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Section 4: Individual and Small Group Health Insurance Markets - Chart Summaries
Below are summaries of the charts, tables and graphs contained in Section 4 of the Minnesota Health Care Chartbook by page number. This chartbook was last updated in March 2023 and contains 59 pages. Pages without charts, tables or graphs are not listed below.
Page 6 - Enrollment Trends in Minnesota’s Individual Market
This chart depicts the enrollment in Minnesota’s individual market from 2007 to 2021.
- 2007= 246,190
- 2008= 248,633
- 2009= 250,589
- 2010= 251,798
- 2011= 249,380
- 2012= 247,315
- 2013= 247,911
- 2014= 292,623
- 2015= 295,458
- 2016= 236,911
- 2017= 149,335
- 2018= 141,110
- 2019= 145,019
- 2020= 153,092
- 2021= 159,654
- Note: Total enrollment reported as end of year enrollment from all plans and issuers in the individual market.
- Source: MDH Health Economics Program; Health Plan Financial and Statistical Report (2007 to 2021).
Page 7 - Percent Change in Premiums in Minnesota’s Individual Market
This chart depicts the premium changes in Minnesota’s individual market from 2006 to 2020.
- 2007= 3.4%
- 2008= 11.2%
- 2009= 4.9%
- 2010= 5.9%
- 2011= 6.1%
- 2012= 1.2%
- 2013= 3.2%
- 2014= 17.1%
- 2015= 8.7%
- 2016= 33.9%
- 2017= 30.4%
- 2018= -3.2%
- 2019=-17.6%
- 2020=1.7%
- 2021=0.0%
- Note: Based on total per member per year (PMPY) premiums collected. Minnesota passed legislation in April 2017 aimed at stabilizing premiums in the individual market through a state-based reinsurance program (the Minnesota Premium Security Plan). This program took effect for plans that began on January 1, 2018.
- Source: MDH Health Economics Program; Health Plan Financial and Statistical Report (2007 to 2021).
Page 8 – Individual Market Plan Use, 2019 to 2021.
This chart depicts Individual Market plans offered and plans chosen
- 2019: plans offered=444, plans chosen=267
- 2020: plans offered=637, plans chosen=415
- 2021: plans offered=813, plans chosen=524
- Note: Plans offered are health plans offered by insurance companies in the individual market; plans chosen are health plans offered in the individual market that have member month enrollment for part of or the whole year.
- Source: MDH Health Economics Program analysis of the Minnesota All Payer Claims Database and National Association of Insurance Commissioner’s Health Plan Binders.
Page 9 - Health Plan Market Shares: Individual Market
This chart depicts the health plan market shares in Minnesota’s individual market.
- 2017 (Premium Volume= $942 million): HealthPartners=27.3%, Blue Plus=31.6%, Medica=26.3%, PreferredOne=0.3%, UCare=14.4%
- 2018 (Premium Volume= $861 million): HealthPartners=29.7%, Blue Plus=21.1%, Medica=29.4%, PreferredOne=0.2%, UCare=19.5%
- 2019 (Premium Volume= $729 million): HealthPartners=30.7%, Blue Plus=20.5%, Medica=29.9%, PreferredOne=0.4%, UCare=18.5%
- 2020 (Premium Volume= $783 million): HealthPartners=27.7%, Blue Plus=21.5%, Medica=26.5%, PreferredOne=1.0%, UCare=23.2%
- 2021 (Premium Volume= $817 million): HealthPartners=25.4%, Blue Plus=21.8%, Medica=21.4%, PreferredOne=1.6%, UCare=29.3%
- Note: Some companies with common ownership have been combined for purposes of this analysis. Market share is based on percent of total premiums collected. If a plan is not shown, its market share was 0 percent.
- Source: MDH Health Economics Program; Health Plan Financial and Statistical Report (2017 through 2021).
Page 10 – Percent of Market On/Off Minnesota’s Health Insurance Exchange (MNsure)
This graph shows the percent of member months on the individual market that enrolled through MNsure (on exchange) or through other sources (off exchange) between 2017 and 2021
- 2017 (Average Monthly Enrollment = 158.8K: MNsure=55.8% (Average Monthly Enrollment = 88.2K), Off Exchange=44.2% (Average Monthly Enrollment = 70.6K)
- 2018 (Average Monthly Enrollment = 150.9K): MNsure=64.3% (Average Monthly Enrollment = 97.1K), Off Exchange=35.7% (Average Monthly Enrollment = 53.8K)
- 2019 (Average Monthly Enrollment = 151.1K): MNsure=64.9% (Average Monthly Enrollment = 98.0K), Off Exchange=35.1% (Average Monthly Enrollment = 53.1K)
- 2020 (Average Monthly Enrollment = 158.9K: MNsure=66.3% (Average Monthly Enrollment = 105.3K), Off Exchange=33.7% (Average Monthly Enrollment = 53.6K)
- 2021 (Average Monthly Enrollment = 162.6K): MNsure=66.3% (Average Monthly Enrollment = 107.9K), Off Exchange=33.7% (Average Monthly Enrollment = 54.7K)
- Note: Enrollment in individual market plans may fluctuate during the plan year; average monthly enrollment is reported as total member months divided by 12 to account for fluctuations during the plan year.
- Source: Source: MDH Health Economics Program Analysis of member months from National Association of Insurance Commissioners (NAIC) and MNsure, Minnesota’s Health Insurance Exchange.
Page 11 – Health Plan Market Share On/Off Minnesota’s Health Insurance Exchange, Select Years
This chart depicts health plan market share in Minnesota’s individual market on and off MNsure (exchange) in 2017 and 2021.
- 2017 MNsure: Blue Plus=24.5%, Medica=23.0%, HealthPartners=26.1%, PreferredOne=0.0%, UCare=26.3%, Quartz=0.0%
- 2017 Off Exchange: Blue Plus=27.2%, Medica=18.1%, HealthPartners=53.9%, PreferredOne=0.4%, UCare=0.3%, Quartz=0.0%
- 2021 MNsure: Blue Plus 16.5%. Medica=15.9%, HealthPartners=19.3%, PreferredOne=0.0%, UCare=47.4%, Quartz=0.9%
- 2021 Off Exchange: Blue Plus=28.3%, Medica=16.7%, HealthPartners=51.8%, PreferredOne=6.2%, UCare=0.0%, Quartz=0.0%
- Note: Some companies with common ownership have been combined for purposes of this analysis. Market share is based on percent of member months. If a plan is not shown, its market share was 0 percent.
- Source: MDH Health Economics Program Analysis of member months from National Association of Insurance Commissioners (NAIC) and MNsure, Minnesota’s Health Insurance Exchange.
Page 12 – Percent of Individual Market Enrollees with Federal Premium Subsidies
This graph shows the percent of individual market enrollees who received federal premium subsidies from 2017 through 2021.
- 2017: Enrolled through MNsure, Tax Credits=38.9% (Average Monthly Enrollment = 61.7K), Enrolled through MNsure, No Tax Credits=16.7% (Average Monthly Enrollment = 26.5K), Enrolled Off Exchange, No Tax Credits=44.4% (Average Monthly Enrollment = 70.6K)
- 2018: Enrolled through MNsure, Tax Credits=41.7% (Average Monthly Enrollment = 62.9K), Enrolled through MNsure, No Tax Credits=22.6% (Average Monthly Enrollment = 34.2K), Enrolled Off Exchange, No Tax Credits=35.7% (Average Monthly Enrollment = 53.8K)
- 2019: Enrolled through MNsure, Tax Credits=39.2% (Average Monthly Enrollment = 59.2K), Enrolled through MNsure, No Tax Credits=25.7% (Average Monthly Enrollment = 38.8K), Enrolled Off Exchange, No Tax Credits=35.1% (Average Monthly Enrollment = 53.1K)
- 2020: Enrolled through MNsure, Tax Credits=36.3% (Average Monthly Enrollment = 57.6K), Enrolled through MNsure, No Tax Credits=30.0% (Average Monthly Enrollment = 47.7K), Enrolled Off Exchange, No Tax Credits=33.7% (Average Monthly Enrollment = 53.6K)
- 2021: Enrolled through MNsure, Tax Credits=36.2% (Average Monthly Enrollment = 59.7K), Enrolled through MNsure, No Tax Credits=30.1% (Average Monthly Enrollment = 48.2K), Enrolled Off Exchange, No Tax Credits=33.7% (Average Monthly Enrollment = 54.7K)
- Note: Federal Premium Subsidies are also called Advanced Premium Tax Credits (APTC), which limit premiums to a percent of income. APTC are available to those who do not have access to employer-based coverage, enroll through MNsure, and provide required proof of income; prior to mid-2021, they were only available to those with incomes under 400 percent of the Federal Poverty Guidelines, in mid-2021 eligibility was expanded to all income levels. If premiums are lower than the percent of income limit for APTC, you do not receive a tax credit; this is more likely to happen for younger people in lower-premium areas of the state. In 2017, the State of Minnesota provided a 25 percent premium rebate to those who did not receive federal tax credits. Enrollment in individual market plans may fluctuate during the plan year; average monthly enrollment is reported as total member months divided by 12 to account for fluctuations during the plan year.
