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Anthem not quite so dominant

August 15, 2011

After adjustments by the Indiana Department of Insurance, it appears Anthem Blue Cross and Blue Shield isn’t quite so dominant in the individual insurance market as previously reported—but it also stands to gain as two of the six largest plans pull back.

The Insurance Department filed updated numbers in an Aug. 10 letter to the U.S. Department of Health and Human Services. The latest figures, based on revised and late filings from the companies, show that Indianapolis-based Anthem covers 59.6 percent of Hoosiers who have individual health insurance policies.

Insurance department data from 2010 showed Anthem covering 65 percent of Hoosiers on individual insurance policies.

Anthem’s nearest competitor, Minnesota-based UnitedHealthcare and its Indianapolis-based subsidiary Golden Rule, cover 15.6 percent of the individual market.

Rounding out the top six are: Time Insurance Co., a subsidiary of Milwaukee-based Assurant Inc., with 7 percent of the market; Texas-based Mega Life & Health Insurance Co., with 2.4 percent; and Louisville-based Humana Insurance Co., with 2.1 percent, and Illinois-based Pekin Life Insurance Co.

Pekin has withdrawn from Indiana. And Mega stopped marketing new health insurance policies in the state as of June 7, according to the Insurance Department.

No other company claims more than 2 percent of lives covered by individual policies in Indiana.

Five health insurers, including Pekin and giants Cigna Corp. and Aetna Inc., have announced their exit from the Indiana individual health insurance market. Their main complaint is the new rule instituted by the federal health reform law requiring them to spend 80 percent of premiums on medical bills.

Many insurers are below that threshold and would have to rebate the difference to their customers. If the rule had been in effect last year, Indiana health insurers would have handed out rebates to individual customers totaling $30.5 million, according to Insurance Department data.

Anthem is pretty close to the mark. It spent 76.6 percent of its individual policy premiums on medical bills last year, according to Insurance Department data. If the 80-percent rule had been in effect, Anthem would have paid $9.3 million.

Anthem spokesman Tony Felts said the company does not anticipate having to pay rebates based on this year’s business trends.

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