Top 3 large-group carriers in each state – Part 2

Published
  • June 05 2018, 12:13pm EDT
There’s approximately $95 billion in fully insured health insurance premium in the U.S. large-groups (100+ employees) market — and there are just a few major carriers who control most of it.

“Bifurcated between the Blue Cross franchises and the big four — Aetna, Kaiser, UnitedHealthcare and Cigna — the Blue Cross franchises control 46% of that $95 billion, and the big four controls 39% of that marketplace,” says miEdge founder and CEO Mark Smith.

Using data from annual Form 5500 Schedule A reporting to the federal government by large-group employers, data analytics firm miEdge ranked the top three carriers in each state based on in-force group health premium, predominantly from the fully insured employer-sponsored healthcare market.

“What it shows is the marketplace is very much controlled by a select few,” says Smith.

Presented in alphabetical order, the listing highlights what the top carriers in each state and the District of Columbia are doing with their significant marketshare. Many are addressing the nation’s opioid crisis, others are investing in their local communities to build access to qualified doctors, nurses and specialty services. Some have recently won awards as top employers and healthcare providers themselves or are undergoing leadership changes with new executives.

Here is part two of the remaining carriers in the United States.

Overview

There’s approximately $95 billion in fully insured health insurance premium in the U.S. large-groups (100+ employees) market — and there are just a few major carriers who control most of it.

“Bifurcated between the Blue Cross franchises and the big four — Aetna, Kaiser, UnitedHealthcare and Cigna — the Blue Cross franchises control 46% of that $95 billion, and the big four controls 39% of that marketplace,” says miEdge founder and CEO Mark Smith.

Using data from annual Form 5500 Schedule A reporting to the federal government by large-group employers, data analytics firm miEdge ranked the top three carriers in each state based on in-force group health premium, predominantly from the fully insured employer-sponsored healthcare market.

“What it shows is the marketplace is very much controlled by a select few,” says Smith.

Presented in alphabetical order, the listing highlights what the top carriers in each state and the District of Columbia are doing with their significant marketshare. Many are addressing the nation’s opioid crisis, others are investing in their local communities to build access to qualified doctors, nurses and specialty services. Some have recently won awards as top employers and healthcare providers themselves or are undergoing leadership changes with new executives.

Here is part two of the remaining carriers in the United States.

Missouri

1) Blue Cross and Blue Shield of Kansas: $332,246,378

2) UnitedHealthcare: $305,242,159

3) Anthem: $257,040,141

In February, the Kansas City Business Journal named Blue Cross and Blue Shield of Kansas City one of its "Healthiest Employers" in the 500-1,499 employees category, highlighting its free 24/7 onsite fitness center, among other attributes. "Blue KC is committed to improving the health of our members and we know that starts within our own workforce. The health and wellness of our employees is a priority and that's why we invest in a workplace culture that promotes a balanced, active lifestyle," said Danette Wilson, president and CEO at Blue KC.

Content Continues Below

Montana

1) Health Care Service Corporation: $68,151,733

2) Cigna: $10,807,207

3) PacificSource Health Plans: $10,716,561

Blue Cross and Blue Shield of Montana, a division of HSCS, recently announced a $15,000 donation to the American Red Cross of Montana to support statewide flood relief efforts. BCBSMT Community Relations Manager Jesse Zentz said, "We care deeply about the health and well-being of our fellow Montanans, and we embrace a culture of giving back to the communities we serve, especially in times of crisis. We're proud to support the Red Cross of Montana and to offer emergency services through our Care Van program."

Nebraska

1) Blue Cross and Blue Shield of Nebraska: $299,735,086

2) UnitedHealthcare: $95,569,851

3) Aetna: $32,992,765

Blue Cross and Blue Shield of Nebraska in late March promoted Steven H. Grandfield to president and CEO. “Steve Grandfield has led the transformation of the information technology and operational areas of the company over the last 15 years,” Steven S. Martin, outgoing president and CEO, said. “In most recent years, he has overseen strategic planning. I cannot think of anyone better suited to lead our company.”

