2012 Commercial health insurance: Overview of financial results

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By Paul R. Houchens | 19 November 2013

With the Patient Protection and Affordable Care Act (ACA) enactment in March 2010, health insurers have had to comply with minimum loss ratio requirements, more stringent rate review, removal of annual benefit limits, first-dollar coverage of preventive care, and other requirements. While the largest reforms enacted by the ACA do not begin until January 1, 2014, for the individual and small group health insurance markets, there are now multiple years of insurer financial experience to evaluate how the ACA is impacting insurer’s profitability and expense structure. 

This report uses data reported by health insurers in their Medical Loss Ratio Reporting Forms (MLR forms) submitted to the Center for Consumer Information and Insurance Oversight (CCIIO) in 2011 and 2012, along with 2010 Supplemental Health Exhibit (SHE) data, to summarize financial results in the commercial health insurance markets.This report provides an overview of health insurer financial results in 2012 and evaluates changes in the health insurance industry’s expense structure and profitability from 2010 to 2012, including changes in the medical loss ratio percentage.