section 7: health plans health plan market shares fully-insured market in total small group and...

Section 7: Health Plans

• Health plan market shares• Fully-insured market in total• Small group and individual market

• HMO financial statistics• Net income & margins• Reserves

• Health Plan Medical Loss Ratios• HMO enrollment statistics

1

HEALTH PLAN MARKET SHARES

Health Plan Market Shares: Total Fully-Insured Private Market, 2011(Premium Volume: $6.2 billion)

30.6% 30.4%

23.7%

3.6%2.5%

0.9% 0.9% 0.7% 0.6% 0.6%

5.5%

0%

5%

10%

15%

20%

25%

30%

35%

Blue CrossBlue Shield of

MN

HealthPartners Medica PreferredOne UnitedHealthcare

FederatedMutual Ins.

Co.

Time Ins. Co.(Assurant

Health)

Aetna Life Genworth Life ConnecticutGeneral Life

Ins. Co.

Other (228Companies)

Companies with common ownership were treated as one entity. For example, Blue Cross Blue Shield of Minnesota includes BCBSM and Blue Plus. Fully insured market only, market share based on premium volume. Source: MDH Health Economics Program, analysis of MCHA Premium Database for 2010.

3

Market Share of Minnesota Non-Profit Health Plans 2004 to 2011

73.9%

69.9%

65.2% 64.8%62.1%

59.5%56.5%

52.0%

0%

10%

20%

30%

40%

50%

60%

70%

80%

2004 2005 2006 2007 2008 2009 2010 2011

Market share calculated as share of premiums in the fully-insured health insurance market.Source: MDH analysis of the premium assessment base for the Minnesota Comprehensive Health Association

4

Health Plan Market Shares: Small Group Market, 2010

43.0%

24.5% 23.5%

5.2%3.3%

0.2% 0.1% 0.1%0%

10%

20%

30%

40%

50%


MN

HealthPartners Medica PreferredOne FederatedMutual Ins. Co.

Principal LifeIns. Co.

Time Ins. Co.(formerly Fortis)

Other (5companies)

Companies with common ownership were treated as one entity. For example, Blue Cross Blue Shield of MN includes Blue Cross Blue Shield of Minnesota and Blue Plus. Market shares based on premium volume; fully insured market only.

Source: Minnesota Department of Commerce, "Report of 2010 Loss Ratio Experience in the Individual and Small Employer Health Plan Markets for: Insurance Companies Nonprofit Health Service Plan Corporations and Health Maintenance Organizations," June 2011.

Total Premium Volume in 2010: $1.49 Billion

5

Health Plan Market Shares: Individual Market, 2010

68.4%

9.5% 9.4% 8.3%

1.7% 1.1% 1.0% 0.8%0%

10%

20%

30%

40%

50%

60%

70%

80%


MN

HealthPartners Medica Time Ins. Co.(Assurant

Health)

AmericanFamily Mutual

Ins. Co.

World Ins. Co. PreferredOneInsurance Co.

Other (6companies)

Companies with common ownership were treated as one entity. For example, Time Ins. Co. includes Time Ins. Co. and John Alden Life Ins. Co. Market shares based on premium volume; fully insured market only. Source: Minnesota Department of Commerce, "Report of 2010 Loss Ratio Experience in the Individual and Small Employer Health Plan Markets for: Insurance Companies Nonprofit Health Service Plan Corporations and Health Maintenance Organizations ," June 2011.

Total Premium Volume in 2010: $648 million

6

HMO FINANCIAL STATISTICS

Summary of HMO Financial Trends, 2006 to 2011

2006 2007 2008 2009 2010 2011

Net Income $33.2 $121.2 $26.0 $175.5 $250.6 $233.7

Total Revenue $5,028.5 $5,366.5 $5,786.3 $6,582.9 $6,954.5 $6,971.7

Operating Income as % of Revenue

-0.9% 0.5% 0.5% 1.9% 2.6% 2.3%

Net Income as % of Revenue 0.7% 2.3% 0.4% 2.7% 3.6% 3.4%

Minnesota products only. Source: MDH Health Economics Program analysis of HMO annual reports