Nevada

1) UnitedHealthcare: $382,816,083

2) Anthem: $69,297,167

3) Aetna: $39,563,028

In its annual “Wellness Check Up Survey,” released May 22, UnitedHealthcare found 27% of employees own an activity tracker, double the number who did in 2016. “By investing in wellness programs, employers are in a unique position to drive engagement and create healthier, happier and more productive workforces,” said Rebecca Madsen, UnitedHealthcare chief consumer officer.

Content Continues Below

New Hampshire

1) Harvard Pilgrim Health Care: $136,497,441

2) Anthem: $134,990,436

3) Cigna: $27,492,645

In April, Harvard Pilgrim announced a partnership with Guardian to begin offering its employer groups dental and vision insurance, basic life and accidental death and dismemberment, life insurance, short and long-term disability and accident, cancer, critical illness and hospital indemnity coverage. The new options will have a July 1 effective date. “We are excited to offer these new insurance products,” said Harvard Pilgrim President and CEO Eric Schultz. “In doing so, we will better serve the needs of our employer groups and their employees. The expansion in insurance choices will provide easy shopping and enable employees to select coverages that meet their individual and family needs.”

New Jersey

1) Horizon Blue Cross Blue Shield of New Jersey: $682,350,275

2) Aetna: $596,784,139

3) UnitedHealthcare: $375,385,102

DiversityInc Magazine named Horizon Blue Cross Blue Shield of New Jersey as a Top Ten Regional Company for Diversity. The May announcement put BCBSNJ in the No. 5 position for 2018. It’s the eighth year in a row the company has made the top 10. “Horizon is a company that thrives and prospers because our workforce is richly diverse, uniquely talented and committed to excellence,” Alison Banks-Moore, chief diversity officer at Horizon BCBSNJ, said. “Diversity empowers our company to better solve problems, achieve peak performance and effectively serve our customers who live in one of the nation’s most diversely populated states.”

New Mexico

1) Health Care Service Corporation: $105,212,580

2) Presbyterian Insurance Company: $28,210,385

3) UnitedHealthcare: $13,194,733

Joining the national effort to combat the opioid crisis, Blue Cross and Blue Shield of New Mexico, a division of HCSM, in May announced it is joining Walgreens to expand the availability of year-round safe medication disposal at select Walgreens locations throughout the state. “We believe that it is important for us to help with and contribute to this effort to increase the number of kiosks in Walgreens locations throughout New Mexico,” said Eugene Sun, vice president and chief medical officer at BCBSNM. “The opioid epidemic affects our communities and fellow New Mexicans, and we are pleased to help provide more access for people to dispose of medication safely and conveniently.”

Content Continues Below

New York

1) UnitedHealthcare: $1,631,235,277

2) Aetna: $1,253,281,904

3) Cigna: $914,536,567

Addressing the New York market, “It’s interesting to me that none of these are Blue Cross franchises,” said miEdge’s Mark Smith, considering there are several Blue Cross-affiliated carriers in New York. “I think what’s happening is there’s clearly competition. United, Aetna and Cigna have found a way to compete aggressively against the Blue Cross franchises.”

North Carolina

1) Blue Cross and Blue Shield of North Carolina: $538,201,275

2) UnitedHealthcare: $299,189,698

3) Kaiser: $255,597,821

Blue Cross and Blue Shield of North Carolina on May 22 joined The Health Care Transformation Task Force, a group of leading healthcare payers, providers, purchasers and patient organizations. The goal is to transform the U.S. healthcare system through a commitment to value-based delivery and other care-improving initiatives. “Blue Cross NC looks forward to bringing its energy and perspective from this geographically and culturally diverse state to the Task Force and learning from the tremendous depth of Task Force members’ experiences,” said Rahul Rajkumar, chief medical officer of Blue Cross NC.

North Dakota

1) Blue Cross Blue Shield of North Dakota: $107,505,389

2) Medica: $12,038,130

3) Sanford Health Plan: $7,777,905

Dr. Gwen Halaas in April joined Blue Cross Blue Shield of North Dakota as Medical Director. She is responsible for providing leadership and oversight for quality management activities, including quality monitoring, fraud, waste and abuse, physician reporting and medical policy development, the company said. She also provides clinical support in the areas of utilization management, case management, disease management and medical policy.

