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Enrollment Increased 5.6M for U.S. Health Plans

Jun 19, 2013
June 12, 2013

Leading U.S. health insurers realized an aggregate membership increase of 5.6 million from 2011 to 2012, according to Mark Farrah Associates (MFA). 

According to a release, the top seven companies analyzed enrolled 135.7 million medical members, which represents approximately 52 percent of the estimated 260.2 million people with health insurance in the United States. The leaders saw significant gains in Medicare and Medicaid business while commercial enrollment growth was slight.

In addition, the group noted:

UnitedHealth, the largest plan in the United States based on membership, reported total enrollment gains year-over-year of 1.93 million new enrollees. UnitedHealth, with growth in Commercial, Medicare and Medicaid, reported 36.50 million medical enrollees for 2012 in its 10K filing with the Securities Exchange Commission (SEC). WellPoint, UnitedHealth's nearest rival, reported an enrollment gain of 1.88 million. The company reported total medical enrollment of 36.13 million, including Amerigroup, for year-end 2012 and 34.25 million for 2011 in its 2012 10K filed with the SEC.

Most of the leaders saw a slight downturn in year-over-year profitability for the year ended December 31, 2012, primarily due to decreases in commercial enrollment and increases in Medicare and Medicaid medical loss ratios (segment premiums divided by segment medical expenses). Acquisition costs and implementation of health reform regulations were also cited as reasons for declining profits. Kaiser was the only top plan to report improvement in profitability year-over-year.

"As reform reshapes the health insurance industry, the industry leaders are setting precedent for other health plans as they modify their business strategies to capitalize on reform opportunities," according to LuAnne Farrah , President of Mark Farrah Associates.

In the latest Healthcare Business Strategy report, MFA analyzes market share and financial performance for industry leaders Aetna, Cigna, Health Care Service Corp. (HCSC), Humana, Kaiser Permanente, UnitedHealth Group and WellPoint.

MFA is a data aggregator and publisher providing health plan market data and analysis tools for the healthcare industry.
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