BASIC FACTS & FIGURES: NONPROFIT HEALTH PLANS 1 Of the 154 health plans in the United States with at least 100,000 enrollees, 97 (or 63%) are nonprofit, 41 are for-profit (27%), and 16 (10%) are government. Of the 230,773,945 total enrollees in these 154 health plans, 104,273,365 (or 45%) are in nonprofit health plans. Fifty-seven percent (57%) of total enrollees (or 132,427,681) are fully insured lives and, of these, 50% come from nonprofit health plans. Fully % % Nonprofit 66,074,819 50% 104,273,365 45% For-Profit 62,377,369 47% 122,407,737 53% Government 3,975,493 3% 4,092,843 2% s 132,427,681 100% 230,773,945 100% The following table ranks these health plans by fully insured enrollment (not including network lives): Fully Fully 1 1 FP UnitedHealthcare 18,420,651 34,675,651 2 2 FP WellPoint, Inc. 13,967,763 29,576,763 3 6 N Kaiser Permanente 8,013,441 8,959,294 4 3 FP Aetna 5,564,193 18,636,285 5 4 N Health Care Service Corporation 4,834,048 12,783,198 6 8 N Blue Cross Blue Shield of Michigan 4,436,836 4,436,836 7 7 FP Humana 4,151,075 6,741,375 8 19 FP Health Net, Inc. 2,574,000 2,574,000 9 10 FP Coventry Health and Life Insurance 2,523,930 3,609,930 10 11 N AmeriHealth Mercy/Independent Blue Cross 2,373,680 3,528,574 11 18 N Blue Shield of California 2,213,761 2,731,983 12 22 N EmblemHealth, Inc. 2,193,706 2,305,015 13 24 FP AMERIGROUP Community Care 1,997,000 1,997,000 14 5 FP Cigna 1,946,913 11,499,083 15 13 N CareFirst Blue Cross Blue Shield 1,896,446 3,496,446 16 26 FP Molina Healthcare, Inc. 1,883,900 1,883,900 17 9 N Highmark, Inc. 1,855,398 4,387,427 18 28 N Horizon Blue Cross Blue Shield 1,736,292 1,736,292 19 12 N BlueCross BlueShield of Tennessee 1,728,594 3,499,743 1 Source: AISʼs Directory of Health Plans: 2012. For simplicity's sake, the term "nonprofit" is used to describe the ownership of these plans. By state law, these plans are either nonprofit because they are owned by the community or non-investor-owned because they are owned by members/subscribers.
Fully Fully 20 16 N Blue Cross and Blue Shield of Florida, Inc. 1,723,073 2,801,087 21 31 FP Centene Corporation 1,615,700 1,626,300 22 33 FP Wellcare Health Plans, Inc. 1,484,160 1,484,160 23 27 N Lifetime Healthcare Companies 1,403,513 1,829,096 24 25 N The Regence Group 1,304,272 1,986,300 25 17 N Blue Cross Blue Shield of Massachusetts 1,230,000 2,750,000 26 14 N Blue Cross and Blue Shield of Alabama 1,117,646 3,043,985 27 37 G LA Care Health Plan 928,779 928,779 28 40 N CareSource, Inc. 892,708 892,708 29 23 N Wellmark, Inc. 881,140 2,112,949 30 20 N Blue Cross and Blue Shield of North Carolina 837,208 2,422,499 31 21 N Blue Cross and Blue Shield of Minnesota 807,896 2,415,472 32 32 FP Triple-S Management Corporation 774,711 1,614,711 33 42 N BlueCross BlueShield of South Carolina 765,569 765,569 34 43 FP Assurant Health 722,000 722,000 35 34 N Blue Cross and Blue Shield of Louisiana 721,394 1,448,708 36 30 N Premera, Inc. 721,042 1,641,268 37 49 G North Carolina State Health Plan 663,000 663,000 38 45 N Arkansas BlueCross BlueShield 658,023 699,798 39 50 N Blue Cross and Blue Shield of Kansas 656,498 656,498 40 44 N Group Health Cooperative 640,201 709,702 41 15 N Medical Mutual of Ohio 636,591 2,811,059 42 52 N Fidelis Care, Inc. 635,016 635,016 43 48 N Priority Health 627,699 667,699 44 55 N Healthfirst 621,933 621,933 45 36 N Tufts Associated Health Plans, Inc. 620,653 940,343 46 35 N Harvard Pilgrim Health Care, Inc. 564,879 1,160,048 47 57 N Government Employees Health Association (GEHA) 563,050 563,050 48 29 N Medica Health Plans 533,894 1,700,894 49 46 N Hawaii Medical Service Association 530,072 689,913 50 59 N Inland Empire Health Plan 520,224 524,721 51 62 N UAW Retiree Medical Benefit Trust 518,000 518,000 52 51 N SelectHealth 507,520 645,060 53 39 N Capital Blue Cross 505,092 905,092 54 41 N HealthPartners, Inc. 492,593 828,354 490,598 625,329 55 54 N BlueCross BlueShield of Western New York and BlueCross BlueShield of Northeastern New York 56 53 N MVP Health Care Preferred