Content Continues Below

Ohio

1) Anthem: $671,490,693

2) UnitedHealthcare: $584,281,253

3) Medical Mutual of Ohio: $401,034,536

Anthem in October announced the launch of a new program to serve staffing, hospitality, retail and healthcare industries where the workforces include large numbers of part-time, temporary, variable-hour, contingent and contract workers. It is available to plan sponsors with at least 1,000 intermittently employed workers in Ohio or its sister health plans in 13 other Anthem states, the company said. “There is strong evidence suggesting the U.S. workforce is in the midst of a fundamental re-structuring, driven by significant growth in the intermittent, or freelance workforce, as employers manage labor costs and workers spanning different generations seek greater lifestyle flexibility,” said Morgan Kendrick, president of Anthem’s national accounts business segment. “This in turn creates a new employment ecosystem where independent workers need access to quality, payroll-deducted group benefits and plan sponsors need a comprehensive, benefits rewards program designed specifically for their on-demand workforce that complements their full-time benefits strategies.”

Oklahoma

1) Health Care Service Corporation: $302,682,893

2) Aetna: $153,658,554

3) UnitedHealthcare: $110,138,695

More than 1,200 students from 15 schools in Oklahoma on May 10 attended Be Smart-Don’t Start Anti-Tobacco Day at the Science Museum Oklahoma, sponsored by HCSC division Blue Cross and Blue Shield of Oklahoma. The carrier initiated the program 14 years ago to teach Oklahoma youth how to live a healthy lifestyle and make smart choices. “Tobacco use is a major health issue affecting the quality of life in Oklahoma,” said Ted Haynes, president of Blue Cross and Blue Shield of Oklahoma. “Educating our children and families can help to improve the health and well-being of Oklahomans today and in the future.”

Oregon

1) Kaiser: $442,709,194

2) Providence Health Plan: $225,267,588

3) Regence BlueCross BlueShield of Oregon: $209,128,299

Portland State University, Kaiser Permanente and Portland Leadership Foundation collaborated this spring to develop a new academic health scholarship designed to attract a diverse generation of doctors, nurses and health professionals to the region. Over the next five years, 100 PSU students will receive $5,000 Ignite scholarships to complete their pre-health undergraduate education at PSU. Kaiser contributed $250,000 toward the scholarship. “One of the most meaningful things we can do to shape the future of healthcare is invest in the next generation of health workers,” said Ruth Williams-Brinkley, president of Kaiser Foundation Health Plan and Hospitals of the Northwest.

Content Continues Below

Pennsylvania

1) Independence Blue Cross: $1,462,516,965

2) Highmark Blue Cross Blue Shield: $1,456,702,228

3) Aetna: $702,758,823

To help combat the growing opioid crisis, Independence Blue Cross this spring sponsored a convention to address the issue in Bucks County, Pa., where there has been a 50% increase in drug-related deaths since 2015. Independence sponsored the Together We Can Convention, a grassroots event held in Newtown, Pa., on National Prescription Drug Take Back Day, April 28. Hundred of people, including legislators, law enforcement, recovery specialists and the public attended.

Rhode Island

1) Blue Cross & Blue Shield of Rhode Island: $477,321,040

2) UnitedHealthcare: $48,185,918

3) Tufts Health Plan: $14,948,804

In May, Blue Cross & Blue Shield of Rhode Island announced two efforts to improve access to high-quality, affordable behavioral healthcare. Effective Jan. 1, 2019, copayments for behavioral health office visits will be consistent with primary care office visits. And, as of Aug. 1, 2018, BCBSRI will remove approval requirements for in-network behavioral health services. “The behavioral healthcare system can be difficult to navigate, leaving many unsure of where to go when they need care,” said Dr. Matt Collins, vice president of clinical integration at BCBSRI. “These new policies help remove barriers to care and improve health outcomes for our members, especially after they leave inpatient treatment. We look forward to continued collaboration with the provider community as we explore more ways to improve the behavioral healthcare delivery system to enable a better experience, better outcomes, and more cost-effective care for Rhode Islanders.”

