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Report: Kaiser tops state health insurance market with 40% share

January 29, 2013|By Chad Terhune
  • Kaiser Permanente employees exercise together in Pasadena. The nonprofit health plan has a dominant share of California employers and individual customers, research shows.
Kaiser Permanente employees exercise together in Pasadena. The nonprofit… (Mark J. Terrill/AP )

Nonprofit healthcare giant Kaiser Permanente had a 40% share of California's $59-billion health insurance market for employers and individuals, new data show.

A report issued this week by Citigroup analyst Carl McDonald compiled nationwide data on 2011 premiums and enrollment among large and small employers and individuals buying their own policies.

Those insurance markets, excluding government healthcare programs and self-insured employers, totaled more than 80 million people and $317 billion in premiums. McDonald noted these figures don't reflect companies' full market share, but he said these businesses and individual customers account for the vast majority of revenue and profits for most insurers.

In California, Kaiser led the way with $23.3 billion in premiums, or a 40% share, and 5.5 million commercial customers. Overall, the Oakland company has about 6.6 million members in the state and runs 35 hospitals here.

Anthem Blue Cross, a unit of industry giant WellPoint Inc., was second in the state with a 23% commercial market share and $13.7 billion in premiums.

Blue Shield of California came in third with a 14% share, followed by Health Net Inc. at nearly 9% and UnitedHealth Group Inc. at 5%, according to Citigroup.

McDonald said the California market has a significant impact on the entire health insurance industry.

"As California goes, so goes the results of the publicly traded plans, with the California the largest market at four of the six publicly traded plans," he wrote in his report.

Nationwide, WellPoint grabbed the biggest share of this commercial market with 14%. UnitedHealth was second at 12%, and Kaiser was third at nearly 10%, Citigroup data show.

Those companies figure to be among the most affected by the federal healthcare law and the launch of state insurance exchanges for individuals and small businesses in January 2014.

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