Pennsylvania: Only 13,000 grandfathered & transitional enrollees left??

2019 OPEN ENROLLMENT ENDS (most states)

Time: D H M S

As you may have noticed, I'm on a bit of a grandfathered/transitional plan data kick this week (there's a reason for it which you'll understand next week). These numbers are tricky to hunt down, since they aren't tracked by the ACA exchanges. Most states either don't track them at all or don't make it easy for the public to locate, and it's even treated as a proprietary trade secret in a few states.

The Kaiser Family Foundation gave a rough estimate of around 2.1 million people still being enrolled in GF/TR plans last year, but they never broke it out by state. Plus, of course, that was last summer; since no one can newly enter these types of policies, their numbers continue to gradually shrink year after year.

In Pennsylvania, Mark Farrah Associates estimated around 300,000 off-exchange individual market enrollees total...but they don't break out how many of them are enrolled in GF/TR plans. My suspicion, based on the limited data I do have from other large states like California and Florida, is that there's probably something like 60,000 combined GF/TR enrollees as of today in PA.

However...assuming there aren't any major numbers missing below, it looks like the actual total in Pennsylvania was down to just 13,000 last year. If so, it' would be even lower today.

First, according to this page on the Pennsylvania Insurance Dept. website:

You can find rate filings for products that either predate the Affordable Care Act ("grandfathered" products), or that have been granted a temporary period in which to transition into compliance with Affordable Care Act ("transitional" products), here.

OK, that seems pretty clear: Grandfathered and Transitional policy rate filings are at that link...and I'm assuming this refers to all GR/TR policies still in effect, since no new ones are available, right?

Geisinger Quality Options; Individual Grandfathered PPO Plan; Rate Filing
View PA Bulletin Notice | View Filing Information

Geisinger Quality Options; Individual Transitional PPO Plan; Rate Filing
View PA Bulletin Notice | View Filing Information

Capital Advantage Assurance Company (CABC-131157380); Individual MU PPO - Transitional Filing; Rate Filing
View PA Bulletin Notice | View Filing Information

Highmark Choice Company; Individual Grandfathered HMO Plan; Rate Filing
View PA Bulletin Notice | View Filing Information

Highmark Inc., d/b/a Highmark Blue Cross Blue Shield; Individual Grandfathered Plans; Rate Filing
View PA Bulletin Notice | View Filing Information

UPMC Health Benefits, Inc. (UPMC-131136215); Individual HSA-Transitional Filing; Rate Filing
View PA Bulletin Notice | View Filing Information

UPMC Health Benefits, Inc. (UPMC-131136230); Individual EPO and GOALS - Transitional Filing; Rate Filing
View PA Bulletin Notice | View Filing Information

When you look at the bulletin notices for each of these and add up the number of covered lives, they total just 12,958 people:

Geisinger Quality Options submitted a rate filing to increase the premium rates for its Grandfathered Individual PPO Plan. The filing proposes a rate increase of 8.6% and will affect approximately 799 members. The proposed rate increase will generate approximately $212,000 of additional annual revenue. The requested effective date of the change is January 1, 2018.

Geisinger Quality Options submitted a rate filing to increase the premium rates for its Transitional Individual PPO Plan. The filing proposes a rate increase of 14.5% and will affect approximately 2,079 members. The proposed rate increase will generate approximately $980,000 of additional annual revenue. The requested effective date of the change is January 1, 2018.

Capital Advantage Assurance Company submitted a rate filing to increase the premium rates for its Individual medically underwritten PPO Non-Grandfathered Plans. The filing proposes a rate increase of 30.0% and will affect approximately 4,472 members. The proposed rate increase will generate an annualized revenue of approximately $3.4 million and will be effective January 1, 2018.

Highmark Choice Company submitted a rate filing to increase the premium rates for its Grandfathered Individual HMO Plan. The filing proposes a rate increase of 8.1% or $62.45 per contract per month and will affect approximately 950 contract holders. The proposed rate increase will generate approximately $720,000 of additional annual revenue. The requested effective date of the change is January 1, 2018.

Highmark Inc., d/b/a Highmark Blue Cross Blue Shield submitted a rate filing to increase the premium rates for its Grandfathered Individual CompleteCare Program (Western Region). The filing proposes a rate increase of 3% or $21.83 per contract per month and will affect approximately 2,100 contract holders. The proposed rate increase will generate approximately $552,000 of additional annual revenue. The requested effective date of the change is January 1, 2018.

UPMC Health Benefits, Inc. submitted a rate filing to increase the premium rates for its Individual HSA Non-Grandfathered Plans. The filing proposes a rate increase of 4.09% and will affect approximately 656 members. The proposed rate increase will generate an annualized revenue of approximately $74,700 and will be effective January 1, 2018.

UPMC Health Benefits, Inc. submitted a rate filing to increase the premium rates for its Individual EPO and GOALS Non-Grandfathered Plans. The filing proposes a rate increase of 4.09% and will affect approximately 1,902 members. The proposed rate increase will generate an annualized revenue of approximately $293,700 and will be effective January 1, 2018.

It's possible that there are additional people covered by other grandfathered or transitional policies, but the PA site seems to be pretty comprehensive.