In Millions of Dollars

8

Net Income and Profitability by HMO, 2011

Net Income

(millions)

Total Revenue

(millions)Net Income as %

of Revenue

Blue Plus $50.6 $1,090.3 4.6%

Group Health $27.0 $931.1 2.9%

HealthPartners $94.5 $1,352.1 7.0%

Medica $17.9 $1,584.9 1.1%

Metropolitan $8.6 $163.8 5.3%

PreferredOne $1.2 $103.8 1.1%

Sanford $0.0 $3.2 -0.4%

UCare $33.9 $1,742.5 1.9%

All HMOs $233.7 6,971.7 3.4%

Minnesota products only.Source: MDH Health Economics Program analysis of HMO annual reports

9

Minnesota HMO Net Income by Product Line, 2006 to 2011


-$100

-$50

$0

$50

$100

$150

$200

$250

$300

2006 ($11.1) ($70.0) $26.1 $75.7 $12.6 $33.2

2007 $23.0 ($21.3) $4.6 $76.9 $38.1 $121.2

2008 $7.0 $18.7 ($0.1) $18.1 ($17.7) $26.0

2009 $35.2 $108.1 $18.6 $31.4 ($17.9) $175.5

2010 $73.90 $125.1 $1.8 $38.1 $11.6 $250.6

2011 $102.60 $39.1 $37.9 $46.3 $7.8 $233.7

CommercialPMAP,

PGAMC, MNCare

MedicareMSHO,

MDHO, and SNBC

All Other Total

PMAP is Prepaid Medical Assistance Program; PGAMC is Prepaid General Assistance Medical Care; MSHO is Minnesota Senior Health Options; All Other includes: Medicare Supplemental, Dental and Minnesota Disability Health OptionsSource: MDH Health Economics Program analysis of HMO annual reports

10

Minnesota HMO Net Income per Member Month by Product Line, 2006 to 2011

-$50

$0

$50

$100

$150

$200

$250

2006 -2.08 -15.06 31.21 207.08 2.95

2007 4.52 -4.84 5.26 202.9 11.22

2008 1.52 4.13 -0.12 33.97 2.46

2009 8.47 21.95 15.79 60.26 16.3

2010 20.35 23.48 1.35 65.09 22.75

2011 36.03 6.67 25.7 101.76 21.84

CommercialPMAP, GAMC,

MNCareMedicare

MNSHO and MNDHO

Minnesota Products Total

PMAP is Prepaid Medical Assistance Program; PGAMC is Prepaid General Assistance Medical Care; MSHO is Minnesota Senior Health Options; and MDHO is Minnesota Disability Health OptionsSource: MDH Health Economics Program analysis of HMO annual reports

11

Minnesota HMO Net Income by Product Line, 2011


$102.57

$51.09

$7.80

$46.29$37.93

$233.66

($12.03)

-$50

$0

$50

$100

$150

$200

$250

Commercial PrepaidMedical

AssistanceProgram(PMAP)

MSHO. MDHOand SNBC

Medicare Other MNCare TotalMinnesotaProducts

PMAP is Prepaid Medical Assistance Program; MSHO is Minnesota Senior Health Options; MDHO is Minnesota Disability Health Options; SNBC is Special Needs Basic Care; All Other includes: Medicare Supplemental, and DentalSource: MDH Health Economics Program analysis of HMO annual reports

12

Minnesota HMO Net Income per Member Month by Product Line, 2011

$101.76

$61.80

$12.06

$36.03

$25.70$21.84

-$7.40

-$50

-$30

-$10

$10

$30

$50

$70

$90

$110

MSHO,MDHO, and

SNBC

Other Commercial Medicare PrepaidMedical

AssistanceProgram(PMAP)

