Comprehensive Health Insurance Enrollment Reports

Last Updated: July 31, 2017

 

Since 2011, the rate review team at the Wisconsin Office of the Commissioner of Insurance (OCI) has issued the Health Insurer Market Survey (HIMS) annually under the authority of s. 601.42, Wis. Stat. This survey is designed to collect enrollment, premium, and claims data which allows OCI staff to monitor the state of the individual, small group, and (to a lesser degree) large group health insurance markets in Wisconsin.

Below are summaries of the enrollment data submitted in the HIMS for survey years 2014 - 2016. Depending on the document, enrollment may be broken down by company, market segment (individual/individual association; small group; large group), type of business (grandfathered; transitional; single risk pool), survey year, and market analysis region. Wisconsin's six market analysis regions are defined at https://oci.wi.gov/Documents/OCIForms/GeoRegionsHealth.xls.


Grandfathered Individual and Small Group (2014 – 2016)

This Excel document summarizes comprehensive individual market and small group market enrollment for policies issued on or before March 23, 2010. These policies are not subject to most provisions of the Affordable Care Act (ACA). Covered lives counts are separated by market segment, company, survey year, and market analysis region. Note that each market is included as a separate worksheet in the Excel document.


Transitional Individual and Small Group (2014 – 2016) 

This Excel document summarizes comprehensive individual market and small group market enrollment for policies issued between March 24, 2010, and December 31, 2013. These policies are subject to limited provisions of the ACA. Covered lives counts are separated by market segment, company, survey year, and market analysis region. Note that each market is included as a separate worksheet in the Excel document.


Single Risk Pool Individual and Small Group (2014 – 2016)

This Excel document summarizes comprehensive individual market and small group market enrollment for policies issued on or after January 1, 2014. These policies are fully compliant with the ACA. Covered lives counts are separated by market segment, company, survey year, and market analysis region. Note that each market is included as a separate worksheet in the Excel document.


Large Group (2014 – 2016)

This Excel document summarizes large group market enrollment for two subsets of the large group market: employer groups with 51 – 100 total employees; employer groups with 101 or more total employees. Covered lives counts are separated by company, market segment subset, and survey year. For companies selling large group policies to employers sized 51 – 100, the data is further broken down into market analysis region. Note that regional data for survey year 2016 was not collected. The aggregate data and regional data are included as separate worksheets in the Excel document.


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