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McKinsey Center for U.S. Health System Reform 1
2016 Individual Exchange Filings
updated September 14, 2015
The content that follows includes publicly available 2016 individual
exchange carrier participation available as of September 14, 2015.
We have identified new entrant participation across 41 states,
have comprehensive filings for 20 of those states, and have
partial participation/rate filings for the remaining states.
Please note: Carrier participation is not final; carriers can still
request to withdraw from 2016 exchanges. This report does
not include off-exchange participation.
Please contact us at reformcenter@mckinsey.com with any questions.
You can also find us online at healthcare.mckinsey.com/reform.
McKinsey Center for U.S. Health System Reform 2
SOURCE: Public individual market exchange carrier participation released as of September 14,
2015 for all states with complete filings and complete carrier participation per State by State map.
By the numbers, 2016
NEW ENTRANTS BY CARRIER TYPE NEW ENTRANTS BY EXPERIENCE
+Based on the number of carriers that offer plans in each state; i.e.,a carrier that offers plans in 3 states is counted 3 times.*Of remaining incumbents not shown, 21 are confirmed withdrawals,
and for 21 we do not yet have confirmed 2016 participation.**Across 41 states-19 states with at least 1 new entrant identified and 22 states with confirmation that there are no new entrants.
26 new entrants across 41 states
New to all insurance
35%
Incumbents
off-exchange
46%
Provider
15%
Medicaid
8%
Regional / Local
23%
National
54%
New entrants in 2016**
262 19
Preliminary filed carriers to date
CARRIER EXCHANGE PARTICIPATION
Incumbents from 2015
of 333 total*
New to
individual
insurance
19%
Carrier participation over time
McKinsey Center for U.S. Health System Reform 3SOURCE: Publicly available individual exchange participation information, 2014-2016, as of September 14, 2015
*2015/2016 new entrant incumbents represent carriers that already had a presence off
exchange in a given state, or on exchange in other states in the year prior to their joining
EXCHANGE ENTRANT PARTICIPATION 2014-2016
Number of carriers entering and exiting, counting participation at a state level
New to all insurance in state
Incumbents off-exchange in state*
New to individual insurance in state
Type of carriers
2015
withdrawals
2015 new
entrants
2015
carriers
2016 new
entrants
announced
to date
2016 carriers
announced
to date
2016
withdrawals
announced
to date
2014
carriers
282 -19
70 -21 26 338
234
65
12
39
333
240
61
32
207
13
46
2
94
1 5
2
15
48
27
9
18
2016 EXCHANGE CARRIER PARTICIPATION AND FILING STATUS
WA
MT
ID
UT
AZ
CO
SD
ND
MN
MO
WI
VT ME
MI
IN
KY
TN
AL GA
SC
VAWV
LA
NE
KS
OK
AR
HI
AK
OR
IA
FL
PA
OH
NY
TX
NV
CA
IL
NH
MA
CT
NJ
RI
DE
MD
DC
State by state
McKinsey Center for U.S. Health System Reform 4SOURCE: Publicly available 2016 individual exchange participation information as of September 14, 2015.
NM
Partial carrier participation and limited/no rate filing tables
Comprehensive carrier participation/rate filing tables
Comprehensive carrier participation but limited/no rate filing tables
State status
NC
MS
WY

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2016 Individual Exchange Filings and Carrier Participation

  • 1. McKinsey Center for U.S. Health System Reform 1 2016 Individual Exchange Filings updated September 14, 2015 The content that follows includes publicly available 2016 individual exchange carrier participation available as of September 14, 2015. We have identified new entrant participation across 41 states, have comprehensive filings for 20 of those states, and have partial participation/rate filings for the remaining states. Please note: Carrier participation is not final; carriers can still request to withdraw from 2016 exchanges. This report does not include off-exchange participation. Please contact us at reformcenter@mckinsey.com with any questions. You can also find us online at healthcare.mckinsey.com/reform.
  • 2. McKinsey Center for U.S. Health System Reform 2 SOURCE: Public individual market exchange carrier participation released as of September 14, 2015 for all states with complete filings and complete carrier participation per State by State map. By the numbers, 2016 NEW ENTRANTS BY CARRIER TYPE NEW ENTRANTS BY EXPERIENCE +Based on the number of carriers that offer plans in each state; i.e.,a carrier that offers plans in 3 states is counted 3 times.*Of remaining incumbents not shown, 21 are confirmed withdrawals, and for 21 we do not yet have confirmed 2016 participation.**Across 41 states-19 states with at least 1 new entrant identified and 22 states with confirmation that there are no new entrants. 26 new entrants across 41 states New to all insurance 35% Incumbents off-exchange 46% Provider 15% Medicaid 8% Regional / Local 23% National 54% New entrants in 2016** 262 19 Preliminary filed carriers to date CARRIER EXCHANGE PARTICIPATION Incumbents from 2015 of 333 total* New to individual insurance 19%
  • 3. Carrier participation over time McKinsey Center for U.S. Health System Reform 3SOURCE: Publicly available individual exchange participation information, 2014-2016, as of September 14, 2015 *2015/2016 new entrant incumbents represent carriers that already had a presence off exchange in a given state, or on exchange in other states in the year prior to their joining EXCHANGE ENTRANT PARTICIPATION 2014-2016 Number of carriers entering and exiting, counting participation at a state level New to all insurance in state Incumbents off-exchange in state* New to individual insurance in state Type of carriers 2015 withdrawals 2015 new entrants 2015 carriers 2016 new entrants announced to date 2016 carriers announced to date 2016 withdrawals announced to date 2014 carriers 282 -19 70 -21 26 338 234 65 12 39 333 240 61 32 207 13 46 2 94 1 5 2 15 48 27 9 18
  • 4. 2016 EXCHANGE CARRIER PARTICIPATION AND FILING STATUS WA MT ID UT AZ CO SD ND MN MO WI VT ME MI IN KY TN AL GA SC VAWV LA NE KS OK AR HI AK OR IA FL PA OH NY TX NV CA IL NH MA CT NJ RI DE MD DC State by state McKinsey Center for U.S. Health System Reform 4SOURCE: Publicly available 2016 individual exchange participation information as of September 14, 2015. NM Partial carrier participation and limited/no rate filing tables Comprehensive carrier participation/rate filing tables Comprehensive carrier participation but limited/no rate filing tables State status NC MS WY