Maryland Insurance Administration Secures 11.9% Average Decrease for Individual Market in 2021
Innovative State Reinsurance Program Has Helped Drive Premiums Down By More Than 30% Over Three Years
Governor Larry Hogan today announced that Maryland Insurance Commissioner Kathleen A. Birrane has approved an average 11.9% premium rate decrease for individual health insurance plans with an effective date of January 1, 2021. This means that for the third consecutive year, all individual insurance rates in Maryland under the Affordable Care Act (ACA) will see significant decreases.
Individual Health Insurance Premiums In Maryland
The lower rates reflect the impact of the State Reinsurance Program, which has helped to stabilize the individual health insurance market after years of major premium increases. The three-year cumulative impact is a rate decrease of 31.4% versus 2018 premiums.
“While Washington continues to bicker back and forth about health care, we have delivered three consecutive years of lower premiums in Maryland,” said Governor Hogan. “Our innovative program to make health care more affordable continues to bring more stability and peace of mind to Marylanders, and serves as a model for the rest of the nation.”
In 2018, facing predicted health insurance rate increases of up to 50%, Governor Hogan worked in bipartisan fashion with legislative leaders to develop landmark legislation establishing a state reinsurance program. The legislation directed the Maryland Health Benefit Exchange, which operates the Maryland Health Connection insurance marketplace, to submit a State Innovation Waiver under Section 1332 of the Affordable Care Act (ACA) to the U.S. Secretaries of Health, Human Services, and Treasury to establish the program. The waiver was approved by the Centers for Medicare and Medicaid Services on August 22, 2018.
The legislation combined with this waiver set up a reinsurance pool to provide funding for catastrophic claims for policyholders in the individual market.
“I am very pleased to be able to continue the downward trajectory in premium rates for the individual market,” Commissioner Birrane said. “Maryland’s innovative and bipartisan approach to stabilizing what had been a spiraling market has been incredibly successful, has benefited Marylanders, and become a blueprint for other states. Under Governor Hogan’s leadership, Maryland has been the thought leader and trend setter in bringing rate relief to this market.”
To assist the administration in making its rate decision, MIA actuaries reviewed the data, methodologies, and assumptions companies used to develop their proposed premium rates. The MIA also considered public comments, along with other relevant factors, in determining whether to approve, modify, or deny requested rates.
The MIA has approved the following premium changes in the individual market:
|Company Name||Type of Network||Members as of 06/30/20||2021 Filed Renewal (5/1/20)||2021
|Difference (Approved – Filed)|
|CareFirst BlueChoice, Inc.||HMO||135,515||-1.1%||-11.9%||-10.8%|
|CareFirst of Maryland, Inc. and Group Hospitalization and Medical Services, Inc. (both CareFirst Companies)||PPO||11,936||-12.0%||-17.1%||-5.1%|
|Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc.||HMO||65,132||-11.0%||-11.0%||0.0%|
|Optimum Choice, Inc.||HMO||N/A||N/A||N/A||-7.6%|
The MIA has approved the following premium changes in the small group market:
|Company Name||Type of Network||Members as of 06/30/20||2021 Filed Renewal (5/1/20-All Quarters)||2021 Approved Renewal (All Quarters)||Difference (Approved – Filed)|
|Aetna Health, Inc.||HMO||83||-7.7%||-16.8%||-9.1%|
|Aetna Life Insurance Co.||PPO||482||-9.0%||-14.7%||-5.7%|
|CareFirst BlueChoice, Inc.||HMO||169,820||6.0%||3.1%||-2.9%|
|CareFirst of Maryland, Inc. and Group Hospitalization and Medical Services, Inc. (both CareFirst companies)||PPO||21,296||1.8%||2.0%||+0.2%|
|Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc.||HMO||10,755||-5.0%||-5.0%||0.0%|
|UnitedHealthcare of the Mid-Atlantic||HMO||4,745||8.3%||3.5%||-4.8%|
|Optimum Choice (a UHC company)||HMO||14,548||3.0%||-2.7%||-5.7%|
|MAMSI Life and Health Insurance Co. (a UHC company)||EPO||19,546||4.7%||1.0%||-3.7%|
|UnitedHealthcare Insurance Co.||PPO||21,748||9.8%||4.5%||-5.3%|
For more information about the Maryland Insurance Administration’s rate review process, please refer to the Administration’s frequently asked questions guide on the Health Insurance Rates and Review Process.