South Carolina

1) BlueCross BlueShield of South Carolina: $486,234,341

2) Florida Blue: $99,034,795

3) UnitedHealthcare: $80,646,620

Forbes magazine in May named BlueCross BlueShield of South Carolina to its annual ranking of America’s Best Employers. It is the second time in three years that the carrier made the list. “Our employees are our greatest asset,” said David Cote, vice president of human resources at BlueCross. “Just as our employees are responsive to our customers, BlueCross leadership seeks to create an environment that fosters excellence and professional growth, encourages community involvement and recognizes the importance of work-life balance.”

Content Continues Below

South Dakota

1) Wellmark Blue Cross Blue Shield: $176,123,715

2) Sanford Health Plan: $53,990,881

3) Medica: $18,923,671

Wellmark Blue Cross and Blue Shield announced in March its annual “Wellmarkability” report highlighting the company’s progress toward the goal of building and maintaining a sustainable healthcare system. As part of that report, Wellmark said 77 Blue Distinction Centers and Blue Distinction Centers+ that provide specialty care across Iowa and South Dakota have become an average of 20% more cost-efficient, with a proven track record of fewer complications and readmissions. “Working toward a sustainable healthcare system for future generations is Wellmark’s top priority,” said John Forsyth, chairman and CEO of Wellmark. “Each year, we take significant steps toward that goal, working both inside and outside the healthcare system.”

Tennessee

1) BlueCross BlueShield of Tennessee: $876,347,052

2) UnitedHealthcare: $227,434,525

3) Cigna: $180,844,254

In May, Forbes magazine selected BlueCross BlueShield of Tennessee as one of America’s Best Employers. BlueCross ranked no. 491 out of 500 large employers in the U.S. Recently, the carrier implemented a higher minimum wage for all starting employees, increased pay for many skilled nurses and added a competitive paid parental leave program. “We’re thankful for this national honor, which reflects our employees’ views on our mission-driven workplace,” said Karen Ward, senior vice president and chief human resources officer for BlueCross.

Texas

1) UnitedHealthcare: $2,946,128,633

2) Health Care Service Corporation: $2,220,839,379

3) Aetna: $965,339,231

Almost one-third of employees with access to wellness programs are willing to spend at least an hour each day to improve their health, UnitedHealthcare found in its annual “Wellness Check Up Survey,” released May 22. This is compared to 25% of those without access to such initiatives, the company said. Additionally, 30% of wellness plan participants report it helped them to detect a disease. “This year’s results underscore the importance of workplace wellness programs, which can encourage well-being, prevent disease before it starts and, as a result, help lower medical costs,” said Rebecca Madsen, UnitedHealthcare chief consumer officer. “By investing in wellness programs, employers are in a unique position to drive engagement and create healthier, happier and more productive workforces.”

Content Continues Below

Utah

1) SelectHealth: $212,977,061

2) Regence BlueCross BlueShield: $198,188,740

3) UnitedHealthcare: $149,636,198

SelectHealth is Utah’s top-ranked health plan, according to NCQA's Health Insurance Plan Rankings 2017–2018, receiving a 4.0 for high performance. Based on clinical quality, member satisfaction and NCQA accreditation, SelectHealth has been recognized as the highest-ranked plan in Utah each year since 2005, when the rankings were first introduced, the carrier noted.

Vermont

1) Blue Cross and Blue Shield of Vermont: $48,336,943

2) Cigna: $23,472,882

3) The Vermont Health Plan: $7,743,221

BCBSVT has expanded its partnership with telemedicine service American Well (Amwell) to give members 24/7/365 virtual doctor access. In addition to help with issues such as respiratory infections, bronchitis, urinary tract infections, pharyngitis, rashes, pink eye, cough, flu, stuffy head and allergies,
effective Jan. 1 newly added services include nutritional counseling, breastfeeding support and mental health and substance abuse support. “We are very excited to be able to offer our members 24/7 access to providers,” said Dr. Joshua Plavin, vice president and chief medical officer at BCBSVT. “... With over half the state’s population living in more rural areas, having a way to connect with round-the-clock care via phone or computer can significantly increase healthcare access in Vermont.”