MNCare TotalMinnesotaProducts


13

Minnesota HMO Profitability by Product Line, 2006 to 2011

Net Income as % of Revenue

-20%

-10%

0%

10%

20%

30%

40%

50%

2006 -0.6% -4.6% 4.4% 9.4% 14.2% 0.7%

2007 1.1% -1.3% 0.7% 8.5% 38.1% 2.3%

2008 0.3% 1.0% 0.0% 1.4% -12.7% 0.4%

2009 1.6% 4.8% 2.1% 2.4% -11.6% 2.7%

2010 3.2% 5.3% 0.2% 3.9% 2.5% 3.6%

2011 5.1% 1.5% 3.4% 4.1% 4.7% 3.4%

CommercialPMAP,

PGAMC, MNCare

MedicareMSHO,

MDHO, and SNBC

All Other Total


14

Sources of HMO Net Income, 2006 to 2011

2006 2007 2008 2009 2010 2011

Sources of Net Income:

Net underwriting gain/loss ($43.8) $26.8 $31.3 $123.1 $181.4 $161.7

Investment Income $78.9 $93.3 ($5.5) $52.4 $69.4 $44.5

Other ($1.9) $1.2 $0.2 $0.0 ($0.2) 27.5

Net Income $33.2 $121.2 $26.0 $175.5 $250.6 $233.7

Investment income as % of net income 237.6% 77.0% -21.2% 29.8% 27.7% 19.1%

Minnesota products onlySource: MDH Health Economics Program analysis of HMO annual reports


15

Investment Income as a Percent of Net Income by HMO, 2011

Investment Income

(millions)

Net Income (millions)

Investment Income as Pct of

Net Income

Blue Plus $15.4 $50.6 30.5%

Group Health $7.1 $27.0 26.3%

HealthPartners $2.6 $94.5 2.8%

Medica $10.6 $17.9 59.2%

Metropolitan $0.6 $8.6 7.1%

PreferredOne $0.7 $1.2 58.1%

Sanford $0.0 $0.0 3.9%

UCare $7.5 $33.9 22.1%

All HMOs $44.5 $233.7 19.1%

Source: MDH Health Economics Program analysis of HMO annual reports

16

Reserves, Medical Expenses, and Regulatory Minimum Level by HMO, 2011

Reserves

(millions)

Total Expenses

(millions)

Reserves as % of Total

Expenses

Reserves as % of Regulatory

Level

Blue Plus $357.2 $953.2 37.5% 924%

Group Health* $98.7 $378.8 26.1% 565%

HealthPartners* $616.9 $1,137.7 54.2% 385%

Medica $416.3 $1,145.6 36.3% 754%

Metropolitan $19.0 $131.7 9.2% 284%

PreferredOne $10.6 $90.5 9.9% 252%

Sanford $1.3 $2.8 58.1% 394%

UCare $321.9 $1,578.5 21.4% 524%

All HMOs $1,842.0 $5,418.7 34.0% 626%

*Fee-for-service revenue earned was subtracted from expenses to approximate member only expenses.“Regulatory level” is the authorized control level; total expenses is from line 16 of HMO Minnesota Supplement Report #1.Minnesota products only.Source: MDH Health Economics Program analysis of HMO annual reports

17

Total Minnesota HMO Reserves Relative to Regulatory Minimum Levels, 2001 to 2011

0%

100%

200%

300%

400%

500%

600%

700%

800%

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Re

se

rve

s a

s a

Pe

rce

nto

f Re

gu

lato

ry

Min

imu

m

18

Fee-for-service revenue earned was subtracted from expenses to approximate member only expenses.“Regulatory minimum level” is the authorized control level. Source: MDH Health Economics Program analysis of HMO annual reports

HEALTH PLAN MEDICAL LOSS RATIOS

Medical Loss Ratio in the Individual Market, 2011 (Carriers with $2 million or more in Premium Revenue)

