Report dubs Anthem largest health plan, passes United

Membership for Anthem, a company of for-profit Blue Cross Blue Shield Plans in 14 states, increased 1.9 percent to 37.5 million.

Anthem is now the nation’s largest health plan, taking away that title from UnitedHealth Group, according to a new report.

The largest health insurers increased membership by more than 5 percent last year, according to a study by Mark Farrah Associates.

The Kennebunk, Maine-based Mark Farrah tracked enrollment and profitability for Aetna, Anthem, Cigna, Health Care Services Corp., Humana, Kaiser Permanente and UnitedHealth Group. UnitedHealth was the only one to see enrollment drop in 2014, dropping to second place for the first time in three years.

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Not including Medicare Supplement plans known as Medigap, UHG’s membership declined from 37.2 million to 36.8 million in 2014. Membership for Anthem, a company of for-profit Blue Cross Blue Shield Plans in 14 states, increased 1.9 percent to 37.5 million, “positioning the company the leading health plan based on total membership,” according to Mark Farrah Associates.

Now, if Medigaps plans are included in the tally, UnitedHealth remains the nation’s largest health plan, counting 41.6 million U.S. members in March 2015 across commercial, Medicaid and Medicare segments, including 3.9 million Medigap members. Without those Medicare Supplement members, United’s membership stands at 37.7 million as of the first quarter of 2015. Anthem’s total membership at the end of the first quarter was 38.5 million, including about 500,000 members in Medicare Supplement plans from its 1.4 million Medicare customers.

Aetna still remains the third largest health plan, with 23.1 million members at the end of 2014, up 1.3 percent from 2013, Farrah found.

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HCSC, operator of Blues plans in Illinois, Montana, New Mexico, Oklahoma and Texas, remained the fourth largest insurer and largest nonprofit, with membership increasing by 1.2 percent to 14.5 million at the close of 2014.

Behind HCSC was Cigna, with 13.7 million health plan members, and Humana with some 13 million members and Kaiser Permanente with more than 10 million members.

Humana saw the largest increase in risk-based enrollment, which was up 27 percent, but it also lost administrative services only membership, a segment the company is rethinking its interest in, any way.

Profit margins for most of these companies increased as well, the study found. “Health insurers continue to strive for cost containment while investing in reform-driven expansion initiatives, technology and partnerships to sustain and grow business for the long term,” the report said.

Kaiser Permanente had a 2014 net income of $3.1 billion on revenues of $57.6 billion, a profit margin of 5.34 percent. UnitedHealth's margin declined from 6.3 percent in 2013 to 5.8 percent in 2014, but still a net income of nearly $7 billion on total revenues of $119.8 billion. The company chalked up the margin decline in part to ACA fees and Medicare Advantage rate reductions.

Aetna’s 2014 profit margin stood at 4.0 percent (down from 4.3 percent), with $2.2 billion on revenues of $55.1 billion. Anthem’s margin was 3.5 percent, earning $2.5 billion on $73.8 billion.

UHG is still very much the giant of managed care and arguably more diversified thanks to its bustling Optum subsidiary. UHG’s $130 billion in 2014 revenue far surpasses Anthem’s $74 billion, Aetna’s $58 billion, Humana’s $48 billion and Cigna’s $34.9 billion.

Twitter: @AnthonyBrino