Summary

As a follow-up to our 2002 report on the competitiveness of the small group health insurance market, Congress requested updated information on each state and the District of Columbia. Specifically, Congress asked us to identify--for each state--the number of carriers licensed in the small group market, the largest carriers, and their market share.

In summary, the median number of licensed carriers in the small group market per state was 28, with a range from 3 in Rhode Island to 75 in Georgia. The median market share of the largest carrier in the small group market was about 43 percent, with a range from about 19 percent in Texas to about 93 percent in North Dakota. The five largest carriers in the small group market, when combined, represented three-quarters or more of the market in 26 of the 34 states supplying information, and they represented 90 percent or more in 12 of these states. Thirty of the 40 states supplying information identified a Blue Cross and Blue Shield (BCBS) carrier as the largest carrier offering health insurance in the small group market, and in all but 1 of the remaining 10 states, a BCBS carrier was among the five largest carriers. The median market share of all the BCBS carriers in the 34 states supplying information was about 44 percent, with a range from about 6 percent in Wisconsin to about 93 percent in North Dakota; in 13 of these states BCBS carriers combined for half or more of the market. The market share of the largest small group carrier has increased since our 2002 report. The median market share of the largest small group carrier was about 43 percent, compared to the 33 percent reported in 2002. The combined market share of the five largest small group carriers represented three-quarters or more of the market in 26 of 34 states, compared to 19 of 34 states reported in 2002. Finally, the median market share of all the BCBS carriers in 34 reporting states was about 44 percent, compared to the 34 percent reported in 2002.