Health Care and Insurance and Employee Benefits and Health Care Reform and WellPoint and Health Insurance and Health Care & Life Sciences and Health Care & Insurance

WellPoint insures two-thirds of Hoosier workers

July 25, 2011
wellpoint-2col.jpg

If you’re an Indiana employer looking to actually buy health insurance—as opposed to insuring yourself—odds are 2-to-1 that you’ll find your way to WellPoint Inc. and its Anthem subsidiary.

Indianapolis-based WellPoint insured 63 percent of all employees covered by small-group employers (those with fewer than 50 workers) and 66 percent of the workers at larger employers, according to Seattle-based actuarial firm Milliman Inc., which based its calculations on 2010 information from Massachusetts-based Highline Data.

WellPoint also insured 65 percent of all Hoosiers buying individual coverage at year-end 2010.

The numbers were part of a July 13 presentation by Seema Verma, a consultant for the Indiana Family and Social Services Administration who is spearheading efforts to prepare the state for health care reform requirements, most of which hit in 2014.

Perhaps because of Anthem’s dominance, relatively few Indiana employers actually buy full health insurance coverage, according to Milliman. Most insure themselves, then hire Anthem, Cigna, UnitedHealthcare or some other third-party administrator to negotiate discounts with doctors and to process claims.

Among the 3.6 million workers in Indiana covered by employer-sponsored health insurance, only 22 percent have full insurance from a health insurance company.

The remaining 78 percent are technically insured by the employer itself, with some other company providing administration services only.

That percentage is significantly higher than national averages. According to a 2010 employer survey by California-based Kaiser Family Foundation, 59 percent of workers with health benefits are covered by self-insured employers. That percentage has risen from 52 percent in 2003.

Employers in Indiana provide health insurance coverage to 56 percent of the state’s 6.4 million people. The rest are covered by Medicare or other public programs, or by health insurance they pay for entirely themselves, or are uninsured.

Data showing WellPoint’s dominance of the commercial health insurance market in Indiana are not new, but the numbers presented by the state government are higher than any put out previously.

In January, IBJ published market share data for the commercial market from Tennessee-based HealthLeaders-InterStudy. It showed WellPoint had 53 percent of the market, which includes all employers—both fully insured and self-insured—as well as individual customers.

WellPoint officials claimed the numbers were too high, but declined to provide a corrected figure.

“That number seems inflated to us,” WellPoint spokesman Tony Felts said. “It’s higher than anything we’ve ever seen.”

 

ADVERTISEMENT

Recent Articles by J.K. Wall

Comments powered by Disqus