Mark Farrah Associates (MFA), www.markfarrah.com, examined trends in membership, claims incurred PMPM (per member per month), adjusted premiums PMPM, and MLRs (Medical Loss Ratios) for the Individual and Small Group comprehensive medical/health insurance markets and segment leaders. Based on an analysis of the National Association of Insurance Commissioners (NAIC) Supplemental Health Care Exhibit (SHCE), MFA also analyzed the profitability of both health insurance segments for the last five years.

• The Individual and Small Group business segments were profitable for insurers in 2024 where both experienced higher MLRs between 2023 and 2024.
• The Individual segment experienced enrollment growth of 21%, to 21.5 million members for 2024. Premiums PMPM increased 1.8%, to a segment average of $559 PMPM. The average medical claims PMPM of $493 in 2024 was an increase of 2.3% from 2023.
• The Small Group segment continues to lose membership, down another 7% to 7.9 million in 2024. Average claims incurred PMPM increased from $495 in 2023 to $537 in 2024, an 8.4% increase.

To read the full text of "An Analysis of Profitability for the Individual and Small Group Health Insurance Markets in 2024” 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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