With only two open enrollment periods (OEPs) completed and one year of financial performance data available, it is too early to tell which carriers are winners and losers on the public exchanges. There have been challenges to date for both new entrants and established carriers, and this market will take years to play out. The findings that follow, therefore, provide only a preliminary look at how the competitive landscape is unfolding.

Opening of federal and state marketplaces, the individual mandate, and premium subsidies have encouraged many new entrants to enter the individual health insurance market. During the 2014 OEP, about one-quarter of the 282 carriers that offered health plans on the exchanges were new entrants. Forty-eight (17%) of the carriers had prior insurance experience but no individual insurance experience in states where entering. An additional 27 (10%) had no insurance experience at all. Only four of these new entrants did not re-file for the 2015 exchanges, and an additional two withdrew during the 2015 OEP (CoOportunity Health in Iowa and Nebraska). For the 2015 OEP, 24 more new entrants joined the exchanges that had no prior individual insurance experience in the state, and 46 carriers offering individual insurance outside of the exchanges in given states entered exchanges in those states. (Note: Because insurance is regulated at the state level, we count a carrier that offers health insurance in two states as two carriers. Such a carrier would be considered a new entrant in one state if previously it had offered individual insurance only in the other state. All counts focus exclusively on on-exchange carriers.) Read the entire story