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Life Health > Health Insurance

PPACA pushed Florida's 2014 individual loss ratio to 92%

By Allison Bell

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The Patient Protection and Affordable Care Act (PPACA) changes that took effect in January 2014 helped increase the state’s overall individual health premium revenue to $5.2 billion in 2014, from $2.2 billion in 2013.

But the state’s overall individual health loss ratio also increased, to 92.32 percent, from 78.66 percent.

The Florida small-group health market ended up with a loss ratio of 76.02 percent on $3.1 billion in revenue for 2014, compared with a loss ratio of 78.63 percent on $3.7 billion in revenue for 2013.

The large-group market came in with a loss ratio of 83.09 percent on $7.1 billion for 2014, compared with a loss ratio of 82.81 percent on $6.6 billion in revenue the year before.

The Florida Health Insurance Advisory Board included those figures in its official 2015 Florida health insurance market report.

PPACA imposed many new mandates on the individual and small-group markets in 2014, and it also banned almost all underwriting based on individual health status factors other than age in the individual market.

But people who have individual policies purchased before President Obama can keep those “grandfathered policies,” and Florida residents who have transitional policies purchased between the time PPACA became law and the major PPACA commercial health insurance changes took effect can keep those policies through 2016, according to the advisory board.

For individually underwritten coverage purchased in Florida, the loss ratio fell to 74.09 percent in 2014, from 75.99 percent in 2013.

The loss ratio for PPACA-compliant coverage was 123.25 percent for individual policies purchased outside the exchange system and 95.98 percent for policies purchased through the exchange system.

Florida has been letting U.S. Department of Health and Human Services (HHS) provide public exchange services for its residents through the HealthCare.gov enrollment system.

Exchange coverage has been popular in Florida. During the first two PPACA open enrollment periods, most of the ZIP codes with the highest exchange plan sales have been in South Florida.

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