This report provides a detailed review of the commercial health insurance industry’s financial results in 2020 and evaluates changes in the market’s expense structure and enrollment relative to prior years. We also discuss emerging financial trends. Our analysis is based on a combination of medical loss ratio data submitted to the Centers for Medicare and Medicaid Services, insurance marketplace enrollment reports, and statutory filings. The main sections include:

• Financial results overview for 2020
• Detailed individual market enrollment trends: 2014 through 2022
• Insurer financial outlook for 2021 and 2022
• An appendix of aggregate health insurer financial results, 2010-2020