- Source: MDH Health Economics Program analysis of MNsure data, Minnesota’s Health Insurance Exchange.
Page 13 – Average Advanced Premium Tax Credit Amount and Enrollment
This chart depicts the average Advanced Premium Tax Credit (APTC) amount received and the total enrollment in individual market coverage on MNsure with a tax credit from 2017 to 2021.
- 2017: Average APTC= $432; MNsure Enrollment with APTC= 61,726
- 2018: Average APTC= $391; MNsure Enrollment with APTC= 62,933
- 2019: Average APTC= $310; MNsure Enrollment with APTC= 59,206
- 2020: Average APTC= $287; MNsure Enrollment with APTC= 57,635
- 2021: Average APTC= $316; MNsure Enrollment with APTC= 59,694
- Note: Federal Premium Subsidies are also called Advanced Premium Tax Credits (APTC), which limit premiums to a percent of income. APTC are available to those who do not have access to employer-based coverage, enroll through MNsure, and provide required proof of income; prior to mid-2021, they were only available to those with incomes under 400 percent of the Federal Poverty Guidelines, in mid-2021 eligibility was expanded to all income levels. If premiums are lower than the percent of income limit for APTC, you do not receive a tax credit; this is more likely to happen for younger people in lower-premium areas of the state. In 2017, the State of Minnesota provided a 25 percent premium rebate to those who did not receive federal tax credits. Average monthly enrollment may vary from average annual enrollment; APTC enrollment data reported as average annual enrollment.
- Source: MDH Health Economics Program analysis of MNsure data, Minnesota’s Health Insurance Exchange.
Page 14 - Individual Market Enrollment by Metal Level On and Off Minnesota’s Health Insurance Exchange, 2014 and 2021
This chart depicts individual market average monthly enrollment by metal level on and off exchange in 2014 and 2021.
- Off Exchange, 2014: Platinum= 32,962, Gold=78,700, Silver= 70,524, Expanded Bronze= 0, Bronze= 68,480, Catastrophic= 5,110
- On Exchange (MNsure), 2014: Platinum= 9,965, Gold= 4,377, Silver= 13,025, Expanded Bronze= 0, Bronze= 8,007, Catastrophic= 214
- Off Exchange, 2021: Platinum= 78, Gold= 11,448, Silver= 12,766, Expanded Bronze= 28,385, Bronze= 139, Catastrophic= 1,915
- On Exchange (MNsure), 2021: Platinum= 0, Gold=16,609, Silver= 31,885, Expanded Bronze= 56,826, Bronze= 0, Catastrophic= 2,562
- Note: All plans have an actuarial value (AV), which estimates the percent of health care costs the plan will cover for an average consumer; metal levels are assigned based off the plan AV. Platinum represents an AV of 90%, Gold 80%, Silver 70%, Expanded Bronze 65%, Bronze 60%, and Catastrophic <60%. Expanded Bronze plans introduced in 2018. Enrollment by metal level excludes legacy plans. Plans could be purchased from the state’s health insurance exchange, MNsure, or directly from a health plan or broker (off exchange). Enrollment in individual market plans may fluctuate during the plan year; average monthly enrollment is reported as total member months divided by 12 to account for fluctuations during the plan year. Data from 2015 to 2018 are not available.
- Source: MDH Health Economics Program analysis of the Small Group and Individual Market Survey (2014), Minnesota All Payer Claims Database, National Association of Insurance Commissioner’s Health Plan Binders (2021).
Page 15 - Individual Market Metal Level Market Share On and Off Minnesota’s Health Insurance Exchange, 2014 and 2021
This chart depicts individual market enrollment by metal level on and off exchange in 2014 and 2021.
- Off Exchange, 2014: Platinum= 12.9%, Gold=30.8%, Silver= 27.6%, Expanded Bronze= 0.0%, Bronze= 26.8%, Catastrophic= 2.0%
- On Exchange (MNsure), 2014: Platinum= 28.0%, Gold=12.3%, Silver= 36.6%, Expanded Bronze= 0.0%, Bronze= 22.5%, Catastrophic= 0.6%
- Off Exchange, 2021: Platinum= 0.1%, Gold=20.9%, Silver= 23.3%, Expanded Bronze= 51.9%, Bronze= 0.3%, Catastrophic= 3.5%
- On Exchange (MNsure), 2021: Platinum= 0.0%, Gold=15.4%, Silver= 29.6%, Expanded Bronze= 52.7%, Bronze= 0.0%, Catastrophic= 2.4%
- Note: All plans have an actuarial value (AV), which estimates the percent of health care costs the plan will cover for an average consumer; metal levels are assigned based off the plan AV. Platinum represents an AV of 90%, Gold 80%, Silver 70%, Expanded Bronze 65%, Bronze 60%, and Catastrophic <60%. Expanded Bronze plans introduced in 2018. Enrollment by metal level excludes legacy plans. Plans could be purchased from the state’s health insurance exchange, MNsure, or directly from a health plan or broker (off exchange). Data from 2015 to 2018 are not available.
- Source: MDH Health Economics Program analysis of the Small Group and Individual Market Survey (2014), Minnesota All Payer Claims Database, National Association of Insurance Commissioner’s Health Plan Binders (2021).
Page 16 - Enrollment Trends in Minnesota’s Individual Market by Cost Sharing Variation
This chart depicts enrollment in the individual market by cost sharing reduction, 2019 to 2021
- 2019= No Cost Sharing Reduction Average Monthly Enrollment = 137,284 (92.3%), Cost Sharing Reduction Average Monthly Enrollment = 11,392 (7.7%)
- 2020= No Cost Sharing Reduction Average Monthly Enrollment = 146,383 (93.3%), Cost Sharing Reduction Average Monthly Enrollment = 10,526 (6.7%)
- 2021= No Cost Sharing Reduction Average Monthly Enrollment = 150,964 (93.7%), Cost Sharing Reduction Average Monthly Enrollment = 10,234 (6.3%)
- Note: Cost sharing reductions lower the amount paid for deductibles, copayments, and coinsurance in the Individual Market. Enrollment in individual market plans may fluctuate during the plan year; average monthly enrollment is reported as total member months divided by 12 to account for fluctuations during the plan year.
- Source: MDH Health Economics Program analysis of the Minnesota All Payer Claims Database and National Association of Insurance Commissioner’s Health Plan Binders.
Page 17 – Share of Individual Market Enrollment in High Deductible Health Plans with Health Savings Account Eligibility
This chart depicts individual market share of enrollees in high deductible health plans with health savings account eligibility, 2019 to 2021
- HSA eligible: 2019=44.5%, 2020=45.7%, 2021=45.9%
- Not HSA eligible, meets deductible minimum: 2019=39.5%, 2020=37.2%, 2021=40.6%
- Deductible too low for HAS eligibility: 2019=16.0%, 2020=17.1%, 2021=13.6%
- Note: This is the percent of plans that are Qualified High Deductible Health Plans (HDHP), as determined by the Internal Revenue Service (for 2019 the minimum deductible is $1,350; for 2020 and 2021 the minimum was $1,400) and have the option to be paired with a Health Savings Account (HSA). The proportion of people with an HSA is unknown, Health Plan Binder Data reports only if plans are HSA eligible and Minnesota APCD data do not report HSA utilization.
- Source: MDH Health Economics Program analysis of the Minnesota All Payer Claims Database and National Association of Insurance Commissioner’s Health Plan Binders.
Page 19 - Individual Market Average Deductible by Metal Level, 2019 to 2021
This chart depicts individual market average deductible by metal level, 2019 to 2021
- Platinum: 2019= $0.8K, 2020= $0.8K, 2021= $0.8K
- Gold: 2019= $1.0K, 2020= $1.1K, 2021= $1.1K
- Silver: 2019= $3.1K, 2020= $3.2K, 2021= $3.2K
- Expanded Bronze: 2019= $6.6K, 2020= $6.5K, 2021= $6.7K
- Bronze: 2019= $6.6K, 2020= $7.3K, 2021= $7.5K
- Catastrophic: 2019= $7.9K, 2020= $8.2K, 2021= $8.6K
- Note: All plans have an actuarial value (AV), which estimate the percent of health care costs the plan will cover for an average consumer; metal levels are assigned based off the plan AV. Platinum represents an AV of 90%, Gold 80%, Silver 70%, Expanded Bronze 65%, Bronze 60%, and Catastrophic <60%. Expanded Bronze plans introduced in 2018. Plans could be purchased from the state’s health insurance exchange, MNsure, or directly from a health plan or broker (off exchange). Plans with cost sharing reductions excluded.
- Source: MDH Health Economics Program analysis of the Minnesota All Payer Claims Database and National Association of Insurance Commissioner’s Health Plan Binder
Page 20 - Distribution of Per Person Annual Deductibles in the Individual Market, Select Years
This bar graph shows the distribution of deductibles in the individual market from 2011 to 2021.
