMC is General Assistance Medical Care; MSHO is Minnesota Senior Health Options Source: MDH Health Economics Program analysis of HMO annual reports

  34. Rates of Enrollment Growth for Minnesota HMOs by Product Line, 2011 to 2016 Enrollment figures are as of December 31st of each year. 1Other Medicare includes Medicare Cost, Minnesota Senior Health Options, Medicare Supplement, and Special Needs Basic Care. PMAP is Prepaid Medical Assistance Program; GAMC is General Assistance Medical Care; MSHO is Minnesota Senior Health Options Source: MDH Health Economics Program analysis of HMO annual reports

  35. HMO Enrollment in Minnesota by Firm, 2011 to 2016 Enrollment figures are as of December 31st of each year. Prior to 2016 Hennepin Health was known as Metropolitan Health Plan. Source: MDH Health Economics Program analysis of HMO annual reports

  36. Commercial Enrollment in Minnesota HMOs, 2011 to 2016 Enrollment figures are as of December 31st of each year. Prior to 2016 Hennepin Health was known as Metropolitan Health Plan. Source: MDH Health Economics Program analysis of HMO annual reports

  37. Medicare Advantage Enrollment in Minnesota HMOs, 2011 to 2016 Enrollment figures are as of December 31st of each year. Prior to 2016 Hennepin Health was known as Metropolitan Health Plan. Source: MDH Health Economics Program analysis of HMO annual reports

  38. Other Medicare1 Enrollment in Minnesota HMOs, 2011 to 2016 Enrollment figures are as of December 31st of each year. Prior to 2016 Hennepin Health was known as Metropolitan Health Plan. 1Other Medicare includes Medicare Cost, Minnesota Senior Health Options, Medicare Supplement, and Special Needs Basic Care. Source: MDH Health Economics Program analysis of HMO annual reports

  39. PMAP Enrollment in Minnesota HMOs, 2011 to 2016 Enrollment figures are as of December 31st of each year. Prior to 2016 Hennepin Health was known as Metropolitan Health Plan. PMAP is Prepaid Medical Assistance Program; MSHO is Minnesota Senior Health Options Source: MDH Health Economics Program Analysis of HMO Annual Report

  40. MinnesotaCare Enrollment in Minnesota HMOs, 2011 to 2016 Enrollment figures are as of December 31st of each year. Prior to 2016 Hennepin Health was known as Metropolitan Health Plan. Source: MDH Health Economics Program analysis of HMO annual reports

  41. Distribution of Minnesota HMO Enrollment by Product Line, 2016 Enrollment figures are as of December 31st of each year. Prior to 2016 Hennepin Health was known as Metropolitan Health Plan. 1Other Medicare includes Medicare Cost, Minnesota Senior Health Options, Medicare Supplement, and Special Needs Basic Care. PMAP is Prepaid Medical Assistance Program; MSHO is Minnesota Senior Health Options Source: MDH Health Economics Program analysis of HMO annual reports

  42. Minnesota HMO Enrollment by Firm and Age, 2016 Includes health plan members that are non-Minnesota residents. Prior to 2016 Hennepin Health was known as Metropolitan Health Plan. Enrollment figures are as of December 31st of each year. Source: MDH Health Economics Program analysis of HMO annual reports.

  43. Distribution of Total Minnesota HMO Enrollment by Product Line and Age, 2016 Includes health plan members that are non-Minnesota residents for BluePlus, Group Health, Hennepin Health, HealthPartners, Medica, PreferredOne, Sanford, and UCare. 1Other Medicare includes Medicare Cost, Minnesota Senior Health Options, Medicare Supplement, and Special Needs Basic Care. PMAP is Prepaid Medical Assistance Program; GAMC is General Assistance Medical Care; MSHO is Minnesota Senior Health Options Enrollment figures are as of December 31st of each year. Source: MDH Health Economics Program analysis of HMO annual reports

  44. Additional Information from the Health Economics Program Available Online • Health Economics Program Home Page • Health Economics Program Home Page • Publications • Health Economics Program Publications • Health Care Market Statistics (Presentation Slide Decks) • Health Economics Program Chartbook Homepage A summary of the charts and graphs contained within is provided at Chartbook Summaries – Section 7. Direct links are listed on each page. Please contact the Health Economics Program at 651-201-3550 or health.hep@state.mn.us if additional assistance is needed for accessing this information.

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