Membership drains plague top U.S. health plans

Health insurers still cannot escape the impact of the recession and high unemployment. Major U.S. health plans endured continuing membership losses through calendar third-quarter 2009 (3Q09), and most leading plans project year-end 2009 and 2010 membership declines as well, according to Kennebunk, Maine-based market data provider Mark Farrah Associates (MFA).

Aggregate declines for the top eight plans totaled more than 1.7 million members, or 1.3 percent, from September 2008 to September 2009 for both the fully insured and administrative services-only (ASO) segments. Specifically, risk enrollment dropped 1.6 percent, while ASO enrollment fell 1.1 percent.

Year-over-year enrollment declines for WellPoint Inc. in Indianapolis and UnitedHealth Group in Minneapolis--the nation's two largest health plans--respectively totaled 1.482 million and 820,000. The insurers attributed the declines to the economy and the need to maintain strict pricing and underwriting discipline.

On a consecutive-quarter basis, risk enrollment for the top eight health plans decreased 0.9 percent and ASO enrollment declined 0.4 percent from 2Q09 to 3Q09, which amounts to a combined loss of 860,000 members.

Only two of the top eight health plans experienced enrollment gains in 3Q09 vs. 2Q09: Humana Inc. in Louisville, Ky., and Health Care Services Corp. (HCSC) in Chicago, which includes Blue Cross Blue Shield plans in Illinois, New Mexico, Oklahoma, and Texas.

In addition to WellPoint, UnitedHealth, Humana and HCSC, MFA analyzed enrollment and financial trends at Aetna Inc., CIGNA Corp., Health Net Inc. and Kaiser Permanente. These eight health plans covered 131.5 million members in 3Q09, down from 133.2 million in 3Q08. Nevertheless, the plans accounted for almost 60 percent of the total U.S. insured population, up 0.1 percent from 3Q08.

To learn more about health plan trends:
- read MFA's Healthcare Business Strategy report