Tip Sheets

Covering health insurance? You’ll want to tap these sources on a regular basis

By Bob Herman

Covering health insurance markets can be a daunting task. Insurance itself can be extremely complicated, especially when writing about it for the first time. Also, health insurers have complex structures. The largest insurers are for-profit, and their financial data are relatively easy to find and sift through.

However, many other insurers are private or not-for-profit, or they are part of a health system, all of which makes reporting on their financial data more difficult. On top of all these complications, each state regulates health insurers differently. For journalists covering this beat, here are some resources I use regularly:

• Get SEC alerts. Get these alerts on the largest for-profit health insurers: Aetna, Anthem, Centene, Cigna, Humana, Molina Healthcare, UnitedHealth Group and WellCare Health Plans. Read the 10-Q and 10-K reports from these companies. Securities laws require publicly traded companies to use Form 10-Q to submit quarterly reports and Form 10-K for annual reports. These reports are long but usually full of vital statistics and other information such as federal probes. Insurance companies have to file their reports within 45 days of the quarter ending (unless they get an extension for some reason).

• Use the NAIC filing system. Become acquainted with the National Association of Insurance Commissioner’s filing system, which is nothing short of a labyrinth. If you check the association’s database at least every quarter, you’ll find financial statements of all health insurers, including those of not-for-profits such as the big Blue Cross Blue Shield plans. The NAIC gives journalists free access to downloads. Exploring the site and the filings is time well spent.

• Reach out to experts such as health insurers, consultants, actuaries (such as here and here) and consumer groups to explain what’s going on and the reasons behind the trends. These folks eat, sleep, and drink everything related to insurance, so it is worth absorbing what they have to say. As with any other beat, and particularly with health insurance, there are no dumb questions.

• Track Medicare Advantage and Part D plan data. CMS has enrollment data for these types of private Medicare plans broken out in several different ways. By exploring these data, you will find what’s happening with these plans in your state or nationwide. Seniors are aging into Medicare at a high rate, and there is so much money tied up in these plans that we could almost make the argument that Medicare Advantage and Part D plans are becoming more critical than employer-sponsored health insurance.

• Stay in touch with state insurance departments. Because each state regulates its insurance markets, it is vital to understand what the state insurance commissioners and top health officials are doing.

• Reach out to health insurance brokers. Because brokers are on the front lines selling health plans to individuals and companies, they know what’s going on in each market, and where the problems could be.

In addition to these primary public agency sources, get become familiar with the data from these two private sources:

• The Kaiser Family Foundation has excellent data that the foundation updates regularly, such as its reports on Medicare Advantage plans. Check out Medicare Advantage 2018 Data Spotlight: First Look and the Kaiser/HRET Employer Health Benefits Survey, the latter an annual employer health insurance benchmark survey that comes out in September.

• Mark Farrah Associates, a publisher of business information and analytics for the health care industry. MFA aggregates industry data and market metrics for its database products that it sells via subscription to health insurers, managed care organizations, consultants, investment banks and technology companies.

• Two other useful sources are The Commonwealth Fund, which closely tracks health insurance, and the Health Care Cost Institute, which publishes reports based on health insurers’ spending.

I recommend journalists also listen to the quarterly conference calls that for-profit health insurers hold with investors. The content can seem canned and full of jargon, but give journalists the opportunity hear the occasional sincere view of what top executives are thinking about their companies and the industry. Following the presentations by the CEOs, CFOs, and other executives, Wall Street analysts ask questions. These Q&As can be the most useful because the analysts understand these companies well. After listening to a few calls, you learn what’s useful and what’s fluff.

Given that many analysts’ calls are early in the morning East Coast time, you often can get the transcripts from Seeking Alpha for free if you register as a user.

For health care reporters in the states, contact your state insurance departments and develop good contacts there. There you can find out every company operating in your state and get data on each one. Brokers in your state also can be especially good sources for state-level reporters.

This final piece of advice about beat reporting applies to just about any journalist, but for those covering health insurance it may be even more important: Make sure you thoroughly understand the numbers behind every story. You may have to double, triple and quadruple check them. If something does not sound right, ask about it. In your story, be sure to explain complex topics with as little jargon as possible (doing so can make even the medical loss ratio sound interesting). As is, insurance is complicated and boring (for most people), therefore, making it understandable and relatable is critical since it affects just about everyone.

Other useful sites include some resources listed here and the following:

• America’s Health Insurance Plans, and

• The Self-Insurance Institute of America.

Bob Herman (@bobjherman) is a health care business reporter for Axios, where he covers the health care industry, hospitals, health insurers, pharmaceutical companies, physicians, medical devices and health policy. Previously, he served as Midwest bureau chief for Modern Healthcare and as a senior editor for Becker's Hospital Review.