April 28, 2022
Based on data filed in statutory financial reports from the NAIC (National Association of Insurance Commissioners), the CA DMHC (California Department of Managed Health Care), CMS (Centers for Medicare and Medicaid Services) and various state agencies, approximately 305 million people received medical coverage from U.S. health insurers as of December 31, 2021. This number is up from 297.5 million, or approximately 7.6 million additional members, from a year ago. Between 4Q20 and 4Q21, membership growth was significant in Medicare Advantage as this segment gained approximately 1.5 million more members. In addition, the individual health insurance market and Managed Medicaid also experienced marked membership increases. The Employer-group ASO (administrative services only for self-funded plans) and Employer-group risk segments provide the largest sources of coverage in the industry, however, these segments combined continued to demonstrate year-over-year declines in enrollment. In this brief, Mark Farrah Associates (MFA) assesses the latest year-over-year enrollment trends, comparing fourth quarter 2020 with fourth quarter 2021 segment membership.
About the Data
The data used in this analysis brief was obtained from Mark Farrah Associates' Health Coverage Portal™ database. It is important to note that MFA estimated fourth quarter 2021 enrollment for a small number of health plans that are required to report quarterly enrollment but hadn’t yet filed. Employer group ASO figures may be estimated by Mark Farrah Associates using credible company and industry resources. Individual, Non-group membership reported by some carriers may include CHIP (Children’s Health Insurance Program). These adjustments may have resulted in moderate understatement or overstatement of enrollment changes by segment. Findings reflect enrollment reported by carriers with business in the U.S. and U.S. territories. Data sources include NAIC (National Association of Insurance Commissioners), the CA DMHC (California Department of Managed Health Care), CMS (Centers for Medicare and Medicaid Services) and various state agencies.
Market analysts throughout the industry rely on enrollment data and segment performance metrics to gain better insights into health plan market share and competitive positioning. As always, MFA will continue to report on important plan performance and competitive shifts across all segments.
About Mark Farrah Associates (MFA)
Mark Farrah Associates (MFA) is a leading data aggregator and publisher providing health plan market data and analysis tools for the healthcare industry. Our product portfolio includes Health Coverage Portal™, County Health Coverage™, Medicare Business Online™, Medicare Benefits Analyzer™, 5500 Employer Health PLUS, and Health Plans USA™. For more information about these products, refer to the informational videos and brochures available under the Our Products section of the website or call 724-338-4100.
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