Claims ExpenseMLR2

Net Premium1 Incurred Claims

Quality Improvement Fraud Total

BCBSM 438,117,129 386,071,789 1,470,850 33,979 387,576,618 88.5%

Medica IC 69,743,150 56,419,779 2,983,883 0 59,403,662 85.2%

Time IC 46,758,831 34,341,701 199,604 35,624 34,576,929 73.9%

HealthPartners IC 39,204,000 32,697,000 307,000 0 33,004,000 84.2%

HealthPartners Inc. 23,670,000 23,610,000 236,000 0 23,846,000 100.7%

PreferredOne IC 9,769,795 6,712,705 107,066 17,790 6,837,561 70.0%

Medica Health Plans 7,817,929 7,006,768 1,824 0 7,008,592 89.6%

American Family Mutual Ins. Co. 7,310,840 5,161,178 0 0 5,161,178 70.6%

World IC 4,866,517 4,226,549 21,551 0 4,248,100 87.3%

John Alden LIC 3,333,772 3,020,422 12,207 4,415 3,037,044 91.1%

Total 643,281,123 554,106,713 5,339,985 91,808 559,538,506 87.0%

20

Source: MDH Health Economics Program analysis of data from National Association of Insurance Commissioners (NAIC), Supplementary Health Care Exhibit—Part 1; Note 1: premiums exclude taxes and fees. Note 2: Beginning in 2012, federal law requires insurance companies that don’t include certain small and new companies to issue rebates to consumers for an MLR under 80% in the individual market for the prior year.

Medical Loss Ratio in the Small Group Market, 2011 (Carriers with $2 million or more in Premium Revenue)

Claims ExpenseMLR2

Net Premium1 Incurred Claims

Quality Improvement Fraud Total

BCBSM 555,158,220 470,081,244 2,664,391 34,791 472,780,426 85.2%

Medica IC 296,213,019 252,208,085 577,782 0 252,785,867 85.3%

HealthPartners Inc. 292,759,000 241,704,000 2,413,000 0 244,117,000 83.4%

HealthPartners IC 73,031,000 62,191,000 583,000 0 62,774,000 86.0%

Federated Mutual IC 52,647,519 43,744,165 0 0 43,744,165 83.1%

PreferredOne HP 46,087,486 42,082,148 339,361 38,458 42,459,967 92.1%

PreferredOne IC 28,813,679 26,248,908 232,140 27,499 26,508,547 92.0%

Blue Plus 19,660,300 15,800,114 95,709 1,139 15,896,962 80.9%

Total 1,364,370,223 1,154,059,664 6,905,383 101,887 1,161,066,934 85.1%

21

Source: MDH Health Economics Program analysis of data from National Association of Insurance Commissioners (NAIC), Supplementary Health Care Exhibit—Part 1 ; Note 1: premiums exclude taxes and fees.Note 2: Beginning in 2012, federal law requires insurance companies that don’t include certain small and new companies to issue rebates to consumers for an MLR under 80% in the small group market for the prior year.

Medical Loss Ratio in the Group Market, 2011

(Carriers with $2 million or more in Premium Revenue)Claims Expense

MLR2

Net Premium /1 Incurred Claims Quality Improvement Fraud Total

BCBSM 959,415,527 860,720,080 4,231,953 75,776 865,027,809 90.2%

HealthPartners IC 546,177,000 473,772,000 4,441,000 - 478,213,000 87.6%

HealthPartners Inc. 528,956,000 432,340,000 4,317,000 - 436,657,000 82.6%

Medica IC 448,766,811 387,123,055 3,916,091 - 391,039,146 87.1%

PreferredOne IC 66,616,171 61,201,876 534,428 55,860 61,792,164 92.8%

Medica Health Plans 62,750,731 52,314,731 489,621 - 52,804,352 84.1%

PreferredOne HP 53,911,413 48,424,151 377,534 39,912 48,841,597 90.6%

Blue Plus 37,872,193 33,418,644 311,596 2,303 33,732,543 89.1%

Guarantee Trust Life Ins Co 10,984,065 9,941,039 - - 9,941,039 90.5%

Connecticut Gen Life Ins Co 6,104,994 3,717,581 169,931 - 3,887,512 63.7%

Federated Mutual IC 3,570,792 3,891,863 - - 3,891,863 109.0%

Sanford HP 2,372,642 2,248,809 27,960 - 2,276,769 96.0%

Total 2,727,498,339 2,369,113,829 18,817,114 173,851 2,388,104,794 87.6%

22

Source: MDH Health Economics Program analysis of data from National Association of Insurance Commissioners (NAIC), Supplementary Health Care Exhibit—Part 1; Note 1: premiums exclude taxes and fees.Note 2: Beginning in 2012, federal law requires insurance companies that don’t include certain small and new companies to issue rebates to consumers for an MLR under 85% in the large group market for the prior year.

