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The national average monthly premium for small-group health increased 5.7% between 2022 and 2023, to $610, according to managers of a federal government risk-smooth program for commercial health insurance.
That compares with an increase of 2.4%, to $597, for individual non-catastrophic market.
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At the state level, monthly small-group standardized premiums ranged from about $378, in Utah, to $986 in West Virginia.
The Centers for Medicare and Medicaid Services published the 2023 figures earlier this week in set of new reports it uses to run the Affordable Care Act risk-adjustment program, and it posted the 2022 figures about a year earlier on the same section of its website.
For brokers, benefits consultants and others, the reports provide extra individual and small-group data.
Because the reports come from the federal government, the information is free from copyright.
Brokers can put the data in their own reports, social media posts and presentations without worrying about having to get permission or pay the data provider.
The Affordable Care Act risk-adjustment program: CMS is supposed to use the premium figures, enrollment figures, enrollees health risk scores and related data to pull cash from issuers with relatively low-risk enrollees and push cash toward the issuers with relatively high-risk enrollees.
The program covers most individual and small-group coverage sold today, including coverage sold outside the ACA public exchange system.
One challenge CMS has faced over the years is that any efforts to rate enrollees' risk usually end up being controversial.
The entities that are supposed to provide cash for the high-risk issuers often end up accusing CMS of bungling the risk-scoring rules or the high-risk issuers of finding ways to pump up their enrollees' risk scores.
Sick people and metal levels: The reports give clues about enrollee risk levels as well as premiums.
CMS analysts include tables showing, for example, the average individual coverage enrollee risk score by "metal level," or benefits richness category.
Platinum plans pay about 90% or more of the actuarial value of a standard benefits package, and bronze plans pay about 70% of the actuarial value.
Conventional wisdom is that sicker people choose richer plans.
The risk-adjustment report shows that, for individual platinum coverage sold off-exchange, the average 2023 risk score 3.418.
For individual off-exchange bronze coverage, the average risk score was just 0.993.
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Allison Bell
Allison Bell, a senior reporter at ThinkAdvisor and BenefitsPRO, previously was an associate editor at National Underwriter Life & Health. She has a bachelor's degree in economics from Washington University in St. Louis and a master's degree in journalism from the Medill School of Journalism at Northwestern University. She can be reached through X at @Think_Allison.
