Wonder

Health Insurance Competitive Landscape

Delivered November 26, 2019. Contributor: Teresa W.

Goals

To understand the competitive landscape of the health insurance sector including large national players, key regional players in Florida, and disruptors. Specifically, to understand how the comeptitive landscape has changed over time, strengths and weaknesses of key players, and marketing approaches of key players. 

Early Findings

Top PlayersThe top five national health insurance companies by revenue and number of members are UnitedHealth Group, Anthem, Aetna, Cigna, and Humana. 
 Regional competitors to Florida Blue include Captial Health Plan, AvMed, Florida Health Care Plans, Health First, and Health Options. 
The top five health insurance sector disruptors include Bright Health, Clover Health, Oscar Health, Zest Health, and Zipari. 
Health Insurance CompetitionA recent study by the AMA found that most health insurance markets in the United States are highly concetrated with one payer owning the largest market share. 
Over the last several years there has been a slide toward insurance monopolies with an increase in mergers and consolidations. 
In 91% of Metropolitan Statistical Areas at least one insurer has a market share of at least 30% in combined HMO+PPO+POS+EXCH.
In 48% of Metropolitan Statistical Areas at least one insurer has a market share of at least 50% in combined HMO+PPO+POS+EXCH.
In 13% of Metropolitan Statistical Areas at least one insurer has a market share of at least 70% in combined HMO+PPO+POS+EXCH. 
In Florida, Blue Cross Blue Shield holds a 40% market share and United Healthcare holds a 21% market share in combined HMO+PPO+POS+EXCH. 

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