Top Health Plans’ Medical Expenses Rising, Membership Falling

KENNEBUNK, Maine-The nation’s leading health insurers saw an aggregate decline of 836,000 members for the first six months of 2009. Declining commercial enrollment was offset primarily by gains in products offered to seniors and growth in Medicaid business. Administrative Services Only (ASO) enrollment experienced its first quarterly decline since June 2007. The difficult economy is still taking a toll in terms of rising medical expenses and declining membership for most plans however profitability is showing signs of improvement for some of the top plans in the country.

Mark Farrah Associates (MFA), a leading provider of market data and intelligence solutions, found -- for the eight leading U.S. health insurers -- aggregate membership was down to 132.4 million members from 133.2 million members at year-end 2008. For these top insurers, combined Medicare Supplement and Medicare Advantage enrollment increased by 405,000 members between 4Q08 and 2Q09 offsetting some of the 1.452 million membership decline experienced in the Commercial sector. Medicaid enrollment increased 211,000 for the same period.

ASO enrollment decreased -0.9% and risk enrollment declined -0.2% for these plans between 2Q08 and 2Q09. Between first and second quarter 2009 ASO enrollment declined -4.6%, the first quarterly decline since June 30, 2007. Of the top plans, all but Aetna, HCSC and Health Net reported decreases in ASO covered lives.

In the latest Healthcare Business Strategy report, MFA reviewed enrollment and financial trends among eight top health insurers: Aetna, CIGNA, Health Care Service Corporation (HCSC), Health Net, Humana, Kaiser Permanente, UnitedHealth Group and WellPoint. These eight health plans cover 59% of the total insured population in the nation, up 2.3% from second quarter 2008. Membership data, financial statistics and observations were gleaned from the October 2009 Health Insurer Insight™ series.

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