Mark Farrah Associates (MFA), www.markfarrah.com, compared 2Q25 and 2Q26, per member per month (PMPM) health premiums and expenses for the Individual, Employer-Group, Medicare, and Medicaid segments. Financial insights were gleaned from aggregated statutory financial data from MFA’s Health Coverage Portal™.
Highlights include:
- For 2Q26, the average medical expense ratio (MER) for the Individual segment was 79.5%, as compared to 86.7% in 2Q25.
- For the Employer-Group Risk segment, stronger growth in premium revenue relative to medical costs helped improve operating results, with the average medical expense ratio decreasing to 84.9% for 2Q26 from 86.6% in 2Q25.
- For Medicare Advantage, Premiums increased while medical expenses grew resulting in an improved MER from 88.4% through 2Q25 to 86.6% through 2Q26.
- For Managed Medicaid, premium growth outpaced medical cost growth, the MER improved from 92.1% in 2Q25 to 90.7% in 2Q26.
Market analysts throughout the industry rely on enrollment data and segment performance metrics to gain better insights into health plan market share and competitive positioning. Mark Farrah Associates maintains financial data as well as enrollment and market share for the health insurance industry in its subscription-based Health Coverage Portal™. MFA will continue to monitor health plan performance and competitive shifts across all healthcare segments.
To read the full text of “Second Quarter Health Insurance Segment Profitability Trends“, visit the Analysis Briefs library on Mark Farrah Associates’ website.
About Mark Farrah Associates (MFA)
Mark Farrah Associates (MFA) is a leading data aggregator and publisher providing health plan market data and analysis tools for the healthcare industry. Our product portfolio includes Health Coverage Portal™, County Health Coverage™, Medicare Business Online™, Medicare Benefits Analyzer™, 5500 Employer Health PLUS, ASO Employer Health plus and Health Plans USA™. For more information about these products, refer to the product pages and brochures available under the Our Products section of the website (www.markfarrah.com), or call 724-338-4100.
Also, for the latest insights about health plan enrollment trends and financial performance, visit the FREE MFA Healthcare Business Strategy Briefs on the MFA website.
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