Hawaii Medical Service Association said it plans to use a $14.6 million profit in the third quarter to boost member reserves in case of emergencies.
The gains of the state’s largest health insurer were down from $17.8 million in the year-earlier quarter. HMSA’s main competitor, Kaiser Permanente Hawaii, lost $300,000 in the quarter, reversing a year-earlier profit of $7.7 million.
HMSA collected $821.2 million in premiums from its 732,370 members, up from $801.4 million a year ago, and paid $737.5 million in medical benefits, an increase from $721.7 million. Administrative expenses jumped to $82.9 million from $56.4 million due to an accounting adjustment in 2016 expenses, the company said.
The insurer reported a modest $18,104 operating profit that was bolstered by $15.9 million in investment gains, up from $6.8 million a year ago. The operating gain was $19.9 million in the year-ago quarter.
HMSA
THIRD-QUARTER NET
$14.6 million
YEAR-EARLIER NET
$17.8 million
—–
KAISER
THIRD-QUARTER LOSS
$300,000
YEAR-EARLIER NET
$7.7 million
|
The company said the remainder of revenue was used for fees and taxes associated with the federal Affordable Care Act, which requires most Americans to obtain medical coverage or pay tax penalties.
The health plan’s reserve stood at $462.1 million, or $630 per member, at the end of the quarter, up from $372.6 million, or $508 per member, a year ago.
“Our reserve provides peace of mind for our members, employers, and doctors and hospitals. It ensures that funds are always available to pay for health services during emergencies such as the hepatitis A outbreak last year,” HMSA CEO Michael Gold said in a news release.
Meanwhile, Kaiser — both an insurer and medical provider — collected $370.1 million in premium revenue, up from $350.2 million, and paid $371.7 million in benefit expenses, up from $343.2 million.
The HMO reported a $1.6 million operating loss, compared with a $7 million year-earlier gain. Income from investments totaled $1.3 million, an increase from $700,000.
Kaiser, which took over three Maui County hospitals in July, saw membership grow by more than 1,200 this year to 250,955.
“We continue to work to bend the cost trend and deliver affordable, high-quality care to our members and patients. Major drivers of the quarter’s results were higher-than-expected outside medical spending and pharmacy costs, especially new, high-cost specialty drugs,” spokeswoman Laura Lott said in a statement.
Both HMSA and Kaiser are raising rates at the start of the year for roughly 34,000 individuals covered by the ACA, also known as Obamacare.
HMSA is boosting premiums for Obamacare plans by an average 19.8 percent, while Kaiser’s ACA rate hike will average 24.1 percent.