Study: North Dakota Health Insurance Market Near Monopoly

December 5, 2012

An American Medical Association study concludes that North Dakota’s health insurance market is almost a monopoly but the state’s dominant health insurer says consumers are not getting gouged.

The study says a concentration of health insurance among a handful of companies leads to less-generous benefits and higher premium costs, the Forum newspaper reported

Blue Cross Blue Shield is the state’s dominant health insurer, with about 85 percent of premiums in the standard private health insurance market, according to the state Insurance Department.

“I would argue that having a dominant market share has not increased premiums,” said Judd Wagner, Blue Cross Blue Shield’s chief marketing officer.

He said the average 2011 employee contribution for single coverage provided through an employer was $987 in North Dakota, compared to a national average of $1,090, according to figures from Kaiser Family Foundation. Blue Cross Blue Shield of North Dakota health plans also typically are ranked in the top 10-25 percent in terms of benefit offerings, Wagner said.

State Insurance Commissioner Adam Hamm said the study confirms that a single health insurer dominates in North Dakota but said consumers are getting more choices, with companies introducing six new major medical coverage plans in the state last year.

It is not known whether health insurance exchanges – online marketplaces to help consumers comparison-shop for coverage that are part of federal health care law – will help attract new insurers to the North Dakota market starting in 2014.

“We are still a couple of years away from finding out conclusively what, if any, promises the federal government has been able to keep,” Hamm said.

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