Participating Firms |
Scale and Location |
Primary Products |
---|---|---|
National Firms | ||
Aetna |
Over 13 million covered lives that are served by 6 regions. |
Primarily commercial; mix of HMOs and PPOs; serves large national accounts, among others, and has some Medicare business. |
Cigna |
Approximately 13 million covered lives in at least 42 states and DC. |
Primarily commercial; mix of HMO and PPO products; serves large national accounts, among others. |
Kaiser Permanente |
Approximately 8.5 million covered lives, served mainly through integrated care system in 8 regions. |
Primarily commercial with HMO products; Medicare products, particularly for those "aging in." |
United Healthcare |
Over 18 million covered lives; operates through related businesses for the commercial market (United Healthcare), Seniors (Ovations), Medicaid (Americhoice), and others. |
Primarily commercial, although the firm offers a mix of products that address Medicare, Medicaid, and other market sectors. Recent merger with PacifiCare has enlarged its role in Medicare. |
WellPoint |
Approximately 28 million covered lives after the recent merger with Anthem. Affiliated with Blue Cross-Blue Shield (BC-BS) and offers products in 13 states. |
Primarily commercial through a range of HMO, PPO, and other products. Also serves Medicare and Medicaid. |
Regional Firms | ||
Harvard Pilgrim Healthcare |
About 900,000 covered lives in nonprofit health plan based in Massachusetts, Maine, and New Hampshire. |
Primarily commercial with range of HMO, PPO, and other products, and some Medicare business. |
HealthPartners |
Over 630,000 covered lives in nonprofit health plan serving Minnesota and western Wisconsin. Has a staff model HMO affiliate (Group Health). |
Primarily commercial in a variety of HMO, PPO products, and some Medicare business. |
Highmark Inc. |
Over 4.1 million covered lives in an independent, nonprofit BC-BS licensed plan serving western and central Pennsylvania. |
Primarily commercial with some Medicare supplemental products (is affiliated with a Medicaid plan). |
Molina Healthcare |
Over 500,000 covered lives in 6 states in the west and north central United States. Headquartered in California. Includes a staff model unit. |
Medicaid, SCHIP, and related programs. |
Source: MPR summary based on publicly available information, 2005.
HMO = Health Maintenance Organization; PPO = Preferred Provider Organization; SCHIP = State Children's Health Insurance Program.