washington state hospital association health information program the following slides illustrate key...
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![Page 1: Washington State Hospital Association Health Information Program The following slides illustrate key findings from 2004 for Washington health plans. The](https://reader035.vdocuments.net/reader035/viewer/2022062216/56649dc75503460f94abcc1a/html5/thumbnails/1.jpg)
Washington State Hospital Association Health Information Program
• The following slides illustrate key findings from 2004 for Washington health plans.
• The data are from annual statements filed with the Office of the Insurance Commissioner.
• For more information, contact Rachelle Tsunehara ([email protected])
Profile of Washington Health Plans, May 2005
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Washington State Hospital Association Health Information Program
2004 - A Very Good Year For Health Plans
• All plans except one had positive underwriting margins.
• Aggregate underwriting margin was 4.5%.
• Plans made over $370 million on health insurance operations.
• Plans had nearly $540 million in net income.
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Washington State Hospital Association Health Information Program
• In aggregate, claims expenses were only 82.6% of premiums.
• Annual premiums (based on 12 member months) increased by 8.6% between 2003 and 2004.
• Plans based primarily in Washington have 2.7 months of premium in reserve.
Other Indicators Show Plans’ Financial Success
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Washington State Hospital Association Health Information Program
Premiums:In 2004, Premera, Regence, Group Health and their subsidiaries represent 76% of total premiums.
Premera Blue Cross – 23%
LifeWise Health Plan – 1%
Regence BlueShield – 20%
Asuris Northwest Health – 1%
RegenceCare – 1%
Regence Oregon Plans – 1%Group Health Cooperative – 24%
Group Health Options – 4%
Kaiser Foundation Health Plan – 4%
Community Health Plan of Washington – 5%
PacifiCare of Washington – 7%
Molina Healthcareof Washington – 6%
Other Plans – 3%
(Premera)
(Regence)
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Washington State Hospital Association Health Information Program
Year-End Enrollment in Selected Plans:In 2004, Premera, Regence, Group Health and their subsidiaries account for 75% of enrollment.
853
683
421
263206
110 94 83 64 50 35 29 21 14
0
400
800
1,200
Regenc
e Blu
eShi
eld
Prem
era
Blue C
ross
Gro
up H
ealth
Coo
pera
tive
Moli
na Hea
lthca
re o
f WA
Comm
unity
Hea
lth P
lan
of W
A
Gro
up H
ealth
Opt
ions
PacifiC
are o
f Was
hing
ton
Kaise
r Fou
ndatio
n Hea
lth P
lan
Life
Wise
Healt
h Pla
n
KPS Hea
lth P
lans
Colum
bia Unite
d Pro
viders
Asuris
Nor
thwest
Health
Regenc
eCar
e
Aetna
Hea
lth In
c
Th
ou
san
ds
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Washington State Hospital Association Health Information Program
Enrollment Compared to Washington Population:Year-end enrollment in insured plans dropped again while population increased.
0
2
4
6
8
1998 1999 2000 2001 2002 2003 2004
Mil
lio
ns
WA State Population Total Enrollment
Note: Does not include enrollment in self insured plans; that data not available from OIC plan filings.
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Washington State Hospital Association Health Information Program
Claims Expense Compared to Premiums:
88.1% 88.2%87.8%
84.7%
85.9%
83.1%82.6%
80%
82%
84%
86%
88%
90%
1998 1999 2000 2001 2002 2003 2004
Premiums continue to be high compared to claims expenses.
Pe
rce
nt
of
pre
miu
ms
us
ed
fo
r c
laim
s
Reasonable Ratio = 85%
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Washington State Hospital Association Health Information Program
$662 $681$762
$942$990
$1,045 $1,071
$0
$250
$500
$750
$1,000
$1,250
1998 1999 2000 2001 2002 2003 2004
Mil
lio
ns
Administrative Expenses:Administrative expenses have increased steadily since 1998.
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Washington State Hospital Association Health Information Program
Administrative Expense Ratio:Administrative expense as a percent of premiums remains stable.
14.1%13.3%
12.7%
14.0% 13.7% 13.2% 13.0%
0%
6%
12%
18%
1998 1999 2000 2001 2002 2003 2004
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Washington State Hospital Association Health Information Program
Underwriting Margins in Selected Plans:
All but one plan had a positive underwriting margin in 2004.
10.6%
8.6%
6.6%
3.8% 3.7%3.0% 2.7% 2.4% 2.3%
1.1% 1.0% 0.9% 0.9%
-1.4%
-4.0%
0.0%
4.0%
8.0%
12.0%
16.0%
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Washington State Hospital Association Health Information Program
Annual Premiums for Selected Plans:Average premium varies considerably, due to benefit designs and enrollee demographics.
$5,709
$4,696
$3,859
$3,462$3,191
$2,868$2,718 $2,715
$2,424
$2,134$1,943 $1,892 $1,839 $1,786
$0
$2,000
$4,000
$6,000
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Washington State Hospital Association Health Information Program
Note: Includes health plans based primarily in Washington only.
$45
$26
$18
$12 $12
$8
$5 $4 $4 $3$2 $1
-$2
-$10
$0
$10
$20
$30
$40
$50
Net Income Per Member Per Month:The more enrollees in a plan, the better it’s financial position.
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Washington State Hospital Association Health Information Program
Health plans should have approximately two months of premium in reserves to be financially secure.
Months of Premium in Reserve:
Note: Includes health plans based primarily in Washington only.
4.5
3.7
3.1
2.8
2.4 2.3 2.3
1.9 1.8
1.5 1.5
1.0
2.7
0
1
2
3
4
5M
on
ths o
f P
rem
ium
in
Reserv
e
A
vera
ge