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Market Snapshot - Small Group Health

Company (State of Domicile) NAIC# Number Insured Market Share
  12/31/10 12/31/11 12/31/10 12/31/11
HMO (Including Standardized and POS):
HMO Maine (Anthem BC/BS) (Maine)1 52618 9,291 4,668 9% 5%
Harvard Pilgrim (MA) 96911 5,954 4,824 6% 5%
Aetna Health (Maine) 95517 1,268 941 1% 1%
Subtotal 16,513 10,433 17% 11%
Indemnity (Including Standardized) and PPO:
Aetna Life (CT) 60054 29,916 25,411 30% 27%
Anthem BC/BS (Maine) - PPO 52618 41,478 42,946 42% 46%
HPHC (MA) 18975 7,438 12,196 8% 13%
MEGA Life & Health (OK) 97055 1,560 1,351 2% 1%
Excellus (NY) 551072 1,213 1,155 1% 1%
United Healthcare (CT) 79413 284 554 0% 1%
HM Life (PA) 93440 206 156 0% 0%
Guardian (NY) 64246 139 124 0% 0%
John Alden (MN) 65080 6 0 0% 0%
Transamerica Life (IA) 79413 3 3 0% 0%
Subtotal 82,243 83,896 83% 89%
Total 98,756 94,329 100% 100%
1 HMO Maine is a line of business of Anthem Blue Cross and Blue Shield.
2 Excellus is not licensed in Maine but covers some small employers through a group plan issued to Dairylea, an agricultural cooperative.

 

 

Average Rate Increases
Following are the average small group rate increases weighted by premium across the entire market by calendar year. Figures for 2001 and for the current year are based on a partial year's data, but represent an annual increase.
Year Average
2001
33%
2002
29%
2003
16%
2004
6%
2005
13%
2006
8%
2007
14%
2008
10%
2009
15%
2010
21%
2011
17%
2012
11%

 

Recent Rate Increases
Company Annual Average
Increase
Number of Lives
Affected
Coverage Type Effective Date SERFF Tracking Number1
Aetna Health
2.5% 196 HMO 10/1/2012 AETN-128611788
-4.2% 139 HMO 7/1/2012 AETN-128320978
-6.1% 129 HMO 4/1/2012 AETN-128056758
-6.1% 273 HMO 1/1/2012 AETN-127783341
-1.3% 154 HMO 10/1/2011 AETN-127341086
Aetna Life
11.8% 6,748 PPO 7/1/2012 AETN-128319145
7.3% 4,274 PPO 4/1/2012 AETN-128056900
6.7% 9,540 PPO 1/1/2012 AETN-127783507
8.8% 5,184 PPO 10/1/2011 AETN-127341970
11.0% 6,894 PPO 7/1/2011 AETN-127137916
Anthem BC/BS (HMO and PPO)
13.9% 7,860 All 10/1/2012 AWLP-128603150
14% 8,999 HMO & PPO 7/1/2012 AWLP-128307870
10.5% 7,886 HMO & PPO 4/1/2012 AWLP-128016900
13% 16,799 HMO & PPO 1/1/2012  
21.2% 9,163 HMO & PPO 10/1/2011 AWLP-127339393
Excellus (Dairylea)
13% 1,033 All others 1/1/2011 MUSA-126885032
4.5% 101 Senior Plan 1/1/2011 MUSA-126885094
Guardian
4% 0 PPO & Indemnity 10/1/2010 GARD-126743785
10% 135 PPO & Indemnity 7/1/2010 GARD-126587928
2% 0 PPO & Indemnity 4/1/2010 GARD-126467704
6% 0 PPO & Indemnity 1/1/2010  
Harvard Pilgrim
5.6% 1,531 HMO 10/1/2012 HPHC-128610909
6.5% 880 HMO 7/1/2012 HPHC-128052944
6.3% 797 HMO 4/1/2012 HPHC-128052944
10.8% 2,049 HMO 1/1/2012 HPHC-127344906
9.7% 1,490 HMO 10/1/2011 HPHC-127344906
HPHC Ins Co
5.6% 2,196 PPO 10/1/2012 HPHC-128610933
6.5% 1,452 PPO 7/1/2012 HPHC-128052536
6.3% 1,045 PPO 4/1/2012 HPHC-128052536
10.8% 3,945 PPO 1/1/2012 HPHC-127342408
9.7% 2,354 PPO 10/1/2011 HPHC-127342408
HPHC Ins Co (DirigoChoice)
7.25% 808 DirigoChoice 10/1/2012 HPHC-128588680
8.9% 727 DirigoChoice 7/1/2012 HPHC-128236998
12.7% 783 DirigoChoice 4/1/2012 HPHC-127951074
8.7% 1,417 DirigoChoice 1/1/2012 HPHC-127688229
8% 758 DirigoChoice 10/1/2011 HPHC-127313025
John Alden
14% 40 PPO & Indemnity 12/1/2009  
14% 34 PPO & Indemnity 1/1/2009  
United Healthcare
-6.5% 181 POS & PPO 10/1/2011 UHLC-127341635
1 To link to SERFF to view filings, go to .http://www.maine.gov/pfr/insurance/PPACA/HFAI.htm#. Under The Health Filing Access Interface (HFAI), select "Click here to Search Public Filings." You must first agree to the terms of use. Then on the search screen enter a SERFF Tracking Number (displayed above) in the Tracking Number field and click on the Search button. Details about the filing will appear and you can click on the "View Filing" link on left side to see the actual filing.

 

Pending Rate Increases
Company Average
Increase
Number
Affected
Coverage Type
Effective date
SERFF Tracking Number1
Aetna Life
5% 5,295 PPO 10/1/2012 AETN-128611773
United Healthcare
7.5% 184 PPO and POS 10/1/2012 UHLC-128572021
1 To link to SERFF to view filings, go to .http://www.maine.gov/pfr/insurance/PPACA/HFAI.htm#. Under The Health Filing Access Interface (HFAI), select "Click here to Search Public Filings." You must first agree to the terms of use. Then on the search screen enter a SERFF Tracking Number (displayed above) in the Tracking Number field and click on the Search button. Details about the filing will appear and you can click on the "View Filing" link on left side to see the actual filing.

 

Source: Bureau of Insurance

Last Updated: August 23, 2012