Mark Farrah Associates (MFA), www.markfarrah.com, examined trends in membership, claims incurred PMPM (per member per month), adjusted premium PMPM, and MLR (Medical Loss Ratio) for the Individual and Small Group comprehensive segment leaders. Based on an analysis of the National Association of Insurance Commissioners (NAIC) Supplemental Health Care Exhibit (SHCE), MFA analyzed the profitability of both health insurance segments for 2022.

• Both Small Group and Individual segments were profitable for insurers in 2022, but still have not yet returned to pre-pandemic levels.
• The Individual segment experienced enrollment growth of 4.8%, to 13.8 million members for 2022. Premiums increased 2.2%, to a segment average of $539 premiums PMPM. The average medical claims PMPM of $481 for 2022 was a decrease of 0.3% from 2021.
• The Small Group segment continues to lose membership, down another 3.6% to 9.2 million in 2022. Small Group PMPM premiums have increased an average of 2.7% annually, since 2019.

To read the full text of "An Analysis of Profitability for the Individual and Small Group Health Insurance Markets in 2022” visit the MFA Briefs library on Mark Farrah Associates' website. MFA will continue to monitor health plan performance and competitive shifts across all healthcare segments.

About Mark Farrah Associates (MFA)

MFA is a leading data aggregator and publisher providing health plan market data and analysis tools for the healthcare industry. Committed to simplifying analysis of health insurance business, our products include: Health Coverage Portal™, Medicare Business Online™, Medicare Benefits Analyzer™, County Health Coverage™, Health Plans USA™ and 5500 Employer Health ^Plus. Follow us on LinkedIn!

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