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Comprehensive Health Insurance Enrollment Reports

​​​​​​​​Last Updated: February 27, 2024

 

The Wisconsin Office of the Commissioner of Insurance (OCI) issues the Health Insurer Market Survey (HIMS) annually to collect enrollment data on comprehensive health plans. The data ​gathered allow OCI to monitor the state of Wisconsin's health insurance markets both by type of business (grandfathered, transitional, single risk pool) and market segment (individual, small group, large group).

Below are summary reports of enrollment data since 2014. The regions used in the reports are defined at: oci.wi.gov/Documents/OCIForms/GeoRegionsHealth.pdf​

   Grandfathered (GF)

  • GF policies are not subject to most provisions of the Affordable Care Act (ACA).
  • This document summarizes comprehensive individual and small group market enrollment (covered lives) for policies issued on or before
    March 23, 2010. 
  • Covered lives are reported by market segment, company, survey year, and region. Each market segment is a separate worksheet in the Excel document.

   Transitional (TR)

  • TR policies are subject to limited provisions of the ACA.
  • This document summarizes comprehensive individual and small group market enrollment (covered lives) for policies issued between
    March 24, 2010, and December 31, 2013.
  • Covered lives are reported by market segment, company, survey year, and region. Each market segment is a separate worksheet in the Excel document.

   Single Risk Pool (SRP)

  • SRP policies are fully compliant with the ACA.
  • This document summarizes comprehensive individual and small group market enrollment (covered lives) for policies issued on or after January 1, 2014.
  • Covered lives are reported by market segment, company, survey year, and region. Each market segment is a separate worksheet in the Excel document.

   Large Gr​oup (LG)

  • LG policies are subject to limited provisions of the ACA.
  • This document summarizes comprehensive large group market enrollment (covered lives) for two subsets of the large group market: employer groups with 51 – 100 total employees and employer groups with 101 or more total employees.
  • Covered lives are reported by company, market segment subset, and survey year. 

Questions on the HIMS data should be directed to OCIRateReview@wisconsin.gov.