HMO ENROLLMENT STATISTICS

Minnesota HMO Member Months by Product Line, 2006 to 2011

0

2,000,000

4,000,000

6,000,000

8,000,000

10,000,000

12,000,000

2006 5,351,090 4,648,946 835,773 364,661 64,337 11,264,807

2007 5,080,402 4,403,678 882,481 375,975 62,122 10,804,658

2008 4,574,441 4,529,156 1,011,580 395,520 59,400 10,570,097

2009 4,157,413 4,926,689 1,179,530 425,050 79,196 10,767,878

2010 3,633,053 5,327,847 1,340,216 657,733 58,813 11,017,662

2011 2,846,525 5,860,173 1,476,138 454,917 62,959 10,700,712

CommercialPMAP,

PGAMC, MNCare

Medicare MSHO OtherTotal

Minnesota Products

PMAP is Prepaid Medical Assistance Program; PGAMC is Prepaid General Assistance Medical Care; MSHO is Minnesota Senior Health Options; All Other includes: Medicare Supplemental, Dental and Minnesota Disability Health OptionsSource: MDH Health Economics Program analysis of HMO annual reports

24

Distribution of Minnesota HMO Enrollment by Region, 2011

Northwest NortheastWest

Central Central Southwest Southeast Twin Cities State-wide

Blue Plus 15,348 10,200 15269 37,769 23,301 45,805 54,062 201,754

Group Health 176 637 344 4,460 293 1,895 43,022 50,827

HealthPartners 164 439 442 28,599 2,995 3,708 191,525 227,872

Medica 1,505 19,974 6719 23,709 112 1,361 123,312 176,692

Metropolitan 1 1 0 6 2 7 18,992 19,009

PreferredOne 228 775 661 3,560 930 2,685 12,794 21,633

Sanford 0 0 0 2 880 17 0 899

Ucare 3,290 12,710 3176 23,943 7,981 29,466 135,349 215,915

All HMOs 20,712 44,736 26,611 122,048 36,494 84,944 579,056 914,601


25

Minnesota HMO Enrollment as Percent of Regional Population, 2011

Northwest NortheastWest

Central Central Southwest Southeast Twin Cities State-wide

Blue Plus 9.0% 3.1% 6.9% 5.2% 8.3% 6.3% 1.9% 3.8%

Group Health 0.1% 0.2% 0.2% 0.6% 0.1% 0.3% 1.5% 1.0%

HealthPartners 0.1% 0.1% 0.2% 3.9% 1.1% 0.5% 6.6% 4.3%

Medica 0.9% 6.1% 3.0% 3.2% 0.0% 0.2% 4.3% 3.3%

Metropolitan 0.0% 0.0% 0.0% 0.0% 0.0% 0.0% 0.7% 0.4%

PreferredOne 0.1% 0.2% 0.3% 0.5% 0.3% 0.4% 0.4% 0.4%

Sanford 0.0% 0.0% 0.0% 0.0% 0.3% 0.0% 0.0% 0.0%

Ucare 1.9% 3.9% 1.4% 3.3% 2.8% 4.0% 4.7% 4.0%

All HMOs 12.2% 13.7% 11.9% 16.7% 13.0% 11.7% 20.1% 17.1%


26

Minnesota HMO Enrollment as Percent of Regional Population, 2011

12.2%

13.7%

11.9%16.7%

13.0%

11.7%

20.1%

Source: MDH Health Economics Program analysis of HMO annual reports; U.S. Census Bureau

27

Minnesota HMO Enrollment by Firm, 2011Blue Plus

17.6%

Group Health5.8%

HealthPartners27.2%Medica

20.0%

Metropolitan2.1%

PreferredOne3.1%

Sanford0.1%

UCare24.0%

Source: MDH Health Economics Program analysis of Minnesota Supplement # 1 available April 1st of the following calendar year