- 2011: $0 Deductible= 2.2%, $1 to $2,500= 29.5%, $2,501 to $6,350= 58.4%, $6,350 + = 9.8%
- 2013: $0 Deductible= 0.1%, $1 to $2,500= 23.0%, $2,501 to $6,350= 62.4%, $6,350 + = 14.5%
- 2014: $0 Deductible= 4.1%, $1 to $2,500= 42.0%, $2,501 to $6,350= 52.8%, $6,350 + = 1.2%
- 2019: $0 Deductible= 0.1%, $1 to $2,500= 24.1%, $2,501 to $6,350= 30.8%, $6,350 + = 45.0%
- 2020: $0 Deductible= 0.1%, $1 to $2,500= 23.0%, $2,501 to $6,350= 35.2%, $6,350 + = 41.6%
- 2021: $0 Deductible= 0.3%, $1 to $2,500= 22.0%, $2,501 to $6,350= 36.1%, $6,350 + = 41.7%
- Note: Deductibles cannot exceed maximum out of pocket limits set by the Center for Medicaid and Medicare Services (CMS). Max out of pocket limits were introduced in 2014 and apply to in-network coverage. Limits increase annually after 2014: 2014 – $6,350; 2019 – $7,900; 2020 – $8,150; 2021 - $8,550. Distributions are by share of total enrollment. Category distribution excludes those in plans that are only available as family-only coverage and those in plans with a “per sickness” deductible, as deductibles in these plans cover more than one person or are not based on a calendar year (applies to 2011 to 2014). Data from 2012 and 2015 to 2018 are not available.
- Source: MDH Health Economics Program analysis of the Small Group and Individual Market Survey (2011 to 2014), Minnesota All Payer Claims Database (2019 to 2021), and National Association of Insurance Commissioner’s Health Plan Binders (2019 to 2021).
Page 21 - Per Person Annual Deductible Ranges, 2019 to 2021
This slide shows box plots of the averages and ranges of per person deductibles for plans chosen and plans offered in the individual market from 2019 to 2021.
- 2019 Plans Offered: Average= $4.0K, Maximum= $7.9K, 75th Percentile= $6.8K, Median= $4.0K, 25th Percentile= $1.2K, Minimum= $0.1K
- 2019 Plans Chosen: Average= $5.0K, Maximum= $7.9K, 75th Percentile= $6.8K, Median= $6.2K, 25th Percentile= $3.0K, Minimum= $0.8K
- 2020 Plans Offered: Average= $4.1K, Maximum= $8.2K, 75th Percentile= $6.9K, Median= $4.2K, 25th Percentile= $1.4K, Minimum= $0.4K
- 2020 Plans Chosen: Average= $4.9K, Maximum= $8.2K, 75th Percentile= $6.8K, Median= $5.9K, 25th Percentile= $3.0K, Minimum= $0.9K
- 2021 Plans Offered: Average= $4.2K, Maximum= $8.6K, 75th Percentile= $7.0K, Median= $4.0K, 25th Percentile= $1.5K, Minimum= $0.6K
- 2021 Plans Chosen: Average= $4.9K, Maximum= $8.6K, 75th Percentile= $7.0K, Median= $5.9K, 25th Percentile= $3.0K, Minimum= $0.9K
- Note: Plans offered are health plans offered by insurance companies in the individual market; plans chosen are health plans offered in the individual market that have member month enrollment for part of or the whole year. Cost sharing reduction plans excluded for plans offered and plans chosen.
- Source: MDH Health Economics Program analysis of the Minnesota All Payer Claims Database and National Association of Insurance Commissioner’s Health Plan Binders.
Page 22 - Per Person Deductible Distribution for Metal Levels with Highest Enrollment, 2021
This slide shows per person deductibles box plots of the averages and ranges for plans chosen and plans offered by metal level in the individual market, 2021.
- Catastrophic Plans Offered: Average= $8.6K, Maximum= $8.6K, 75th Percentile= $8.6K, Median= $8.6K, 25th Percentile= $8.6K, Minimum= $8.6K
- Catastrophic Plans Chosen: Average= $8.6K, Maximum= $8.6K, 75th Percentile= $8.6K, Median= $8.6K, 25th Percentile= $8.6K, Minimum= $8.6K
- Expanded Bronze Plans Offered: Average= $6.4K, Maximum= $8.5K, 75th Percentile= $7.0K, Median= $7.0K, 25th Percentile= $6.7K, Minimum= $2.3K
- Expanded Bronze Plans Chosen: Average= $6.7K, Maximum= $7.2K, 75th Percentile= $7.0K, Median= $6.9K, 25th Percentile= $6.3K, Minimum= $5.9K
- Silver Plans Offered: Average= $3.6K, Maximum= $8.5K, 75th Percentile= $4.2K, Median= $3.5K, 25th Percentile= $3.0K, Minimum= $1.4K
- Silver Plans Chosen: Average= $3.2K, Maximum= $4.2K, 75th Percentile= $3.5K, Median= $3.0K, 25th Percentile= $3.0K, Minimum= $1.4K
- Gold Plans Offered: Average= $1.4K, Maximum= $3.0K, 75th Percentile= $1.4K, Median= $1.4K, 25th Percentile= $1.1K, Minimum= $0.6K
- Gold Plans Chosen: Average= $1.1K, Maximum= $1.9K, 75th Percentile= $1.4K, Median= $1.1K, 25th Percentile= $1.0K, Minimum= $0.9K
- Note: Cost sharing reduction plans excluded for plans offered and plans chosen. Plans offered are health plans offered by insurance companies in the individual market; plans chosen are health plans offered in the individual market that have member month enrollment for part of or the whole year. Bronze and Platinum Plans excluded due to low enrollment (less than 200). All plans have an actuarial value (AV), which estimate the percent of health care costs the plan will cover for an average consumer; metal levels are assigned based off the plan AV. Platinum represents an AV of 90%, Gold 80%, Silver 70%, Expanded Bronze 65%, Bronze 60%, and Catastrophic <60%. Expanded Bronze plans introduced in 2018. Plans could be purchased from the state’s health insurance exchange, MNsure, or directly from a health plan or broker (off exchange).
- Source: MDH Health Economics Program analysis of the Minnesota All Payer Claims Database and National Association of Insurance Commissioner’s Health Plan Binders.
Page 23 - Per Person Out-of-Pocket Limits in the Individual Market, Select Years
This bar graph shows the per person distribution of out-of-pocket limits in the individual market from 2011 to 2021.
- 2011: Less than $1,200= 1.6%, $1,201 to $2,500= 18.0%, $2,501 to $4,500= 41.3%, $4,501 to $6,350 = 22.9%, $6,351+ = 16.3%
- 2013: Less than $1,200= 0.1%, $1,201 to $2,500= 14.4%, $2,501 to $4,500= 46.4%, $4,501 to $6,350 = 18.9%, $6,351+ = 20.2%
- 2014: Less than $1,200= 10.3%, $1,201 to $2,500= 22.1%, $2,501 to $4,500= 24.7%, $4,501 to $6,350 = 40.1%, $6,351+ = 2.8%
- 2019: Less than $1,350= 0.2%, $1,350 to $2,500= 0.1%, $2,501 to $4,500= 0.4%, $4,501 to $6,350 = 7.7%, $6,351 to $7,899 = 81.9%, $7,900= 9.8%
- 2020: Less than $1,400= 0.2%, $1,400 to $2,500= 0.1%, $2,501 to $4,500= 0.3%, $4,501 to $6,350 = 3.0%, $6,351 to $8,149 = 75.4%, $8,150= 21.1%
- 2021: Less than $1,400= 0.9%, $1,400 to $2,500= 0.2%, $2,501 to $4,500= 0.3%, $4,501 to $6,350 = 0.7%, $6,351 to $8,549 = 73.2%, $8,550= 24.8%
- Note: Distributions are by share of total enrollment. Out-of-pocket limit applies to covered services provided by in network providers only. Data from 2012 and 2015 to 2018 are not available.
- Source: MDH Health Economics Program analysis of the Minnesota All Payer Claims Database and National Association of Insurance Commissioner’s Health Plan Binders.
Page 24 – Family Level Annual Deductibles in the Individual Market, 2011 to 2021, Select Years
This bar graph shows the distribution of family level deductibles in the individual market from 2011 to 2021.
- 2011: $0 Deductible=0.0%, $1 to $5,000= 29.7%, $5,001 to $10,000= 44.7%, $10,000+ = 25.5%
- 2013: $0 Deductible=0.2%, $1 to $5,000= 22.1%, $5,001 to $10,000= 46.9%, $10,000+ = 30.9%
- 2014: $0 Deductible=4.3%, $1 to $5,000= 38.8%, $5,001 to $10,000= 30.1%, $10,000+ = 26.8%
- 2019: $0 Deductible=0.1%, $1 to $5,000= 21.4%, $5,001 to $10,000= 17.1%, $10,000+ = 61.4%
- 2020: $0 Deductible=0.1%, $1 to $5,000= 20.2%, $5,001 to $10,000= 18.8%, $10,000+ = 60.9%
- 2021: $0 Deductible=0.3%, $1 to $5,000= 20.6%, $5,001 to $10,000= 19.2%, $10,000+ = 60.0%
- Note: Deductibles cannot exceed maximum out of pocket limits set by the Center for Medicaid and Medicare Services (CMS). Max out of pocket limits were introduced in 2014 and apply to in-network coverage. Limits increase annually after 2014: 2014 – $12,700; 2019 – $15,800; 2020 – $16,300; 2021 - $17,100. Distributions are by share of total enrollment. Data from 2012 and 2015 to 2018 are not available.
