Mark Farrah Associates presents regular information on enrollment levels and profitability for the seven largest US health insurers–Aetna, Cigna, HCSC (a collection of Blues plans), Humana, Kaiser, UnitedHealth and WellPoint (now officially known as Anthem and also a collection of Blues plans). The latest data is as of the end of the second quarter of 2014. (MFA Release) Collectively they covered over 143 million Americans in self-funded, insured and government-sponsored plans. Membership in insured plans grew 4% and self-funded enrollment rose 3%. Of these seven large plans, only one, UnitedHealth, had a year-over-year membership decline. Aetna, HCSC and WellPoint all had gains of over one million members in the trailing twelve-month period, while Humana experienced an increase of over 900,000. Aetna had 10% growth in risk-based members and more moderate growth in other segments. It said some self-funded accounts are moving to insured private exchange models. Cigna’s enrollment was close to flat. HCSC had a large jump in individual insured policies of over 800,000 people, probably from the exchanges. It will be interesting to see the financial effects on the companies which gained large numbers of enrollees on the exchanges, where pricing and utilization was very uncertain. Humana lost self-funded groups, but also had a large jump in individual policies of over 550,000 members. Kaiser picked up good self-funded growth, but otherwise was close to flat. UnitedHealth attributed its drop in self-funded enrollees to loss of a large state employee group and said it had very slow insured plan growth because it maintained price discipline. UnitedHealth also largely avoided exchange participation in 2014. WellPoint picked up 12% more self-funded business and had strong overall membership growth of 1.6 million. Although profit margins remained healthy, they were generally down compared to the year-earlier period. Kaiser had a profit margin of 7.5%, which is interesting since it is supposedly a non-profit company. Aetna’s margin was 3.8%, UnitedHealth’s was 5.4% and WellPoint’s was at 3.9%. The data suggest that the largest health plans continue to gain market share in most segments and to do so in a profitable manner.