28

Minnesota HMO Enrollment by Product Line, 2011

Commercial26.6%

Medicare13.8%

Prepaid Medical Assistance Program39.6%

Other0.6%

MN Seniors Health Options, MN Disability Health Options, and SNBC

4.3%

MinnesotaCare15.2%

Source: MDH Health Economics Program analysis of Minnesota Supplement # 1 available April 1st of the following calendar year

29

Total Minnesota HMO Enrollment, 2005 to 2011

980

894

870 864

887

934

915

800

820

840

860

880

900

920

940

960

980

1,000

2005 2006 2007 2008 2009 2010 2011

In

Tho

usan

ds


30

Minnesota HMO Market Penetration, 2005 to 2011

2005 2006 2007 2008 2009 2010 2011

Total HMO Enrollment

980,374 894,429 869,906 864,119 886,554 933,616 914,601

Minnesota Population

5,106,992 5,147,857 5,191,267 5,230,567 5,262,824 5,310,584 5,344,861

HMO Enrollment as Percent of Population, by Type of Product

Commercial 9.6% 8.1% 7.5% 6.9% 6.0% 5.2% 4.0%

Public 9.5% 9.2% 9.2% 9.6% 10.8% 12.3% 13.1%

All Products 19.1% 17.3% 16.7% 16.5% 16.8% 17.6% 17.1%

Source: MDH Health Economics Program analysis of HMO annual report, U.S. Census Bureau

