Health Plans Project 2019 Premiums to Increase by 5.2% for Group Fully-Insured Plans and 4.4% for Individual Plans

11/13/18

PHILADELPHIA--(BUSINESS WIRE)--Health plans are expecting 2019 premium rates to increase by 5.2% for Group fully-insured plans, while growing by 4.4% for Individual plans. For Group plans, this growth is 2.0 percentage points lower than their expectations for 2018. For Individual plans, growth expectations are lower by 16.8 percentage points. Individual members include all who purchase insurance individually who are not eligible for Medicare or Medicaid.

Anticipated premium rate increases after the effect of buy-downs for Group and Individual plans is 3.8% and 3.1%, respectively. A buy-down is a change in a product’s benefit design to secure a lower premium.

For plans participating in this survey, we infer that overall medical trends are projected to increase by 6.1% for Group plans and 7.9% for Individual plans. This is based on their anticipated MLR increase for Groups of 0.7 percentage points and an increase of 2.8 percentage points for Individual plans. We estimate an increase in consumer cost sharing to be 8.2% for Group plans and 7.4% for Individuals.

There were 55 respondents to our survey. The plans serve 17.9 million people in fully-insured commercial group and non-group products, or 20.4% of the United States total. This is Sherlock Company’s twenty-fourth annual survey of premium pricing trends.

Additional information concerning the survey results, including regional segmentation, is available through our newsletter PULSE.

Sherlock Company (www.sherlockco.com), based in North Wales, Pennsylvania, provides informed solutions for health plan financial management. Since its founding in 1987, Sherlock Company has been known for its impartiality and technical competence in service to its clients.

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