Care 469,765 630,748 57 65 N Affinity 441,432 441,432 58 66 G CalOPTIMA 434,637 434,637 59 56 N UPMC Health Plan, Inc. 431,727 589,323 60 61 N Blue Cross and Blue Shield of Kansas City 423,470 519,680 61 71 G MetroPlus Health Plan, Inc. 411,475 411,475 62 60 N Blue Cross Blue Shield of Arizona 381,280 521,876 63 64 N Health Alliance Plan of Michigan 367,170 467,641 64 78 FP Healthspring USA, LLC 345,898 345,898 65 79 N Texas Children's Health Plan 336,949 336,949 66 67 N Sentara Health Plans, Inc. 333,406 434,063 67 80 FP First Medical Health Plan, Inc. 326,913 326,913 68 77 N Capital District Physicians Health Plan, Inc. 322,476 355,579 69 47 N Blue Cross and Blue Shield of Nebraska 322,114 672,374 70 70 FP Care1st Health Plan 316,007 411,760 2
Fully Fully 71 82 N MDWise 306,100 306,100 72 73 N Blue Cross & Blue Shield of Mississippi 303,956 403,956 73 72 FP Presbyterian Health Plan/Presbyterian Insurance 297,090 407,994 74 83 N Health Plus (PHSP), Inc. 293,564 293,564 75 84 FP Meridian Health Plan of Michigan, Inc. 290,000 290,000 76 68 N Blue Cross of Idaho Health Service, Inc. 288,223 417,673 77 76 N Independent Health Association, Inc. 286,004 360,905 78 87 N Community Health Plan of Washington 267,718 267,718 79 69 N Blue Cross Blue Shield of North Dakota 267,576 411,982 80 63 N Blue Cross & Blue Shield of Rhode Island 261,764 484,029 81 89 N Community Health Network of Connecticut, Inc. (CHNCT) 257,131 257,131 82 88 FP Dean Health Insurance, Inc. 256,968 265,800 83 85 N Geisinger Health Plan 253,404 275,270 84 93 N Neighborhood Health Plan, Inc. 244,014 244,014 85 94 N Boston Medical Center HealthNet Plan 237,691 237,691 86 81 N AvMed, Inc. 235,465 310,656 87 86 FP PacificSource Health Plans 227,858 272,827 88 95 N UCare 223,734 223,734 89 97 N HealthPlus of Michigan, Inc. 214,483 214,483 90 92 FP Health Alliance Medical Plans, Inc. 214,113 250,113 91 99 N Family Health Partners 213,336 213,336 92 100 G Central California Alliance for Health 209,074 209,074 93 101 G Community Health Choice, Inc. 207,232 207,232 94 102 N Partnership Health Plan of California 206,637 206,637 95 75 N Providence Health Plan 205,459 389,697 96 105 N Priority Partners 204,539 204,539 97 106 FP Aveta, Inc. 203,354 203,354 98 107 N Phoenix Health Plan/Abrazo Advantage 197,860 197,860 99 110 N Parkland Community Health Plan 193,784 193,784 100 111 FP Health Choice AZ, Inc. 192,770 192,770 101 114 N Security Health Plan of Wisconsin, Inc. 180,451 180,451 102 115 FP Healthmarkets, Inc. 171,816 171,816 103 98 FP Lovelace Health Plan 169,506 214,000 104 116 G CalViva Health 168,753 168,753 105 117 FP Universal Health Care 164,839 164,839 106 119 N Fallon Community Health Plan 162,579 162,579 107 120 N Maryland Physicians Care (MPC) 162,000 162,000 108 58 N Blue Cross of Northeastern Pennsylvania 160,692 531,380 109 121 N Health Partners of Philadelphia 159,436 159,436 110 122 N Virginia Premier Health Plan, Inc. 157,320 157,320 111 123 FP Universal American Corporation- MA Division 156,752 156,752 112 104 FP Arise Health Plan 155,252 206,272 113 124 N CareOregon 154,452 154,452 114 112 N Paramount Care, Inc. (ProMedica Health System) 151,764 190,448 115 126 FP South Carolina Solutions 142,960 142,960 116 127 N Community Health Group 136,789 136,789 117 128 G Santa Clara Family Health Plan 135,472 135,472 118 129 G North Carolina Health Choice (NCHC) for Children 134,625 134,625 119 118 N Scott and White Health Plan 132,469 164,014 120 132 N SCAN Health Plan 131,098 131,098 121 131 FP Landmark Healthplan of California, Inc. 130,994 133,555 3