31

HMO Enrollment in Minnesota by Product Line, 2005 to 2011

2005 2006 2007 2008 2009 2010 2011

Commercial 492,440 417,084 391,717 360,564 318,285 278,485 212,905

Public Programs

Medicare Advantage

39,865 36,717 39,983 50,788 63,017 74,571 82,944

Other Medicare 41,485 69,817 69,281 75,180 79,266 124,017 131,142

Prepaid Medical Assistance Program

258,482 238,253 245,079 255,129 286,744 305,578 367,290

Prepaid General Assistance Medical Care

25,197 20,727 14,819 16,212 19,406 0 0

MinnesotaCare 122,905 111,830 109,027 106,246 119,836 150,965 120,320

Public Programs, Total

487,934 477,345 478,189 503,555 568,269 655,131 701,696

All Products 980,374 894,429 869,906 864,119 886,554 933,616 914,601


32

Rates of Enrollment Growth for Minnesota HMOs by Product Line, 2006 to 2011

2006 2007 2008 2009 2010 2010

Commercial -15.3% -6.1% -8.0% -11.7% -12.5% -23.5%

Public Programs

Medicare Advantage

-7.9% 8.9% 27.0% 24.1% 18.3% 11.2%

Other Medicare 68.3% -0.8% 8.5% 5.4% 56.5% 5.7%

Prepaid Medical Assistance Program

-7.8% 2.9% 4.1% 12.4% 6.6% 20.2%

Prepaid General Assistance Medical Care

-17.7% -28.5% 9.4% 19.7% -100.0%

MinnesotaCare -9.0% -2.5% -2.6% 12.8% 26.0% -20.3%

Public Programs, Total -2.2% 0.2% 5.3% 12.9% 15.3% 7.1%

All Products -8.8% -2.7% -0.7% 2.6% 5.3% -2.0%


33

HMO Enrollment in Minnesota by Firm, 2005 to 2011

2005 2006 2007 2008 2009 2010 2011

Blue Plus 157,841 151,751 136,204 132,279 136,210 176,357 201,754

FirstPlan 10,140 10,347 15,573 16,057 11,130 0 0

Group Health 34,636 26,047 23,986 21,634 51,334 48,626 50,827

HealthPartners 331,564 334,938 320,734 328,621 286,953 265,930 227,872

Medica 263,377 183,884 179,045 157,957 171,445 192,087 176,692

MHP 17,843 16,941 17,861 21,624 18,662 18,112 19,009

PreferredOne 46,212 48,187 50,022 46,301 37,596 37,440 21,633

Sanford 594 459 419 521 965 813 899

UCare 118,167 121,875 126,062 139,125 172,259 194,251 215,915

All HMOs 980,374 894,429 869,906 864,119 886,554 933,616 914,601

Change from previous year

-10.3% -8.8% -2.7% -0.7% 2.6% 5.3% -2.0%


34

Commercial Enrollment in Minnesota HMOs, 2005 to 2011

2005 2006 2007 2008 2009 2010 2011

Blue Plus 40,638 42,649 32,268 26,289 16,302 11,114 9,661

FirstPlan 1,255 1,285 1,810 1,580 618 0 0

Group Health 24,354 23,172 22,210 16,088 15,030 11,121 10,151

HealthPartners 253,394 250,881 234,995 245,219 226,436 201,758 157,709

Medica 126,005 50,472 50,024 24,615 21,620 16,585 13,160

MHP 0 0 0 0 0 0 0

PreferredOne 46,212 48,187 50,022 46,301 37,596 37,440 21,633

Sanford 582 438 388 472 683 467 591

UCare 0 0 0 0 0 0 0

All HMOs 492,440 417,084 391,717 360,564 318,285 278,485 212,905

-18.8% -15.3% -6.1% -8.0% -11.7% -12.5% -23.5%


35

Medicare Advantage Enrollment in Minnesota HMOs, 2005 to 2011

2005 2006 2007 2008 2009 2010 2011

Blue Plus 0 0 0 0 0 0 0

FirstPlan 0 0 0 0 0 0 0

Group Health 10,282 2,875 1,776 1,549 0 0 0

HealthPartners 0 0 0 0 839 503 16

Medica 0 0 0 0 0 0 0

MHP 0 15 1,018 4,567 218 46 0

PreferredOne 0 0 0 0 0 0 0

Sanford 0 0 0 0 0 0 308

UCare 29,583 33,827 37,189 44,672 61,960 74,022 82,620

All HMOs 39,865 36,717 39,983 50,788 63,017 74,571 82,944


-1.0% -7.9% 8.9% 27.0% 24.1% 18.3% 11.2%


36

Other Medicare Enrollment in Minnesota HMOs, 2005 to 2011

2005 2006 2007 2008 2009 2010 2011

Blue Plus 2,217 12,060 9,520 10,885 10,934 40,406 62,704

FirstPlan 205 838 1,077 1,160 1,263 0 0

Group Health 0 0 0 3,997 36,304 37,505 40,676

HealthPartners 26,641 35,574 37,186 35,049 4,424 4,611 4,604

Medica 7,039 11,629 11,194 13,137 14,341 30,462 12,562

MHP 378 931 836 824 1,015 1,161 1,286


Sanford 12 21 31 49 282 346 0

UCare 4,993 8,764 9,437 10,079 10,703 9,526 9,310

All HMOs 41,485 69,817 69,281 75,180 79,266 124,017 131,142


3.5% 68.3% -0.8% 8.5% 5.4% 56.5% 5.7%

*Other Medicare includes Medicare Cost, Minnesota Senior Health Options, Minnesota Disability Health OptionsMN Senior Care Plus, and Special Needs Basic CareSource: MDH Health Economics Program analysis of HMO annual reports

37

Prepaid Medical Assistance Program Enrollment in Minnesota HMOs, 2005 to 2011

2005 2006 2007 2008 2009 2010 2011

Blue Plus 56,792 48,242 49,873 52,162 61,445 66,983 82,200

FirstPlan 4,257 4,338 7,055 7,692 5,334 0 0

Group Health 0 0 0 0 0 0 0

HealthPartners 33,520 30,616 31,653 32,282 36,325 38,933 49,508

Medica 92,343 86,618 85,891 87,680 97,039 103,288 117,697

MHP 13,333 12,209 12,567 12,851 13,537 14,176 16,207


Sanford 0 0 0 0 0 0 0

UCare 58,237 56,230 58,040 62,462 73,064 82,198 101,678

All HMOs 258,482 238,253 245,079 255,129 286,744 305,578 367,290


3.2% -7.8% 2.9% 4.1% 12.4% 6.6% 20.2%

Source: MDH Health Economics Program Analysis of HMO Annual Report

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Prepaid General Assistance Medical Care Enrollment in Minnesota HMOs, 2005 to 2011

