This report provides an overview of health insurer financial results in 2015 and evaluates changes in the health insurance industry’s expense structure and enrollment relative to prior years. It also explores impacts to the insurance markets from the insurance marketplaces and the Patient Protection and Affordable Care Act (ACA) 3R programs. In addition, the report reviews marketplace enrollment and associated subsidies from 2014 through 2016 in the context of the aggregate individual health insurance market.