Testimony of Thomas R. McCarthy on Behalf of Aetna Inc.

Transcription

1 Testimony of Thomas R. McCarthy on Behalf of Aetna Inc. Before the Florida Office of Insurance Regulation Thomas R. McCarthy, PhD Tallahassee, FL December 7, 2015

2 Overview 1

3 Figure 3 Distribution of All Florida Membership Aetna Humana 56,199 98, ,340 Commercial 547,888 Medicare Advantage Medicaid 1,313, ,482 Total: 1,468,265 Total: 1,482,710 2

4 Commercial 3

5 Table 1 Commercial Insurance Enrollment and Shares Florida 2015 Company Enrollment Share Florida Blue 3,150, % UnitedHealth Group 1,976, % Aetna 1,313, % Cigna 1,164, % Humana 547, % Anthem 471, % SantaFe Healthcare 277, % Health Care Service Corporation 228, % Assurant 126, % Molina Healthcare 126, % Other 1 268, % Total 9,652, % Aetna-Humana Combined 1,861, % 1 Other includes the enrollment shares for Medical Insurance Companies in Florida with a share of less than 1%. Sources: Aetna Enrollment Data, May Humana Enrollment Data, June HealthLeaders-Interstudy Managed Market Surveyor, January

6 Table 2 Florida Commercial Enrollment and Shares by Company Small Group Plans 2014 Company Covered Lives Share BCBS of Florida 343, % UnitedHealthcare 183, % Aetna 118, % Humana 81, % Neighborhood Health Partnership, Inc. 50, % AvMed, Inc. 33, % Capital Health Plan, Inc. 16, % Health First Health Plans, Inc. 12, % Other 1 7, % Total 846, % Aetna-Humana Combined 199, % 1 Other includes the enrollment shares for Medical Insurance Companies in Florida with a share of less than 1%. Source: Florida Office of Insurance Regulation Market Research Unit, "CY2014 Accident and Health Markets Gross Annual Premium and Enrollment," August 26,

7 Table 3 Florida Commercial Enrollment and Shares by Company Large Group Plans 2014 Company Covered Lives Share BCBS of Florida 486, % Aetna 211, % UnitedHealthcare 208, % Cigna 139, % Humana 101, % Capital Health Plan, Inc. 91, % Neighborhood Health Partnership, Inc. 56, % Health Care Service Corporation 31, % AvMed, Inc. 26, % Other 1 26, % Total 1,379, % Aetna-Humana Combined 310, % 1 Other includes the enrollment shares for Medical Insurance Companies in Florida with a share of less than 1%. Sources: Florida Office of Insurance Regulation Market Research Unit, "CY2014 Accident and Health Markets Gross Annual Premium and Enrollment," August 26,

8 Table 4 Company Florida Commercial Enrollment and Shares by Company Individually Underwritten Plans Covered Covered Lives Share Lives Share BCBS of Florida 351, % 580, % Aetna 89, % 305, % Humana 90, % 260, % UnitedHealthcare 129, % 116, % Cigna 85, % 99, % Preferred Medical Plan, Inc. 18, % 87, % Time Insurance Company 17, % 27, % Other 1 31, % 25, % Total 814, % 1,503, % Aetna-Humana Combined 180, % 566, % 1 Other includes the enrollment shares for Medical Insurance Companies in Florida with a share of less than 1%. Sources: Florida Office of Insurance Regulation Market Research Unit, "CY2013 Accident and Health Markets Gross Annual Premium and Enrollment," November 12, Florida Office of Insurance Regulation Market Research Unit, "CY2014 Accident and Health Markets Gross Annual Premium and Enrollment," August 26,

9 Medicare 8

10 Table 6 Florida Medicare Enrollment and Shares 2015 Company Enrollment Share Traditional Medicare 2,369, % Humana 490, % UnitedHealth Group 308, % BCBS of Florida 151, % Aetna 79, % WellCare 72, % Cigna 49, % America's 1st Choice Holdings 39, % Other 1 119, % Total 3,680, % Aetna-Humana Combined 570, % 1 Other includes the enrollment shares for Medical Insurance Companies in Florida with a share of less than 1%. Sources: Aetna Enrollment Data, May Centers for Medicare and Medicaid Services (CMS), "Monthly Enrollment by Contract/Plan/State/County for Medicare Advantage," June CMS, "Plan Directory for Medicare Advantage, Cost, PACE, and Demonstration Organizations," June CMS, "State County Penetration Data for Medicare Advantage," June U.S. Census, "Core based statistical areas (CBSAs) and combined statistical areas (CSAs)," March

11 Medicaid 10

12 Table 8 Florida Medicaid Managed Medical Assistance Enrollment and Shares October 2015 Plan Enrollment Share Staywell Health Plan of Florida 691, % Centene 454, % Amerigroup Florida, Inc. 341, % Humana 326, % Prestige Health Choice 312, % United Healthcare of Florida 276, % Molina Healthcare of Florida 193, % Integral Quality Care 99, % Better Health 94, % Simply Healthcare Plans, Inc. 89, % Children's Medical Services Network 53, % Aetna 51, % SFCCN 42, % Magellan Complete Care, LLC 42, % Others 1 335, % Total 3,406, % Aetna-Humana Combined 377, % 1 "Others" includes MMASC plans for 'AHF/Positive Healthcare', 'Freedom Health, Inc.', and FFS enrollees who are eligible for Medicaid Managed Care plans. 11 Source: Agency for Health Care Administration, Florida Statewide Medicaid Monthly Enrollment Report, "Current Comprehensive Medicaid Managed Care Enrollment Reports," October 2015.

13 Table 9 Florida Medicaid Long Term Care Enrollment and Shares October 2015 Plan Enrollment Share Centene 35, % United Healthcare of Florida, Inc. 19, % Humana 18, % Molina Healthcare of Florida, Inc. 5, % Aetna 4, % Amerigroup Florida, Inc. 4, % Total 89, % Aetna-Humana Combined 23, % Source: Agency for Health Care Administration, Florida Statewide Medicaid Monthly Enrollment Report, "Current Comprehensive Medicaid Managed Care Enrollment Reports," October