2005 2006 2007 2008 2009 2010 2011

Blue Plus 4,273 2,992 1,816 1,962 2,365 0 0

FirstPlan 701 572 749 755 498 0 0


HealthPartners 4,231 3,737 2,718 3,020 3,738 0 0

Medica 8,478 7,081 4,886 5,240 6,342 0 0

MHP 2,287 2,004 1,484 1,524 1,690 0 0


Sanford 0 0 0 0 0 0 0

UCare 5,227 4,341 3,166 3,711 4,773 0 0

All HMOs 25,197 20,727 14,819 16,212 19,406 0 0


8.1% -17.7% -28.5% 9.4% 19.7% -100.00%


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MinnesotaCare Enrollment in Minnesota HMOs, 2005 to 2011

2005 2006 2007 2008 2009 2010 2011

Blue Plus 53,921 45,808 42,727 40,981 45,164 57,854 47,189

FirstPlan 3,722 3,314 4,882 4,870 3,417 0 0


HealthPartners 13,778 14,130 14,182 13,051 15,191 20,125 16,035

Medica 29,512 28,083 27,050 27,285 32,103 41,752 33,273

MHP 1,845 1,782 1,956 1,858 2,202 2,729 1,516


Sanford 0 0 0 0 0 0 0

UCare 20,127 18,713 18,230 18,201 21,759 28,505 22,307

All HMOs 122,905 111,830 109,027 106,246 119,836 150,965 120,320


-7.2% -9.0% -2.5% -2.6% 12.8% 26.0% -20.3%


40

Minnesota HMO Enrollment* by Firm and Age, 2011

<15 15-29 30-44 45-54 55-64 65+ Total

Blue Plus 20.5% 20.1% 17.2% 15.9% 14.3% 21.2% 19.1%

Group Health 0.4% 0.8% 0.9% 2.8% 8.3% 20.1% 5.4%

HealthPartners 26.8% 33.9% 42.8% 47.9% 48.9% 3.9% 29.8%

Medica 26.0% 21.2% 19.2% 15.5% 11.9% 8.8% 18.5%

MHP 3.5% 2.2% 1.4% 1.0% 0.7% 0.8% 2.0%

PreferredOne 3.1% 5.2% 6.8% 8.1% 7.0% 0.2% 4.3%

Sanford 0.0% 0.1% 0.1% 0.1% 0.1% 0.2% 0.1%

UCare 19.7% 16.6% 11.5% 8.7% 8.7% 44.8% 21.0%

All HMOs 100.0% 100.0% 100.0% 100.0% 100.0% 100.0% 100.0%

*Includes health plan members that are non-Minnesota residents.Source: MDH Health Economics Program analysis of HMO annual reports.

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Distribution of Minnesota HMO Enrollment* by Product Line and Age, 2011

<15 15-29 30-44 45-54 55-64 65+

Commercial 19.9% 20.3% 22.7% 19.6% 15.6% 1.9% 100.0%

Medicare Advantage 0.0% 0.0% 0.1% 0.7% 2.4% 96.7% 100.0%

Other Medicare 0.0% 0.3% 0.7% 1.4% 4.0% 93.6% 100.0%

Prepaid Medical Assistance Program (PMAP)

58.1% 24.1% 12.7% 2.7% 0.4% 2.1% 100.0%

MNCare 20.3% 28.3% 21.6% 17.9% 11.8% 0.1% 100.0%

Total 28.1% 18.5% 14.6% 10.0% 7.5% 21.2% 100.0%

*Includes health plan members that are non-Minnesota residents.Source: MDH Health Economics Program analysis of HMO annual reports

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Additional Information from the Health Economics Program Available Online

• Health Economics Program Home Page• www.health.state.mn.us/divs/hpsc/hep/index.html

• Publications• www.health.state.mn.us/divs/hpsc/hep/publications/yearly/2010.html

• Health Care Market Statistics (Presentation Slide Decks)• www.health.state.mn.us/divs/hpsc/hep/chartbook/index.html

• Interactive Health Insurance Statistics• https://pqc.health.state.mn.us/mnha/Welcome.action

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