Fully 122 133 G Maricopa Integrated Health System/University of Arizona Healthcare Fully 130,415 130,415 123 91 N Blue Cross and Blue Shield of Montana 127,757 250,562 124 109 N Rocky Mountain Health Plans 125,406 197,316 125 136 N Kern Health Systems, Inc. 124,852 124,852 126 134 G Community First Health Plans, Inc. 117,103 128,869 127 141 FP CommunityCare Managed Healthcare Plans of Oklahoma 117,040 117,040 128 142 FP Physicians Plus Insurance Corporation 115,801 115,801 129 138 G Health Plan of San Joaquin 114,537 120,121 130 143 G Oklahoma State and Education Employees Group Insurance Board 113,285 113,285 131 144 N Chartered Health Plan Inc., The 110,268 110,268 132 145 N Hudson Health Plan 110,000 110,000 133 146 FP XLHealth Cooperation/Care Improvement Plus 109,391 109,391 134 103 N Blue Cross Blue Shield of Delaware 106,402 206,402 135 148 G CenCal Health 105,788 105,788 136 147 FP American National Insurance 103,335 105,835 137 113 N AultCare Health Plans 103,013 187,932 138 151 G Contra Costa Health Plan 101,318 101,318 139 152 N American Postal Workers Union Health Plans 100,915 100,915 140 153 N Cook Children's Health Plan (CCHP) 100,285 100,285 141 130 FP FirstCare 96,875 133,986 142 137 FP Health New England, Inc. 93,929 121,898 143 135 N McLaren Health Plan 92,456 127,456 144 139 FP Health Plan of the Upper Ohio Valley, Inc. 92,018 117,958 145 125 N Blue Cross and Blue Shield of Vermont 91,678 145,652 146 90 FP ODS Companies, The 80,927 255,077 147 108 FP SummaCare Health Plan, Inc. 70,869 197,539 148 38 N Trustmark Companies 66,574 917,586 149 96 FP Preferred One 64,058 216,491 150 74 N Bluegrass Family Health, Inc. 46,000 396,340 151 140 FP DAKOTACARE 44,040 117,940 152 149 N Hometown Health Plan, Inc. 39,173 103,890 153 150 N University Health Care Health Plans 38,560 102,560 154 154 G US Family Health Plan 0 100,000 132,427,681 230,773,945 Subsidiary/Affiliate Detail: Aetna, Inc. = Aetna and Mercy Care Plan Affinity Health System = Affinity Health Plan and Network Health Plan Arkansas BlueCross BlueShield = Arkansas BlueCross BlueShield and HMO Partners, Inc. Blue Cross Blue Shield of Florida, Inc. = Blue Cross Blue Shield of Florida, Inc., Capital Health Plan, Inc., and Florida Health Care Plans, Inc. Care1st Health Plan = Care 1 st Health Plan and Care 1 st Health Plan of Arizona, Inc. EmblemHealth, Inc. = ConnectiCare of Massachusetts, Inc, ConnectiCare, Inc., GHI, and HIP Group Health Cooperative = Group Health Cooperative and KPS Health Plans Health Care Service Corporation = Blue Cross and Blue Shield of Illinois (7,290,656), Blue Cross and Blue Shield of Texas (4,617,520), Blue Cross and Blue Shield of Oklahoma (598,157), and Blue Cross and Blue Shield of New Mexico (276,865). Highmark, Inc. = Gateway Health Plan, Highmark Blue Cross Blue Shield, and Highmark Blue Cross Blue Shield West Virginia Independence Blue Cross = AmeriHealth Insurance of New Jersey/AmeriHealth HMO, Inc., AmeriHealth Mercy Family of Companies, Independence Blue Cross, Inter-County Health Plans, Inc., and Passport Health Plan/Passport Advantage Kaiser Permanente = Kaiser Foundation Health Plan of Colorado, Kaiser Foundation Health Plan of Georgia, Kaiser Foundation Health Plan of Hawaii, Kaiser Foundation Health Plan of Ohio, Inc., Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc., Kaiser Foundation Health Plan of the Northwest, Inc., and Kaiser Foundation Health Plan, Inc. Lifetime Healthcare Companies = Excellus BlueCross BlueShield, Univera Community Health, and Univera Healthcare Medical Mutual of Ohio = Carolina Care Plan, Inc., and Medical Mutual Premera, Inc. = Lifewise Health Plan of Oregon and Lifewise Health Plan of Washington Promedica Health System = Paramount Care of Michigan and Paramount Care, Inc. The Regence Group = Asuris Northwest Health, Regence BlueCross BlueShield of Oregon, Regence BlueCross BlueShield of Utah, Regence 4
Subsidiary/Affiliate Detail: BlueShield, and Regence BlueShield of Idaho Tufts Associated Health Plans, Inc. = Network Health and Tufts Associated Health Plans, Inc. University of Arizona Healthcare = Maricopa Health Plan, University Care Advantage, LLC, and University Physicians Health Plans University of Pittsburg Medical Center = Pittsburgh Care Partnership, Inc. and UPMC Health Plan, Inc. Wellmark, Inc. = Wellmark Blue Cross and Blue Shield of Iowa and Wellmark Blue Cross and Blue Shield of South Dakota WellPoint, Inc. = MCS Life Insurance and WellPoint, Inc. 5