Virginia

1) Anthem: $629,811,004

2) UnitedHealthcare: $556,925,694

3) Kaiser: $374,842,126

Not long after Anthem first announced it would exit the Affordable Care Act’s health insurance market in Virginia last year, the carrier reversed course, agreeing to continue to serve the counties in the state that had no other option for health coverage under the ACA. "Anthem will remain focused on developments in the individual marketplace and will continue to advocate for solutions that will stabilize the market and allow us to once again offer individual insurance coverage throughout the state of Virginia in the future," the company said. “Thank you, Anthem! You have saved VA lives,” Gov. Terry McAuliffe tweeted in September.

Content Continues Below

Washington

1) Kaiser: $775,254,942

2) Premera Blue Cross: $619,510,249

3) Regence BlueShield: $312,978,258

Last fall, Kaiser Permanente announced Ruth Brinkley as the carrier’s new president of Kaiser Foundation Health Plan and Hospitals of the Northwest, which includes Oregon and markets in Vancouver and Longview/Kelso, Wash. “Ruth’s deep experience in integrated and nonprofit healthcare systems makes her a great fit for this important leadership role,” said Kaiser Permanente Chairman and CEO Bernard J. Tyson. “Her commitment to improving access to high-quality care is very reflective of Kaiser Permanente’s mission. Ruth understands the ever-growing demands of consumers. I look forward to her contributions in the Northwest and to our entire organization.”

West Virginia

1) Highmark Blue Cross Blue Shield: $123,016,012

2) Health Care Service Corporation: $29,636,150

3) Anthem: $7,163,583

In April, Highmark Blue Cross Blue Shield West Virginia collaborated with WVU Medicine Camden Clark Medical Center to encourage employees and area residents to develop a habit of walking through the annual Walk 100 Miles in 100 Days program. The 15-week initiative runs through July 24. "We are excited to partner with WVU Medicine Camden Clark Medical Center and the City of Parkersburg to show people that adopting a healthy habit like walking can have many positive effects on their overall quality of life," said Jim Fawcett, president, Highmark West Virginia. "We hope this walking challenge will provide encouragement to our employees and to the community to get up, get moving and get healthy."

Wisconsin

1) Health Care Service Corporation: $470,228,326

2) UnitedHealthcare: $278,176,039

3) Quartz: $206,750,172

Last month, HCSC announced it plans to double its employee volunteer efforts from 500,000 hours to 1 million by 2021. “We live our values every workday as a partner in the health and well-being of our members," said Joel Farran, senior vice president and chief brand officer, HCSC. “We also live those values beyond our jobs. Whether it’s building a playground to encourage healthy activities for families, packing relief supplies for those recovering from a national disaster or providing access to much-needed health services, our employees show up. Being part of our communities isn’t just what we do, it’s what we love to do.”

Content Continues Below

Wyoming

1) Blue Cross Blue Shield of Wyoming: $5,670,418

2) Cigna: $4,237,926

3) Companion Life Insurance Company: $1,396,357

The Blue Cross Blue Shield of Wyoming Caring Foundation continues to invest in nursing education at the University of Wyoming and the state’s community colleges through the Blue Cross Blue Shield of Wyoming Scholars Program. It is part of a larger initiative, Meeting Wyoming’s Needs Through Nurse Education. “Blue Cross Blue Shield of Wyoming is committed to improving the health of its members and strengthening the Wyoming healthcare system,” said Rick Schum, BCBS of Wyoming president and CEO. “As we meet with local hospital officials, they tell us how difficult it is to find nursing staff. Our Caring Foundation gives us a great opportunity to invest in quality people who will be on the front lines working with patients to ensure they get healthy and stay healthy longer.”