Final Merged Market Rates Effective for 2024
The following table depicts the final overall weighted average premium increase for the merged (individual and small employer) market filed by insurance carriers as part of the Massachusetts Division of Insurance rate review process (for rates effective in 2024).
Merged Market Summary for Proposed Rates Effective for 2024
The following tables depict the proposed overall weighted average premium increase and the key assumptions behind premium development for the merged (individual and small employer) market filed by insurance carriers as part of the Massachusetts Division of Insurance rate review process (for rates effective in 2024). This information is subject to change as the rate review process continues.
The Health Care Access Bureau within the Massachusetts Division of Insurance is currently reviewing these assumptions. This review process will culminate in a final decision in August 2023.
There are 626,705 consumers enrolled in merged (individual/small group) market plans (data as of December 2022).
- The Average Rate Change represents adjustments to reflect benefit changes in renewing plans and it reflects plans that have been terminated and mapped to existing plan offerings. This weighted average rate change represents the average rate change consumers will experience before changes due to age.
- The Medical Expense and Pharmacy Trend Assumptions are the annualized rate of increase due to increases in the unit cost of health care services and in the utilization of health care services.[1] These trend assumptions are generally applied to current claims experience to project 2024 required revenue rates.
- The Non-Medical Portion of Premium represents the percent of overall premium that is required to cover administrative expense, contribution to reserves and required taxes and fees, including premium tax, ACA fees.
- The Risk Adjustment Assumption is the Affordable Care Act’s (ACA) risk adjustment program which redistributes funds from carriers with lower-risk enrollees to plans with higher-risk enrollees.
[1] Provider mix and service mix are typically included within utilization trend assumptions. Cost sharing leverage may also be included in either the pricing AV or utilization assumptions.
Rate Filing Summary Chart 2024
History of Quarterly Merged Market Rate Changes
Prior to Calendar Year 2024, health insurance carriers filed their rates quarterly with the Division of Insurance. Please see the below chart to see prior quarters rate changes.