- Source: MDH Health Economics Program analysis of the Small Group and Individual Market Survey (2011 to 2014), Minnesota All Payer Claims Database (2019 to 2021), and National Association of Insurance Commissioner’s Health Plan Binders (2019 to 2021).
Page 25 - Distribution of Family Level Deductibles in the Individual Market, 2019 to 2021
This slide shows a box plot of the averages and ranges of family level deductibles in the individual market from 2019 to 2021.
- 2019 Plans Offered: Average= $9.1K, Maximum= $15.8K, 75th Percentile= $13.5K, Median= $12.0K, 25th Percentile= $3.6K, Minimum= $0.4K
- 2019 Plans Chosen: Average= $10.2K, Maximum= $15.8K, 75th Percentile= $13.5K, Median= $12.4K, 25th Percentile= $6.0K, Minimum= $2.0K
- 2020 Plans Offered: Average= $9.5K, Maximum= $16.3K, 75th Percentile= $13.7K, Median= $12.0K, 25th Percentile= $4.1K, Minimum= $1.2K
- 2020 Plans Chosen: Average= $10.1K, Maximum= $16.3K, 75th Percentile= $13.5K, Median= $12.0K, 25th Percentile= $6.0K, Minimum= $1.8K
- 2021 Plans Offered: Average= $9.6K, Maximum= $17.1K, 75th Percentile= $13.9K, Median= $10.5K, 25th Percentile= $4.2K, Minimum= $1.3K
- 2021 Plans Chosen: Average= $10.2K, Maximum= $17.1K, 75th Percentile= $13.9K, Median= $12.5K, 25th Percentile= $6.0K, Minimum= $1.8K
- Note: Plans offered are health plans offered by insurance companies in the individual market; plans chosen are health plans offered in the individual market that have member month enrollment for part of or the whole year. Cost sharing reduction plans excluded for plans offered and plans chosen.
- Source: MDH Health Economics Program analysis of the Minnesota All Payer Claims Database and National Association of Insurance Commissioner’s Health Plan Binders.
Page 26 - Family Deductible Distribution for Metal Levels with Highest Enrollment, 2021
This slide shows family level deductible box plots of the averages and ranges for plans chosen and plans offered by metal level in the individual market, 2021.
- Catastrophic Plans Offered: Average= $17.1K Maximum= $17.1K, 75th Percentile= $17.1K, Median= $17.1K, 25th Percentile= $17.1K, Minimum= $17.1K
- Catastrophic Plans Chosen: Average= $17.1K, Maximum= $17.1K, 75th Percentile= $17.1K, Median= $17.1K, 25th Percentile= $17.1K, Minimum= $17.1K
- Expanded Bronze Plans Offered: Average= $13.0K, Maximum= $17.0K, 75th Percentile= $14.0K, Median= $14.0K, 25th Percentile= $13.4K, Minimum= $4.9K
- Expanded Bronze Plans Chosen: Average= $13.4K, Maximum= $14.4K, 75th Percentile= $14.0K Median= $13.8K, 25th Percentile= $12.5K, Minimum= $11.8K
- Silver Plans Offered: Average= $9.5K, Maximum= $17.0K, 75th Percentile= $12.6K, Median= $10.0K, 25th Percentile= $6.0K, Minimum= $4.2K
- Silver Plans Chosen: Average= $7.6K, Maximum= $12.6K, 75th Percentile= $9.6K, Median= $6.0K, 25th Percentile= $6.0K, Minimum= $4.2K
- Gold Plans Offered: Average= $3.7K, Maximum= $6.0K 75th Percentile= $4.2K, Median= $3.9K, 25th Percentile= $3.3K, Minimum= $1.2K
- Gold Plans Chosen: Average= $2.9K, Maximum= $4.2K, 75th Percentile= $4.2K, Median= $3.3K, 25th Percentile= $2.0K, Minimum= $1.8K
- Note: Cost sharing reduction plans excluded for plans offered and plans chosen. Plans offered are health plans offered by insurance companies in the individual market; plans chosen are health plans offered in the individual market that have member month enrollment for part of or the whole year. Bronze and Platinum Plans excluded due to low enrollment (less than 200). All plans have an actuarial value (AV), which estimate the percent of health care costs the plan will cover for an average consumer; metal levels are assigned based off the plan AV. Platinum represents an AV of 90%, Gold 80%, Silver 70%, Expanded Bronze 65%, Bronze 60%, and Catastrophic <60%. Expanded Bronze plans introduced in 2018. Plans could be purchased from the state’s health insurance exchange, MNsure, or directly from a health plan or broker (off exchange).
- Source: MDH Health Economics Program analysis of the Minnesota All Payer Claims Database and National Association of Insurance Commissioner’s Health Plan Binders.
Page 27 – Family Level Out-of-Pocket Limits in the Individual Market, Select Years
This bar graph shows the family level distribution of out-of-pocket limits in the individual market.
- 2009: Less than $2,500= 0.5%, $2,501 to $6,000= 57.2%, $6,001 to $9,000= 12.1%, $9,001 to $12,700 = 18.4%, Over $12,700 = 11.9%
- 2013: Less than $2,500= 0.2%, $2,501 to $6,000= 22.7%, $6,001 to $9,000= 33.3%, $9,001 to $12,700 = 19.1%, Over $12,700 = 24.8%
- 2014: Less than $2,500= 9.8%, $2,501 to $6,000= 27.2%, $6,001 to $9,000= 17.0%, $9,001 to $12,700 = 40.9%, Over $12,700 = 5.0%
- 2019: Less than $2,700= 0.2%, $2,700 to $6,000= 0.2%, $6,001 to $12,000= 4.2%, $12,001 to $15,799 = 85.6%, $15,800 = 9.8%
- 2020: Less than $2,800= 0.2%, $2,800 to $6,000= 0.1%, $6,001 to $12,000= 0.3%, $12,001 to $16,299 = 78.4%, $16,300 = 21.1%
- 2021: Less than $2,800= 0.8%, $2,801 to $6,000= 0.4%, $6,001 to $12,000= 0.1%, $12,001 to $17,099 = 73.8%, $17,100 = 24.8%
- Note: Distributions are by share of total enrollment. Out-of-pocket limit applies to covered services provided by in network providers only. Data from 2010 to 2012 and 2015 to 2018 are not available.
- Source: MDH Health Economics Program analysis of the Minnesota All Payer Claims Database and National Association of Insurance Commissioner’s Health Plan Binders.
Page 28 – Out of Network Deductible Limits for Individual and Family in the Individual Market
This bar graph shows the out of network deductible limit distribution for per person and family level in the individual market from 2019 to 2021.
- 2019:
- Individual Level: $0 Deductible= 0.2%, $1 to $5,000 Deductible= 6.4%, $5,001 to $10,000 Deductible = 6.5%, $10,001 to $15,000 Deductible = 41.2%, $15,001 to $20,000 Deductible = 45.8%
- Family Level: $0 Deductible= 0.2%, $1 to $10,000 Deductible= 6.3%, $10,001 to $20,000 Deductible = 6.6%, $20,001 to $30,000 Deductible = 41.2%, $30,001 to $40,000 Deductible = 45.8%
- 2020:
- Individual Level: $0 Deductible= 0.2%, $1 to $5,000 Deductible= 6.3%, $5,001 to $10,000 Deductible = 8.3%, $10,001 to $15,000 Deductible = 20.5%, $15,001 to $20,000 Deductible = 64.7%
- Family Level: $0 Deductible= 0.2%, $1 to $10,000 Deductible= 6.3%, $10,001 to $20,000 Deductible = 8.3%, $20,001 to $30,000 Deductible = 46.7%, $30,001 to $40,000 Deductible = 38.5%
- 2021:
- Individual Level: $0 Deductible= 0.2%, $1 to $5,000 Deductible= 6.7%, $5,001 to $10,000 Deductible = 8.6%, $10,001 to $15,000 Deductible = 24.1%, $15,001 to $20,000 Deductible = 60.5%
- Family Level: $0 Deductible= 0.2%, $1 to $10,000 Deductible= 6.7%, $10,001 to $20,000 Deductible = 8.7%, $20,001 to $30,000 Deductible = 48.6%, $30,001 to $40,000 Deductible = 35.9%
- Note: Distributions are by share of total enrollment.
