Health-Insurance Q3 Data Snapshot: Membership Trends

In a previous data snapshot, membership trends at the big managed-care companies looked good almost across the board, rising anywhere from two to 16 percent. The real story, however, is significantly less rosy.

Let’s start with trends in fully-insured health plans offered to employers, the traditional bread-and-butter of mainline health-insurance providers like WellPoint and UnitedHealth Group. Because insurers are able to capitalize on the upside risk of these plans, they’re generally much more profitable than these companies’ other major products — administrating self-funded health plans that are actually insured by employers themselves. First, let’s look at the trends in fully-insured membership (all figures in this post refer to membership as of Sept. 30 and its change since the previous year):

Fully-Insured Commercial Health-Plan Membership Trends

Not a pretty picture. From what I’ve been able to glean so far, Humana’s gains here largely reflects a competitive push in the fully-insured market, principally based on high-deductible “consumer-directed” plans and a strategic decision to keep its premiums in this segment flat. Aetna attributed its growth to contract wins with several large employers.

By contrast, let’s take a look at the self-funded segment on the next page.

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