Leading Health Plans Had Mixed Results in First Quarter 2013

Leading Health Plans Had Mixed Results in First Quarter 2013

<0> Mark Farrah AssociatesDebra Donahue, 207-985-8484 </0>

According to a new report released by Mark Farrah Associates (MFA) (), most of the nation’s leading health plans saw enrollment gains in the first quarter of 2013, but five of the seven top health insurance carriers reported a slight downturn in profitability year-over-year. MFA found that during the primary open enrollment season, between December 2012 and March 2013, top plans saw an aggregate increase of nearly 1.1 million members. This is down from the nearly 1.4 million gained from December 2011 to March 2012. Year-over-year, total membership for the seven leading plans increased by nearly 5.4 million, from 131.3 million as of March 2012 to 136.7 million as of March 2013.

Leading health plans' profit margins, net earnings or net income divided by revenues, decreased from a combined average of 5.8% for first quarter 2012 to 5.6% for first quarter 2013. Several factors, including enrollment shifts to lower margin administrative services only (ASO) business and government-sponsored coverage, did impact profitability. Commercial, Senior and Medicaid segments all saw enrollment growth year-over-year. However, while aggregated total Commercial enrollment increased by 1.1% from 1Q12 to 1Q13, all commercial growth came from the ASO segment. Commercial fully-insured (risk) enrollment decreased by nearly 1.5 million members (- 3.7%) from March 2012 to March 2013. Senior (also referred to as Medicare) and Medicaid enrollment increased 10.1% and 38.6%, respectively during the same period. WellPoint's acquisition of Amerigroup drove most of the growth in Medicaid.

In the latest Healthcare Business Strategy report, MFA reviewed enrollment and financial trends for Aetna, Cigna, Health Care Service Corporation (HCSC), Humana, Kaiser Permanente, UnitedHealth Group and WellPoint. Membership data, financial statistics and observations were gleaned from the July 2013 Health Insurer Insights™ series, a Mark Farrah Associates publication. To read the full text of “Mixed Results for Leading Health Plans in First Quarter 2013," visit the Analysis Briefs library on Mark Farrah Associates' website .

About Mark Farrah Associates (MFA)

MFA is a leading data aggregator and publisher providing health plan market data and analysis tools for the healthcare industry. Committed to simplifying analysis of health insurance business, our products include Health Coverage Portal™, County Health Coverage™, Health Insurer Insights™, Medicare Business Online™, Medicare Benefits Analyzer™ and Health Plans USA™.