- Source: MDH Health Economics Program analysis of the Minnesota All Payer Claims Database and National Association of Insurance Commissioner’s Health Plan Binder
Page 29 - Deductible Levels and Cost Sharing for Office Visits in the Individual Market, 2021
This bar graph shows cost sharing deductible levels by metal level in the individual market, 2021.
- Catastrophic:
- Cost Sharing: $0 Deductible= 0.0%, $1 to $2,500= 0.0%, $2,501 to $6,350= 0.0%, Over $6,350= 100.0%
- No Cost Sharing: $0 Deductible= 0.0%, $1 to $2,500= 0.0%, $2,501 to $6,350= 0.0%, Over $6,350= 0.0%
- Expanded Bronze:
- Cost Sharing: $0 Deductible= 0.0%, $1 to $2,500= 2.3%, $2,501 to $6,350= 61.3%, Over $6,350= 36.5%
- No Cost Sharing: $0 Deductible= 0.0%, $1 to $2,500= 0.0%, $2,501 to $6,350= 0.0%, Over $6,350= 100.0%
- Silver:
- Cost Sharing: $0 Deductible= 0.0%, $1 to $2,500= 1.3%, $2,501 to $6,350= 98.7%, Over $6,350= 0.0%
- No Cost Sharing: $0 Deductible= 0.0%, $1 to $2,500= 0.0%, $2,501 to $6,350= 100.0%, Over $6,350= 0.0%
- Gold:
- Cost Sharing: $0 Deductible= 0.0%, $1 to $2,500= 100.0%, $2,501 to $6,350= 0.0%, Over $6,350= 0.0%
- No Cost Sharing: $0 Deductible= 0.0%, $1 to $2,500= 0.0%, $2,501 to $6,350= 100.0%, Over $6,350= 0.0%
- Note: Cost sharing includes copayments and/or coinsurance. Cost sharing reduction plans excluded; Bronze and Platinum plans excluded due to low enrollment (less than 200/1%). Distributions are by share of total enrollment. All plans have an actuarial value (AV), which estimate the percent of health care costs the plan will cover for an average consumer; metal levels are assigned based off the plan AV. Platinum represents an AV of 90%, Gold 80%, Silver 70%, Expanded Bronze 65%, Bronze 60%, and Catastrophic <60%. Expanded Bronze plans introduced in 2018. Plans could be purchased from the state’s health insurance exchange, MNsure, or directly from a health plan or broker (off exchange).
- Source: MDH Health Economics Program analysis of the Minnesota All Payer Claims Database and National Association of Insurance Commissioner’s Health Plan Binders.
Page 30 - Cost Sharing Requirements for Office Visits in the Individual Market, 2019 to 2021
These graphs show the per person office visit cost sharing requirement in the individual market from 2019 to 2021.
- Coinsurance Only: 2019= 23.8%, 2020= 24.5%, 2021= 29.3%
- Copayment Only: 2019= 19.2%, 2020= 20.5%, 2021= 23.1%
- Copayment and Coinsurance: 2019= 28.1%, 2020= 25.0%, 2021= 16.1%
- No additional cost sharing aside from deductible and monthly premiums: 2019= 28.8%, 2020= 30.1%, 2021= 31.5%
- Note: Distributions are by share of total enrollment. Plans with only a deductible and no copayment and no coinsurance, as well as plans with no deductible and no cost sharing are included in “No Additional Cost Sharing Aside from Deductible”.
- Source: MDH Health Economics Program analysis of the Minnesota All Payer Claims Database and National Association of Insurance Commissioner’s Health Plan Binders.
Page 31 - Cost Sharing Requirements for Hospitalization in the Individual Market, 2019 to 2021
These graphs show the per person hospitalization cost sharing requirement in the individual market from 2019 to 2021.
- 1% to 10% Coinsurance: 2019= 0.1%, 2020= 0.1%, 2021= 0.3%
- 11% to 20% Coinsurance: 2019= 36.8%, 2020= 33.0%, 2021= 32.1%
- Greater than 20% Coinsurance= 2019= 31.5%, 2020= 33.7%, 2021= 33.2%
- Copayment Only: 2019= 0.0%, 2020= 0.0%, 2021= 0.0%
- No additional cost sharing aside from deductible and monthly premiums: 2019= 31.6%, 2020= 33.2%, 2021= 34.4%
- Note: Distributions are by share of total enrollment. Plans with only a deductible and no copayment and no coinsurance, as well as plans with no deductible and no cost sharing are included in “No Additional Cost Sharing Aside from Deductible”.
- Source: MDH Health Economics Program analysis of the Minnesota All Payer Claims Database and National Association of Insurance Commissioner’s Health Plan Binders.
Page 32 - Prescription Drug Cost Sharing in the Individual Market, 2019 to 2021
This graph shows prescription drug cost sharing by prescription tier in the individual market from 2019 to 2021.
- Generic Drugs:
- Copayment (no coinsurance): 2019= 48.9%, 2020= 48.3%, 2021= 49.2%
- Less than 20% Coinsurance: 2019= 16.7%, 2020= 16.4%, 2021= 13.1%
- More than 20% Coinsurance: 2019= 2.9%, 2020= 2.3%, 2021= 3.3%
- No Cost Sharing Aside from Deductible and Monthly Premiums: 2019= 31.6%, 2020= 33.0%, 2021= 34.3%
- Preferred Brand Drugs:
- Copayment (no coinsurance): 2019= 9.5%, 2020= 29.5%, 2021= 27.4%
- Less than 20% Coinsurance: 2019= 34.5%, 2020= 30.0%, 2021= 28.4%
- More than 20% Coinsurance: 2019= 24.3%, 2020= 7.3%, 2021= 9.9%
- No Cost Sharing Aside from Deductible and Monthly Premiums: 2019= 31.6%, 2020= 33.2%, 2021= 34.4%
- Specialty Drugs:
- Copayment (no coinsurance): 2019= 9.5%, 2020= 10.2%, 2021= 15.8%
- Less than 20% Coinsurance: 2019= 8.3%, 2020= 11.2%, 2021= 4.4%
- More than 20% Coinsurance: 2019= 50.5%, 2020= 45.5%, 2021= 46.2%
- No Cost Sharing Aside from Deductible and Monthly Premiums: 2019= 31.6%, 2020= 33.2%, 2021= 33.7%
- Note: Distributions are by share of total enrollment. Plans with only a deductible and no copayment and no coinsurance, as well as plans with a deductible and no cost sharing are included in “No Cost Sharing Aside from Deductible and Monthly Premiums”.
- Source: MDH Health Economics Program analysis of the Minnesota All Payer Claims Database and National Association of Insurance Commissioner’s Health Plan Binders.
Page 33 - Prescription Drug Copays in the Individual Market, 2019 to 2021
These graphs show prescription drug average copays by prescription drug tiers, 2019 to 2021.
- Generic Drugs: 2019= $21, 2020= $18, 2021= $18
- Preferred Brand Drugs: 2019= $108, 2020= $158, 2021= $162
- Specialty Drugs: 2019= $536, 2020= $544, 2021= $631
- Note: Distributions are by share of total enrollment. Some insurers and plans include a 4th “Non-preferred brand drugs” tier; “Non-preferred brand drugs” excluded for this analysis.
- Source: MDH Health Economics Program analysis of the Minnesota All Payer Claims Database and National Association of Insurance Commissioner’s Health Plan Binders.
Page 34 - Loss Ratio Experience in the Individual Market
This graph shows the loss ratios of plans in the individual market from 2011 to 2020.
