America's Benefit Specialist August/September 2023

NOTEWORTHY

gions, races and ethnicities, and types of work (white-, blue-, pink-collar) as detailed by the U.S. Census. INDIVIDUAL HEALTH INSURANCE ENROLLMENT TREND The individual market has seen numerous changes in the last 15 years. Enrollment in individual medical plans, both on and off the exchange, totaled approximately 19.5 million as of March 31, 2023, nearing the height of the market in early 2015, according to financial statements filed by insurers, and with estimates by Mark Farrah Associates. The individual segment has been profitable, overall, for health plans since 2017, however, premium growth has, once again, been outpaced by medical expense growth, leading to increasing medical loss ratios. Traditional MLRs for 1Q23 are like those experienced during the first quarters in the years leading up to the ACA, with an average aggregated tradi tional MLR of 79.3%, at premiums per member per month of $528 and claims PMPM of $419. Bright Health and Friday Health Plans withdrew from individual markets in multiple states during the early part of 2023, which could bring change for the segment. Between December 31, 2022, and March 31, 2023, Centene increased membership by over 1 million members. CVS Health (Aetna) and Cigna also experienced membership gains during the period. Florida and Texas have the highest number of people enrolled in the individual coverage marketplace, as of March 31, 2023, with nearly 4 million and 3.6 million, respectively. Five health insurance plans in each state reported changes of greater than 100,000 enrollees from December 31, 2022, to March 31, 2023, including Scott & White, more than tripling its individual enrollment. To read the full text of “Harbingers of Change for Individual Health Insurance Marketplace” visit the MFA Briefs library on www.markfarrah.com. HRAs CONTINUE TO OFFER PERSONALIZED, HIGH-QUALITY HEALTHCARE TO WORKERS In late June, the HRA Council released its 2023 data report on the state of Health Reimbursement Arrangements, including Qualified Small Employer HRAs (QSEHRAs) and Individual Coverage HRAs (ICHRAs). The report shows that between 2022 and 2023, the number of American workers offered insurance through an ICHRA tripled. QSEHRA of ferings, only available to small employers with less than 50 employees, doubled. “ICHRAs and QSEHRAs cover workers with quality ACA health insurance they select based on their own health needs,” said Robin Paoli, executive director of the HRA

WORKERS’ TOP BARRIERS TO ACCESSING MENTAL HEALTH BENEFITS

Amwell recently released results of a survey that asked em ployed U.S. adults about their experience seeking behavioral health treatment and how these factors relate to their health plan and employer offerings. Key findings from the survey: • Eighty-five percent of respondents do not use the mental health benefits available via their health plans; workers were confused about their benefits or were unsure how to access them. • Fifty-three percent of survey participants listed digital programs as their preferred method to self-manage mental health. • Sixty-seven percent of respondents would be willing to use wellbeing or mental health benefits if they were digi tally accessible. • There is a 50% decline in respondents utilizing in-person therapy since the beginning of the pandemic. • Over 80% of parents said mental health coverage for their children is even more important than for themselves. “The pandemic placed mental health at the forefront of the national conversation, yet there’s still an alarming num ber of people—approximately 50 million—navigating mental health challenges without treatment or proper support,” said Ken Cahill, Amwell chief behavioral health officer. “The survey results demonstrate how health plan leaders can continue to support members: offer impactful benefits, and make mental health benefits personalized, digitally accessible and easy to understand. As more people seek hybrid-care options that allow them to access treatment via multiple points and channels, flexibility and access will be critical to achieving a healthier population.” According to Mental Health America, 50 million Ameri cans are currently battling a mental health issue and 55% of those adults are not receiving treatment. The Amwell survey findings point to the fact that traditional mental health treatment options, such as in-person only therapy, do not sufficiently meet the needs of U.S. workers. “This gap in care is due to personal and professional de mands on busy lives, challenges around access, waiting lists, costs of care and inflexibility of scheduling. A hybrid-care platform that interweaves in-person, virtual and automated care is essential to enabling health plans to deliver a holistic healthcare experience and close the gaps highlighted by the survey,” said Cahill. The survey was fielded by Regina Corso Consulting and sponsored by Amwell. Of the 1,500 employed adults surveyed across the U.S., the group was representative of all ages, re

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