Health plan income surges amid reduced use

Boston Statehouse

BOSTON (SHNS) – Massachusetts health plans experienced a 98 percent increase in combined net income between 2019 and 2020, according to a new report from the Massachusetts Health and Hospital Association.

The MHA’s Semi-Annual Health Plan Performance Report found that many plans in 2020 “had the best financial results and the largest profit margins in many years because of reduced utilization and payments resulting from the coronavirus pandemic, even after accounting for required and some voluntary COVID-related premium refunds.”

The association’s report analyzes health insurers’ financial positions by examining measures including membership, premium rates, expense trends, and profitability, and the 2019-2020 edition covers a time period when COVID-19 rocked the state’s health care system, including a pause on elective procedures.

Total health plan reserves climbed to a record high of $5.6 billion in 2020, the report said, representing a 12.4 increase compared to 2019 and a 46 percent increase since 2015. For most plans, the report said enrollment was “quite stable.” HMO Blue lost 56,000 members, “almost exclusively” from its group business, and Tufts Public Plans grew by more than 50,000 members, according to the MHA.

Across plans, monthly premiums ranged from Tufts Public’s $423 per member per month to $795 per member per month for Fallon Health and $850 for Tufts Health Plan.

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