- 2011:
- Total Market= 83%
- Blue Cross Blue Shield of Minnesota (BCBS, MN)= 80%
- Assurant= 71%
- HealthPartners= 85%
- PreferredOne= 66%
- Medica= 80%
- Statutory Minimum= 72%
- 2012:
- Total Market= 91%
- Blue Cross Blue Shield of Minnesota (BCBS, MN)= 94%
- Assurant= 74%
- HealthPartners= 87%
- PreferredOne= 68%
- Medica= 92%
- Statutory Minimum= 72%
- 2013:
- Total Market= 82%
- Blue Cross Blue Shield of Minnesota (BCBS, MN)= 78%
- Assurant= 75%
- HealthPartners= 90%
- PreferredOne= 71%
- Medica= 98%
- Statutory Minimum= 72%
- 2014:
- Total Market= 101%
- Blue Cross Blue Shield of Minnesota (BCBS, MN)= 105%
- Assurant= 67%
- HealthPartners= 102%
- PreferredOne= 94%
- Medica= 116%
- UCare= 158%
- Statutory Minimum= 72%
- 2015:
- Total Market= 116%
- Blue Cross Blue Shield of Minnesota (BCBS, MN)= 115%
- Assurant= 111%
- HealthPartners= 110%
- Medica= 114%
- UCare= 173%
- Statutory Minimum= 72%
- 2016:
- Total Market= 105%
- Blue Cross Blue Shield of Minnesota (BCBS, MN)= 105%
- HealthPartners= 109%
- Medica= 103%
- UCare= 74%
- Statutory Minimum= 72%
- 2017:
- Total Market= 75%
- Blue Cross Blue Shield of Minnesota (BCBS, MN)= 71%
- HealthPartners= 74%
- Medica= 82%
- PreferredOne = 46%
- UCare= 74%
- Statutory Minimum= 72%
- 2018
- Total Market= 63%
- Blue Cross Blue Shield of Minnesota (BCBS, MN)= 56%
- HealthPartners= 68%
- Medica= 65%
- PreferredOne = 62%
- UCare= 62%
- Statutory Minimum= 72%
- 2019
- Total Market= 85%
- Blue Cross Blue Shield of Minnesota (BCBS, MN)= 95%
- HealthPartners= 82%
- Medica= 83%
- PreferredOne = 91%
- UCare= 80%
- Statutory Minimum= 72%
- 2020
- Total Market= 84%
- Blue Cross Blue Shield of Minnesota (BCBS, MN)= 88%
- HealthPartners= 78%
- Medica= 89%
- PreferredOne = 97%
- UCare= 82%
- Statutory Minimum= 72%
- 2021
- Total Market= 95%
- Blue Cross Blue Shield of Minnesota (BCBS, MN)= 89%
- HealthPartners= 97%
- Medica= 90%
- PreferredOne = 102%
- UCare= 101%
- Statutory Minimum= 72%
- Note: Companies with common ownership have been combined for purposes of this analysis. BCBS, MN is Blue Cross Blue Shield of Minnesota. For PreferredOne, data was not available in 2015, and in 2016 the loss ratio was reported at 458 percent. UCare entered the individual market in 2014. Assurant left the individual market after 2015. “Statutory Minimum” refers to Minnesota’s minimum required share of premium dollars spent on beneficiary health expenditures, not the federal medical loss ratio provision of the Affordable Care Act. 458 percent. UCare entered the Individual Market in 2014. Assurant left the individual market after 2015.
- Source: Minnesota Department of Commerce, "Report of 2021 Loss Ratio Experience for Health Plan Companies" June 2021 and prior reports. Loss Ratios and statutory minimums presented are State Loss Ratios.
Page 36 - Enrollment Trends in Minnesota’s Small Group Health Insurance Market
This chart depicts the enrollment in Minnesota’s small group market from 2007 to 2021.
- 2007= 424,660
- 2008= 408,535
- 2009= 383,194
- 2010= 359,775
- 2011= 341,479
- 2012= 327,683
- 2013= 322,671
- 2014= 268,693
- 2015= 253,371
- 2016= 254,278
- 2017= 293,830
- 2018= 277,520
- 2019= 258,735
- 2020= 236,877
- 2021= 226,701
- Notes: Fully Insured market only.
- Source: MDH Health Economics Program; Health Plan Financial and Statistical Report (2007 to 2021).
Page 37 - Percent Change in Premiums Per Member in Minnesota’s Small Group Market
This chart depicts the premium per member changes in Minnesota’s small group market from 2007 to 2021.
- 2007= 5.2%
- 2008= 3.7%
- 2009= 5.3%
- 2010= 5.5%
- 2011= 0.4%
- 2012= 0.9%
- 2013= 0.8%
- 2014= 12.7%
- 2015=0.5%
- 2016= 2.2%
- 2017= 2.9%
- 2018= 12.3%
- 2019= 7.1%
- 2020= 3.7%
- 2021= 2.9%
- Note: Fully Insured market only.
- Source: MDH Health Economics Program; Health Plan Financial and Statistical Report (2007 to 2021). Based on total per member per year (PMPY) premiums collected.
Page 38 - Health Plan Market Shares: Small Group Market
This chart depicts the market shares in Minnesota’s small group market from 2017 to 2021.
- 2017 (Premium Volume= $1.5 billion): Blue Cross Blue Shield of MN=36.8%, Medica=10.2%, HealthPartners=40.8%, PreferredOne=9.5%, Other=2.7%
- 2018 (Premium Volume= $1.6 billion): Blue Cross Blue Shield of MN=33.8%, Medica=18.1%, HealthPartners=41.5%, PreferredOne=6.4%, Other=0.1%
- 2019 (Premium Volume= $1.5 billion): Blue Cross Blue Shield of MN=32.1%, Medica=21.0%, HealthPartners=40.2%, PreferredOne=6.0%, Other=0.7%
- 2020 (Premium Volume= $1.5 billion): Blue Cross Blue Shield of MN=33.7%, Medica=20.1%, HealthPartners=35.4%, PreferredOne=9.5%, Other=1.2%
- 2021 (Premium Volume= $1.5 billion): Blue Cross Blue Shield of MN=34.6%, Medica=18.9%, HealthPartners=32.3%, PreferredOne=12.5%, Other=1.7%
- Note: Some companies with common ownership have been combined for purposes of this analysis.
- Source: MDH Health Economics Program; Health Plan Financial and Statistical Report (2017 to 2021). Market share is based on percent of total premiums collected.
Page 39 - Distribution of Per Person Deductibles in the Small Group Market, 2005 to 2014
This bar graph shows the distribution of per person deductibles in the small group market from 2005 to 2014.
- 2005: No Deductible= 53.6%, $1 to $500= 29.1%, $501 to $1,250= 10.4%, $1,251 to $2,500= 6.2%, $2,501 to $4,000= 0.6%, Greater than $4,000= 0.1%
- 2007: No Deductible= 20.1%, $1 to $500= 15.5%, $501 to $1,250= 13.8%, $1,251 to $2,500= 39.9%, $2,501 to $4,000= 10.0%, Greater than $4,000= 0.8%
- 2009: No Deductible= 18.5%, $1 to $500= 18.3%, $501 to $1,250= 18.3%, $1,251 to $2,500= 29.7%, $2,501 to $4,000= 14.1%, Greater than $4,000= 1.2%
- 2011: No Deductible= 8.3%, $1 to $500= 17.2%, $501 to $1,250= 16.2%, $1,251 to $2,500= 31.6%, $2,501 to $4,000= 16.7%, Greater than $4,000= 10.0%
- 2013: No Deductible= 9.9%, $1 to $500= 14.3%, $501 to $1,250= 16.9%, $1,251 to $2,500= 37.8%, $2,501 to $4,000= 15.4%, Greater than $4,000= 5.8%
- 2014: No Deductible= 9.9%, $1 to $500= 16.7%, $501 to $1,250= 12.6%, $1,251 to $2,500= 30.1%, $2,501 to $4,000= 25.4%, Greater than $4,000= 5.2%
- Note: Distributions are by share of total enrollment. Data after 2014 are not currently available.
- Source: MDH Health Economics Program analysis of Small Group and Individual Market Survey.
Page 40 - Average and Range for Per Person Annual Deductibles in the Small Group Market, 2002 to 2014
- This slide shows a box plot of the averages and ranges of per person annual deductibles in the small group market from 2002 to 2014.
- 2002: Average= $505, Maximum= $2,500, 75th Percentile= $1,000, Median= $500, 25th Percentile= $300, Minimum= $100
- 2005: Average= $774, Maximum= $5,000, 75th Percentile= $1,750, Median= $1,000, 25th Percentile= $500, Minimum= $100
- 2007: Average= $1,612, Maximum= $10,000, 75th Percentile= $2,500, Median= $1,500, 25th Percentile= $750, Minimum= $250
- 2009: Average= $1,654, Maximum= $10,000, 75th Percentile= $2,500, Median= $1,500, 25th Percentile= $750, Minimum= $50
- 2011: Average= $1,845, Maximum= $10,000, 75th Percentile= $3,000, Median= $2,000, 25th Percentile= $1,000, Minimum= $300
- 2013: Average= $1,965, Maximum= $10,000, 75th Percentile= $3,000, Median= $2,000, 25th Percentile= $1,000, Minimum= $250
- 2014: Average= $1,987, Maximum= $10,000, 75th Percentile= $2,500, Median= $2,000, 25th Percentile= $1,250, Minimum= $250
- Note: Results exclude plans with a $0 deductible. Data after 2014 are not currently available.
- Source: MDH Health Economics Program analysis of Small Group and Individual Market Survey.
Page 41 - Distribution of Family Level Deductibles in the Small Group Market, 2005 to 2014
This bar graph shows the distribution of family level deductibles, by share of enrollment, in the small group market from 2005 to 2014.
