Minnesota’s Small Group Market Select Statistics Health Care Access Commission Small Group Insurance Market Work Group September 23, 2010 Stefan Gildemeister Assistant Director, Health Economics Program
Feb 02, 2016
Minnesota’s Small Group MarketSelect Statistics
Health Care Access CommissionSmall Group Insurance Market Work Group
September 23, 2010
Stefan GildemeisterAssistant Director, Health Economics Program
Overview
• Coverage distribution in Minnesota
• Statistics on employer-based coverage, comparing small and large firms
• Trends in health plan benefits in the small group market
• Health plan market shares and loss ratios
Size of Small Group Market
Distribution of Minnesota Population by Primary Source of Insurance Coverage, 2008
Uninsured7.3%
MA, GAMC, MNCare11.1%
Medicare14.4%
Individual4.8%
MCHA0.5%
Job-based coverage
61.9%
Source: MDH Health Economics Program; population estimates are from the U.S. Bureau of Census, July 2009MA is Medical Assistance, MNCare is MinnesotaCare, GAMC is General Assistance Medical Care
Total Population 5.2 Million
Distribution of Minnesota Population by Primary Source of Insurance Coverage, 2008
Uninsured7.3%
MA, GAMC, MNCare11.1%
Medicare14.4%
Individual4.8%
MCHA0.5%
Small Group7.8%
Large Group54.1%
Source: MDH Health Economics Program; population estimates are from the U.S. Bureau of Census, July 2009MA is Medical Assistance, MNCare is MinnesotaCare, GAMC is General Assistance Medical Care
Total Population 5.2 Million
Enrollment in Small Group and Individual Health Plans as a Share of the Population
4.5% 4.3% 4.1% 3.9% 3.8% 4.0%4.4% 4.6% 4.7% 4.7% 4.8%
9.4% 9.6% 9.8% 9.9%9.4%
9.0% 8.9% 8.8%8.5%
8.2%7.8%
0.0%
2.0%
4.0%
6.0%
8.0%
10.0%
12.0%
1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008
Individual
Small Group
450,230483,665 469,474
449,890 437,493408,535
0
100,000
200,000
300,000
400,000
500,000
600,000
1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008
Fully Insured market only.Source: MDH, Health Economics Program; estimates based on data from various sources.
Trends in Minnesota Small Group Health Insurance Enrollment, 1998 to 2008
Characteristics of Small Firms
Trend in the Number of Establishments, by Firm Size
0
20,000
40,000
60,000
80,000
100,000
1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008
Nbr of Establishments in Firms 2 to 50 Number of Establishments in Firms 51 to 100
Source: Minnesota Department of Employment and Economic Development, Quarterly Census of Employee and Wages
Trend in the Number of Employees, by Firm Size
0
100,000
200,000
300,000
400,000
500,000
600,000
700,000
800,000
1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008
Nbr of Employees in Firms 2 to 50 Number of Employees in Firms 51 to 100
Source: Minnesota Department of Employment and Economic Development, Quarterly Census of Employee and Wages
Percent of Minnesota Employers Offering Health Insurance Coverage, by Firm Size (1996/97 & 2008/09)
87.7%
52.2%
94.5%
42.8%
54.5%
97.3%
79.5%
41.3%
0%
20%
40%
60%
80%
100%
1 to 49 50 to 99 100+ All Firms
Number of Employees in Firm
1996/97
2008/09
Source: MDH analysis of data for private employers from the Medical Expenditure Panel Survey/Insurance Component (years are pooled to improve the statistical validity of the estimates.
Preliminary data; difference between estimates have not been tested for statistical significance.
Percent of Employees in Minnesota Establishments Offering Health Insurance Coverage, by Firm Size (1996/97 & 2008/09)
67.4%
92.1%87.7%
98.0%
87.7%
98.1%
89.2%
61.2%
0%
20%
40%
60%
80%
100%
1 to 49 50 to 99 100+ All Firms
Number of Employees in Firm
1996/97
2008/09
Source: MDH analysis of data for private employers from the Medical Expenditure Panel Survey/Insurance Component (years are pooled to improve the statistical validity of the estimates.
Preliminary data; difference between estimates have not been tested for statistical significance.
Percent of Employees Eligible for Health Insurance in Firms Offering Coverage, by Firm Size (1996/97 & 2008/09)
80.9% 77.4% 79.6% 79.8%75.5% 78.6%80.2%
68.9%
0%
20%
40%
60%
80%
100%
1 to 49 50 to 99 100+ All Firms
Number of Employees in Firm
1996/97
2008/09
Source: MDH analysis of data for private employers from the Medical Expenditure Panel Survey/Insurance Component (years are pooled to improve the statistical validity of the estimates.
Preliminary data; difference between estimates have not been tested for statistical significance.
Percent of Eligible Employees Who Enroll in Coverage (Take-up Rate), by Firm Size (1996/97 & 2008/09)
86.5% 84.7%76.1%
82.6%78.1%77.9%74.9%
79.9%
0%
20%
40%
60%
80%
100%
1 to 49 50 to 99 100+ All Firms
Number of Employees in Firm
1996/97
2008/09
Source: MDH analysis of data for private employers from the Medical Expenditure Panel Survey/Insurance Component (years are pooled to improve the statistical validity of the estimates.
Preliminary data; difference between estimates have not been tested for statistical significance.
