Key points from Utah 2018 Health Insurance Market Report

The Utah Insurance Department (ID) released its 2018 Health Insurance Market Report this week. The report looks at data reported in filings with the Department through 2017.

 

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The report noted that the commercial market, regulated by the ID, represents approximately 24.3 percent of the total market in the state compared to the 38.7 percent share occupied by self-funded employer plans. 342 insurers reported commercial health insurance business in Utah in 2017. Of these, 313 are foreign insurers or companies that have a home office in a different state. These foreign insurers account for about 24 percent of Utah’s market.

The report studies complaints handled by the ID as well as highlights trends in the market. Interesting points include:

1.     Though the number of complaints that the Department acted on were down, the total number of complaints to the Department grew substantially. ID stated that this is likely because there were more complaints related to issues they did not have the power to resolve, like long-term care premium increases and drug treatment and mental health facilities.

2.    There was a substantial increase in the number of complaints related to balance billing. Balance billing complaints accounted for about 10 percent of all consumer complaints during 2015 to 2017.

3.    The number of comprehensive health insurers operating in Utah declined from 2008 to 2017. In 2008, there were 65 commercial health insurance companies that reported comprehensive health insurance. As of 2017, this number had dropped to 37 insurers.

4.    From 2008 to 2017, the number of Utah residents covered by comprehensive health insurance as a relative percentage of Utah’s population has declined by about 8.4 percent. Premium increases and market uncertainty appear to the primary drivers of this change. Membership in Federally Funded Marketplace plans, where most members have premium subsidies, did not experience the same change.

5.    From 2008 to 2017, the average premium per member per month for comprehensive health insurance increased on average about 4.9 percent per year. In 2017, the average premium per member per month for comprehensive health insurance was 10 percent higher than in 2016. One of the main causes of the trend appears to be a steady increase in the underlying cost of health care.

6.    Although Utah has continued to experience significant increases in health insurance costs, Utah’s premium average of $330 on a per member per month basis are lower than the national average of $423 per member per month.

The report concluded with seven recommendations for legislative action that Department believes could improve Utah’s health insurance market. Among the recommendations are several ideas that have had traction in other states including:

  • Restricting the practice of balance billing in emergency situations when patients are not given the choice of providers at a contracted facility.
  • Developing electronic data exchange standards to facility the electronic exchange of patient information and better care coordination.
  • Increasing behavioral health integration in primary care settings.
  • Improving the All Payer Claims Database and health care cost transparency.
  • Supporting additional education and training to facilitate greater understanding of health care and health insurance cost.