- 2005: No Deductible= 53.6%, $1 to $500= 1.7%, $501 to $1,250= 27.3%, $1,251 to $2,500= 10.5%, $2,501 to $4,000= 4.6%, $4,001 to $6,350= 2.3%, $6,351 to $12,700= 0.1%, Greater than $12,700= 0.0%
- 2007: No Deductible= 31.9%, $1 to $500= 0.1%, $501 to $1,250= 21.3%, $1,251 to $2,500= 16.8%, $2,501 to $4,000= 16.5%, $4,001 to $6,350= 13.0%, $6,351 to $12,700= 0.5%, Greater than $12,700= 0.0%
- 2009: No Deductible= 18.5%, $1 to $500= 0.1%, $501 to $1,250= 14.3%, $1,251 to $2,500= 19.4%, $2,501 to $4,000= 18.1%, $4,001 to $6,350= 27.4%, $6,351 to $12,700= 2.3%, Greater than $12,700= 0.0%
- 2011: No Deductible= 8.3%, $1 to $500= 0.0%, $501 to $1,250= 10.4%, $1,251 to $2,500= 16.9%, $2,501 to $4,000= 19.6%, $4,001 to $6,350= 29.1%, $6,351 to $12,700= 9.1%, Greater than $12,700= 6.5%
- 2013: No Deductible= 7.6%, $1 to $500= 0.0%, $501 to $1,250= 8.5%, $1,251 to $2,500= 17.6%, $2,501 to $4,000= 23.7%, $4,001 to $6,350= 24.3%, $6,351 to $12,700= 18.2%, Greater than $12,700= 0.2%
- 2014: No Deductible= 9.9%, $1 to $500= 0.0%, $501 to $1,250= 6.1%, $1,251 to $2,500= 17.5%, $2,501 to $4,000= 27.2%, $4,001 to $6,350= 25.4%, $6,351 to $12,700= 10.7%, Greater than $12,700= 3.3%
- Note: Distributions are by share of total enrollment. Data after 2014 are not currently available.
- Source: MDH Health Economics Program analysis of Small Group and Individual Market Survey.
Page 42 - Distribution of Family Level Annual Deductibles in the Small Group Market, 2002 to 2014
This slide shows a box plot of the averages and ranges of family level deductibles in the small group market from 2002 to 2014.
- 2002: Average= $1,169, Maximum= $5,000, 75th Percentile= $2,000, Median= $1,100, 25th Percentile= $900, Minimum= $200
- 2005: Average= $1,595, Maximum= $10,000, 75th Percentile= $3,500, Median= $2,000, 25th Percentile= $1,000, Minimum= $200
- 2007: Average= $2,727, Maximum= $20,000, 75th Percentile= $5,000, Median= $3,000, 25th Percentile= $1,500, Minimum= $500
- 2009: Average= $3,445, Maximum= $20,000, 75th Percentile= $5,000, Median= $3,000, 25th Percentile= $2,000, Minimum= $100
- 2011: Average= $3,980, Maximum= $20,000, 75th Percentile= $6,000, Median= $4,200, 25th Percentile= $2,500, Minimum= $500
- 2013: Average= $4,226, Maximum= $30,000, 75th Percentile= $6,000, Median= $4,500, 25th Percentile= $2,500, Minimum= $500
- 2014: Average= $4,216, Maximum= $20,000, 75th Percentile= $5,500, Median= $4,000, 25th Percentile= $2,500, Minimum= $500
- Note: Results exclude plans with a $0 deductible. Data after 2014 are not currently available.
- Source: MDH Health Economics Program analysis of Small Group and Individual Market Survey
Page 43- Distribution of Deductibles in the Small Group Market, 2014
This chart depicts the distribution of per person and family deductibles in the small group market in 2014.
- Individual:
- No Deductible= 9.9%
- $1 to $500= 16.7%
- $501 to $1,250= 12.6%
- $1,251 to $2,500= 30.1%
- $2,501 to $4,000= 25.4%
- $4,001 to $6,350= 4.7%
- $6,351 to $12,700= 0.0%
- Greater than $12,700= 0.5%
- Family:
- No Deductible= 9.9%
- $1 to $500= 0.0%
- $501 to $1,250= 6.1%
- $1,251 to $2,500= 17.5%
- $2,501 to $4,000= 27.2%
- $4,001 to $6,350= 25.4%
- $6,351 to $12,700= 10.7%
- Greater than $12,700= 3.3%
- Note: Distributions are by share of total enrollment. No Individual plans had a deductible between $6,351 and $12,700; no family plans had a deductible between $1 and $500. Data after 2014 are not currently available.
- Source: MDH Health Economics Program analysis of Small Group and Individual Market Survey.
Page 44 - Small Group Market Enrollment in High Deductible Health Plans with HSA Eligibility, 2005 to 2014
This graph shows the percentage of small group enrollment in high deductible health plans with health savings account eligibility from 2005 to 2014.
- 2005= 2.6%
- 2007= 25.5%
- 2009= 43.3%
- 2011= 44.9%
- 2013= 41.2%
- 2014= 48.3%
- Note: By share of total enrollment. HSA is Health Savings Account. This is the percent of plans that are Qualified High Deductible Health Plans (HDHP), as determined by the Internal Revenue Service (for 2014 the minimum deductible is $1,250), and have the option to be paired with an HSA. The proportion of people with an HSA is unknown. Prior to 2006, HSAs and similar options were rare. In the 2009 survey, firms did not reliably report on HSA pairing, therefore the portion of HDHP plans was determined using only the IRS minimum deductible guideline. In 2011, the plans identified whether it was a HDHP plan. This difference in reporting methodology may be reflected in the 2011 total. Data after 2014 are not currently available.
- Source: MDH Health Economics Program analysis of Small Group and Individual Market Survey.
Page 45 - Comparison of Individual Out-of-Pocket Maximums by High Deductible Health Plan Enrollment, Small Group Market, 2009-2014
This slide shows a box plot comparing of individual out-of-pocket maximums between those in high deductible health plans and those in non-high deductible health plans in the small group market from 2009 to 2014.
- High-Deductible Health Plan:
- 2009: Average= $2,709, Maximum= $7,500, 75th Percentile= $3,500, Median= $2,750, 25th Percentile= $2,000, Minimum= $1,000
- 2011: Average= $3,700, Maximum= $9,500, 75th Percentile= $4,500, Median= $3,500, 25th Percentile= $2,500, Minimum= $1,200
- 2013: Average= $3,621, Maximum= $6,250, 75th Percentile= $4,750, Median= $3,500, 25th Percentile= $2,500, Minimum= $1,200
- 2014: Average= $4,162, Maximum= $6,350, 75th Percentile= $6,000, Median= $4,000, 25th Percentile= $2,750, Minimum= $1,500
- Non-High Deductible Health Plan:
- 2009: Average= $2,728, Maximum= $12,000, 75th Percentile= $3,250, Median= $2,500, 25th Percentile= $1,800, Minimum= $0
- 2011: Average= $3,373, Maximum= $12,000, 75th Percentile= $4,000, Median= $3,000, 25th Percentile= $2,500, Minimum= $1,300
- 2013: Average= $3,554, Maximum= $15,000, 75th Percentile= $4,250, Median= $3,500, 25th Percentile= $2,750, Minimum= $1,000
- 2014: Average= $3,798, Maximum= $7,000, 75th Percentile= $5,350, Median= $3,500, 25th Percentile= $2,500, Minimum= $750
- Note: HDHPs include plans with individual deductibles over $1,250; these plans may or may not be paired with a Health Savings Account (HSA) option. To be considered an HDHP for IRS purposes, a plan must have an HAS option. Data after 2014 are not currently available.
- Source: MDH Health Economics Program analysis of Small Group and Individual Market Survey.
Page 47 - Portion of Small Group Market Enrollees with Deductibles over $1,250, 2014
This chart depicts the portion of small group market enrollees with deductibles less than and greater than $1,250 in 2014.
- Over $1,250= 61.1%
- Less than $1,250= 38.9%
- Note: The minimum deductible in the IRS definition of High Deductible Health Plan (HDHP) was $1,250 in 2014 for an individual plan. Not all plans with deductibles over this amount are classified HDHP by the IRS because they do not meet other requirements for the HDHP designation. This slide shows all enrollees with a deductible burden that meets the IRS minimum requirement regardless of whether or not they meet other HDHP criteria. Data after 2014 are not currently available.
- Source: MDH Health Economics Program analysis of Small Group and Individual Market Survey.
Page 49 - Distribution of Office Visit Copayments in the Small Group Market, 2005 to 2014
This graph shows the distribution of office visit copayments in the small group market from 2005 to 2014.
- 2005: $10= 16.5%, $15= 50.3%, $20= 12.9%, $25= 11.6%, $30+= 8.8%
- 2007: $10= 0.0%, $15= 26.1%, $20= 14.9%, $25= 40.0%, $30+= 19.0%
- 2009: $10= 0.0%, $15= 14.0%, $20= 4.3%, $25= 53.3%, $30+= 28.3%
- 2011: $10= 0.0%, $15= 1.9%, $20= 0.5%, $25= 39.5%, $30+= 58.1%
- 2013: $10= 0.0%, $15= 0.7%, $20= 0.8%, $25= 30.4%, $30+= 68.0%
- 2014: $10= 0.0%, $15= 0.5%, $20= 0.0%, $25= 35.1%, $30+= 64.5%
- Note: Distributions are by share of total enrollment. Includes only enrollees who have an office visit copayment. Data after 2014 are not currently available.
- Source: MDH Health Economics Program analysis of Small Group and Individual Market Survey.
Page 50 – Deductibles and Cost Sharing for Office Visits in the Small Group Market, 2014
This graph shows the per person deductible levels in plans with and without cost sharing for office visits in 2014.