Average Annual Health Insurance Premium in MN for Family Coverage, by Firm Size
$4,588 $4,982 $5,208 $5,067
$11,231
$13,375 $13,910 $13,426
0
5,000
10,000
15,000
20,000
1 to 49 50 to 99 100+ All Firms
Number of Employees in Firm
1996/97
2008/09
Source: MDH analysis of data for private employers from the Medical Expenditure Panel Survey/Insurance Component (years are pooled to improve the statistical validity of the estimates.
Preliminary data; difference between estimates have not been tested for statistical significance.
Average Employee Contribution to Family Coverage, by Firm Size (1996/97 & 2008/09)
24.2%23.1%
31.5%
26.6% 26.0%23.9%
31.2%35.4%
0%
10%
20%
30%
40%
50%
1 to 49 50 to 99 100+ All Firms
Number of Employees in Firm
Source: MDH analysis of data for private employers from the Medical Expenditure Panel Survey/Insurance Component (years are pooled to improve the statistical validity of the estimates.
Preliminary data; difference between estimates have not been tested for statistical significance.
Trends in Small Group Health Plan Benefits
Distribution of Family Level Deductibles in the Small Group Market, 2002 to 2008
45.6%34.2%
13.7%
34.9%
35.3%
23.1%
18.9%
21.5%
30.1%
9.0%
33.3%
0.9%
0%
20%
40%
60%
80%
100%
2002 2005 2008
Pe
rce
nt
of
En
rollm
en
t
Less than $1,000 $1,000 to $1,999 $2,000 to $3,999 $4,000 or higher
Source: MDH, Health Economics ProgramDeductible levels are per family. Distribution of deductibles only includes enrollment in plans with a deductible
Small Group Market Enrollment in High Deductible Health Plans with Savings Option, 2005 and 2008(by share of total enrollment)
3.6%
24.4%
0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
2005 2008
Qualified High Deductible Health Plan enrollment must meet the minimum deductible guidelines for the calendar year, as determined by the Internal Revenue Service (for 2008 the minimum deductible is $1,100), and be paired with (or have the option to pair with) a Health Savings Account.Source: MDH, Health Economics Program
Distribution of Office Visit Copayments in the Small Group Market, 2002 to 2008(by share of enrollment)
Source: MDH, Health Economics ProgramIncludes only enrollees who have an office visit copayment.
7.2%
75.5%
11.2%
6.1%
34.6%
14.9%
59.0%
7.0%2.9%
55.5%
0.0%
26.1%
0%
20%
40%
60%
80%
$10 $15 $20 $25 or more
2002 2005 2008
Family Level Out-of-Pocket Limits in the Small Group Market, 2002 to 2008(by share of total enrollment)
Source: MDH, Health Economics ProgramMedian calculation and distribution excludes enrollees with no out-of-pocket limit. Out-of-pocket limit applies to covered services only.
45.9%
20.7%13.2%
15.7%
15.6%9.7% 6.8%
64.4%
66.4%
37.6%
3.2%0.9%
0%
20%
40%
60%
80%
100%
2002 2005 2008
Less than $4,000 $4,000 to $5,999 $6,000 or more Family Size Dependent
Lifetime Limit on Benefits in the Small Group Market, 2002-2008(by share of total enrollment)
Limits on lifetime benefits define the maximum amount an insurance policy will pay over the life of a policy holder. Source: MDH, Health Economics Program
6.2% 0.2%0.9%
3.9%
40.6%40.8%
70.7%1.2%
1.8%
51.2%
25.2%
57.3%
0%
20%
40%
60%
80%
100%
2002 2005 2008
$2 Million or Less $3 Million $5 Million Unlimited
Market Shares in the Small Group Insurance Market
Health Plan Market Shares: Small Group Market, 2008
45.6%
27.2%
19.8%
3.2% 3.2%0.4% 0.2% 0.4%
0%
10%
20%
30%
40%
50%
Blue Cross BlueShield of MN
Medica HealthPartners PreferredOne FederatedMutual Ins. Co.
Time Ins. Co.(formerly Fortis)
Principal LifeIns. Co.
Other (3companies)
Note: Companies with common ownership were treated as one entity. For example, Blue Cross Blue Shield of MN includes Blue Cross Blue Shield of Minnesota and Blue Plus. Market shares based on premium volume; fully insured market only. Source: Minnesota Department of Commerce, "Report of 2008 Loss Ratio Experience in the Individual and Small Employer Health Plan Markets for: Insurance Companies Nonprofit Health Service Plan Corporations and Health Maintenance Organizations," August 2009.
Total Premium Volume in 2008: $1.54 Billion
Loss Ratio Experience in the Small Group Market, 1998 to 2008
0%
20%
40%
60%
80%
100%
1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008
Total Market BCBSM Medica HealthPartners
Statutory minimum for large companies
Note: Companies with common ownership have been combined for purposes of this analysis. Source: Minnesota Department of Commerce, "Report of 2008 Loss Ratio Experience in the Individual and Small Employer Health Plan Markets for: Insurance Companies, Nonprofit Health Service Plan Corporations, and Health Maintenance Organizations ," August 2009.
Contact Information
• Stefan Gildemeister(651) [email protected]
• www.health.state.mn.us/healtheconomics
• https://pqc.health.state.mn.us/mnha/Welcome.action