- Under $1,000: No Cost Sharing= 4.2%, Cost Sharing= 42.8%
- $1,000 to $1,999: No Cost Sharing= 19.4%, Cost Sharing= 26.4%
- $2,000 to $2,999: No Cost Sharing= 35.3%, Cost Sharing= 16.7%
- $3,000 to $3,999: No Cost Sharing= 34.4%, Cost Sharing= 8.0%
- $4,000 or more: No Cost Sharing= 6.7%, Cost Sharing= 6.1%
- Note: Distributions are by share of total enrollment. Data after 2014 are not currently available.
- Source: MDH Health Economics Program analysis of Small Group and Individual Market Survey.
Page 52 - Per Person Out-of-Pocket Limits in the Small Group Market, 2005 to 2014
This chart depicts the per person out-of-pocket limits in the small group market from 2005 to 2014.
- 2005: Less than $1,500= 47.4%, $1,500 to $1,999= 11.9%, $2,000 to $2,999= 28.7%, $3,000+= 12.1%
- 2007: Less than $1,500= 11.4%, $1,500 to $1,999= 37.1%, $2,000 to $2,999= 38.0%, $3,000+= 13.5%
- 2009: Less than $1,500= 8.6%, $1,500 to $1,999= 26.7%, $2,000 to $2,999= 34.8%, $3,000+= 29.9%
- 2011: Less than $1,500= 2.6%, $1,500 to $1,999= 18.4%, $2,000 to $2,999= 33.4%, $3,000+= 45.6%
- 2013: Less than $1,500= 1.0%, $1,500 to $1,999= 11.1%, $2,000 to $2,999= 28.2%, $3,000+= 59.7%
- 2014: Less than $1,500= 0.5%, $1,500 to $1,999= 7.3%, $2,000 to $2,999= 20.5%, $3,000+= 71.8%
- Note: Distributions are by share of total enrollment. Out-of-pocket limit applies to covered services only. Data after 2014 are not currently available.
- Source: MDH Health Economics Program analysis of Small Group and Individual Market Survey.
Page 53 - Family Level Out-of-Pocket Limits in the Small Group Market, 2002 to 2014
This graph shows the family level out-of-pocket limits in the small group market from 2002 to 2014.
- 2002: Less than $2,500= 2.6%, $2,500 to $4,999= 44.6%, $5,000 to $7,499= 36.2%, $7,500 to $9,999= 0.4%, $10,000+= 16.3%
- 2005: Less than $2,500= 0.7%, $2,500 to $4,999= 23.8%, $5,000 to $7, 499= 57.6%, $7,500 to $9,999= 8.3%, $10,000+= 9.5%
- 2007: Less than $2,500= 7.8%, $2,500 to $4,999= 20.4%, $5,000 to $7, 499= 68.3%, $7,500 to $9,999= 2.8%, $10,000+= 0.8%
- 2009: Less than $2,500= 7.8%, $2,500 to $4,999= 20.8%, $5,000 to $7, 499= 60.8%, $7,500 to $9,999= 4.7%, $10,000+= 6.0%
- 2013: Less than $2,500= 0.9%, $2,500 to $4,999= 17.0%, $5,000 to $7, 499= 48.7%, $7,500 to $9,999= 23.4%, $10,000+= 10.0%
- 2014: Less than $2,500= 0.4%, $2,500 to $4,999= 13.1%, $5,000 to $7, 499= 35.1%, $7,500 to $9,999= 24.8%, $10,000+= 26.6%
- Note: Distributions are by share of total enrollment. Out-of-pocket limit applies to covered services only. This data was not collected in 2011. Data after 2014 are not currently available.
- Source: MDH Health Economics Program analysis of Small Group and Individual Market Survey.
Page 54 - Number of Tiers for Prescription Drug Cost Sharing in the Small Group Market, 2011 to 2014
This graph shows the number of tiers for prescription drug copayments or coinsurance, by share of total enrollment, in the small group market from 2011 to 2014.
- 2011: 1 Tier= 15.7%, 2 Tiers= 2.0%, 3 Tiers= 29.5%, 4 Tiers= 52.8%
- 2013: 1 Tier= 10.7%, 2 Tiers= 0.0%, 3 Tiers= 32.7%, 4 Tiers= 56.6%
- 2014: 1 Tier= 0.0%, 2 Tiers= 0.0%, 3 Tiers= 21.4%, 4 Tiers= 78.6%
- Note: Distributions are by share of total enrollment. If a value is not shown, no plans had that many prescription drug cost sharing tiers. Cost sharing includes copayments and coinsurance only. Number of tiers for prescription drugs was not collected before 2011. Data after 2014 are not currently available.
- Source: MDH Health Economics Program analysis of Small Group and Individual Market Survey.
Page 56 - Lifetime Limit on Benefits in the Small Group Market, 2002 to 2011
This graph shows the lifetime limits on benefits in the small group market from 2002 to 2011.
- 2002: Less than $2 million= 6.2%, $2 to $4 million= 40.8%, $4 to $6 million= 1.9%, Unlimited= 51.2%
- 2005: Less than $2 million= 0.9%, $2 to $4 million= 39.3%, $4 to $6 million= 0.4%, Unlimited= 59.3%
- 2007: Less than $2 million= 0.2%, $2 to $4 million= 3.9%, $4 to $6 million= 70.7%, Unlimited= 25.2%
- 2009: Less than $2 million= 3.2%, $2 to $4 million= 5.6%, $4 to $6 million= 83.3%, Unlimited= 8.0%
- 2011: Less than $2 million= 0.0%, $2 to $4 million= 0.0%, $4 to $6 million= 0.0%, Unlimited= 100.
- Note: Distributions are by share of total enrollment. After 2011, no plans had a lifetime limit.
- Source: MDH Health Economics Program analysis of Small Group and Individual Market Survey.
Page 57 - Loss Ratio Experience in the Small Group Market
This graph shows the loss ratios of plans in the small group market from 2011 to 2020.
- 2011:
- Total Market= 80%
- Blue Cross Blue Shield of Minnesota (BCBS, MN)= 81%
- Medica= 80%
- HealthPartners= 79%
- PreferredOne= 87%
- Statutory Minimum= 82%
- 2012:
- Total Market= 84%
- Blue Cross Blue Shield of Minnesota (BCBS, MN)= 87%
- Medica= 86%
- HealthPartners= 79%
- PreferredOne= 92%
- Statutory Minimum= 82%
- 2013:
- Total Market= 87%
- Blue Cross Blue Shield of Minnesota (BCBS, MN)= 86%
- Medica= 89%
- HealthPartners= 86%
- PreferredOne= 95%
- Statutory Minimum= 82%
- 2014:
- Total Market= 83%
- Blue Cross Blue Shield of Minnesota (BCBS, MN)= 80%
- Medica= 83%
- HealthPartners= 87%
- PreferredOne= 94%
- Statutory Minimum= 82%
- 2015:
- Total Market= 84%
- Blue Cross Blue Shield of Minnesota (BCBS, MN)= 80%
- Medica= 86%
- HealthPartners= 87%
- PreferredOne= 87%
- Statutory Minimum= 82%
- 2016:
- Total Market= 88%
- Blue Cross Blue Shield of Minnesota (BCBS, MN)= 87%
- Medica= 79%
- HealthPartners= 89%
- PreferredOne= 94%
- Statutory Minimum= 82%
- 2017:
- Total Market= 89%
- Blue Cross Blue Shield of Minnesota (BCBS, MN)= 85%
- Medica= 87%
- HealthPartners= 93%
- PreferredOne= 95%
- Statutory Minimum= 82%
- 2018:
- Total Market= 85%
- Blue Cross Blue Shield of Minnesota (BCBS, MN)= 82%
- Medica= 90%
- HealthPartners= 84%
- PreferredOne= 95%
- Statutory Minimum= 82%
- 2019:
- Total Market= 86%
- Blue Cross Blue Shield of Minnesota (BCBS, MN)= 88%
- Medica= 86%
- HealthPartners= 83%
- PreferredOne= 90%
- Statutory Minimum= 82%
- 2020:
- Total Market= 82%
- Blue Cross Blue Shield of Minnesota (BCBS, MN)= 78%
- Medica= 85%
- HealthPartners= 82%
- PreferredOne= 88%
- Statutory Minimum= 82%
- 2021:
- Total Market= 91%
- Blue Cross Blue Shield of Minnesota (BCBS, MN)= 89%
- Medica= 85%
- HealthPartners= 95%
- PreferredOne= 102%
- Statutory Minimum= 82%
- Note: Companies with common ownership have been combined for purposes of this analysis. BCBS, MN is Blue Cross Blue Shield of Minnesota.
- Source: Minnesota Department of Commerce, "Report of 2020 Loss Ratio Experience for Health Plan Companies" June 1, 2021 and prior reports. Not all companies listed in the loss ratio report are illustrated. “Statutory Minimum” refers to Minnesota’s minimum required share of premium dollars spent on beneficiary health expenditures, not the federal medical loss ratio provision of the Affordable Care Act.
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