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2006 Financial Results for Health Insurance Companies in Maine
This brochure is divided into two versions. The first version provides
basic information concerning some of the financial information
for Maine’s health insurance companies and HMOs.
The second
version of this brochure provides more detailed information such as
the formulas used to calculate the results for underwriting gain or loss,
premium per member month, premium trend, claims per member month and claims
trend. Other information includes policy reserves, and comparison information
for 2004 and 2005.
This basic brochure shows how much money Maine’s largest health
insurance companies and HMOs are taking in and paying out in the large
group (employers with more than 50 employees), small group (employers
with 50 or fewer employees), and individual insurance markets.
For each of Maine’s largest companies (those companies who have at least $2 million of premium in Maine), the information below is shown. The “All Other Companies” category provides aggregate data for companies with less than $2 million of premium except for enrollment and per member per month data.
- The number of people enrolled
- How much money was collected in premiums
- How much money was paid to healthcare providers for claims
- How much money was spent on administration
- How much money was left.
The insurance companies report this data to the Bureau of Insurance pursuant
to Rule Chapter 945. The Bureau checks this information for consistency
with other reports submitted to the Bureau.
People enrolled:
The charts below show the number of people enrolled by type of insurance
plan as of December 31, 2006 and the change from December 31, 2005 for Maine’s largest companies.
Overall, the number of people enrolled in a health insurance plan through their employers has decreased slightly over the past year, while the number of individuals buying their own health insurance has increased. Some of the increase in the individual market can be explained by the change MEGA made from selling small group policies to selling individual policies.
| Enrollees 2006 |
| |
Large Group |
Small Group |
Individual |
| Insurers |
12/31/2006 |
Change
% |
12/31/2006 |
Change
% |
12/31/2006 |
Change
% |
| Aetna (Aetna Health Inc + Aetna Life Ins Co) |
29,673 |
14% |
29,475 |
-10% |
75 |
1150% |
| Anthem (Anthem Health Plans of ME Inc + Maine Partners Health Plan Inc) |
144,807 |
-14% |
82,548 |
-6% |
34,435 |
-3% |
| CIGNA (Cigna Healthcare of Me Inc + Connecticut General Life Ins Co) |
33,371 |
-17% |
0 |
0% |
16 |
-20% |
| Harvard Pilgrim Health Care (Includes Harvard Pilgrim Health Care Inc. & HPHC Insurance Company for 2006 only) |
8,906 |
115% |
5,173 |
542% |
14 |
8% |
| Mega Life & Health Ins Co |
31 |
11% |
3,143 |
-3% |
6,797 |
116% |
| United Healthcare Ins Co |
889 |
41% |
98 |
-18% |
0 |
0% |
| Total |
217,677 |
-9% |
120,437 |
-4% |
41,337 |
7% |
Premiums:
Premiums are the dollars paid by employers and individuals for insurance coverage. Overall, the increase in total premium was most significant for individuals. This reflects both the increasing cost of health insurance and the increase in enrollment.
| Premiums Earned 2006 & Change % from 2005 |
| |
Large Group |
Small Group |
Individual |
| Aetna |
11% |
$107,313,340 |
6% |
$115,707,032 |
136% |
$139,948 |
| Anthem |
6% |
$611,202,925 |
6% |
$290,516,248 |
18% |
$94,706,405 |
| CIGNA |
-14% |
$140,673,799 |
0% |
$0 |
-6% |
$229,002 |
| Harvard Pilgrim Health Care Inc. |
150% |
$28,295,841 |
886% |
$10,633,046 |
10% |
$182,309 |
| Mega Life & Health Insurance Co. |
-77% |
$45,914 |
-30% |
$9,355,669 |
68% |
$11,051,864 |
| United Healthcare Insurance Co. |
37% |
$3,221,453 |
-10% |
$180,041 |
0% |
$0 |
| All other Companies |
-21% |
$6,215,132 |
-35% |
$3,584,974 |
-33% |
$3,937,945 |
| Total |
4% |
$896,968,404 |
7% |
$429,977,010 |
18% |
$110,247,473 |
Average Monthly Premium per Person:
Insurance policies vary widely in deductibles, copayments, policy limits, and restricted provider networks. Therefore comparing the average premium for different companies may be like comparing “apples and oranges.” Also, when looking at the percentage change from the 2005 average premium, keep in mind that as rates increase, it is not uncommon for some employers and individuals to make changes to their policies to lower the increase.
| Average Monthly
Premium per Person 2006 & % Change since 2005 |
| |
Large Group |
Small Group |
Individual |
| |
Change
% |
2006 |
Change
% |
2006 |
Change
% |
2006 |
| Aetna (Aetna Health Inc + Aetna Life Ins Co) |
11% |
$326 |
-3% |
$297 |
-83% |
$153 |
| Anthem (Anthem Health Plans of ME Inc + Maine Partners Health Plan Inc) |
14% |
$352 |
2% |
$299 |
22% |
$227 |
| CIGNA (Cigna Healthcare of Me Inc + Connecticut General Life Ins Co) |
1% |
$338 |
0% |
$0 |
6% |
$1,245 |
Harvard Pilgrim Health Care
(Includes Harvard Pilgrim Health Care Inc. & HPHC Insurance Company for 2006 only) |
-5% |
$294 |
32% |
$340 |
-1% |
$1,139 |
| Mega Life & Health Ins Co |
298% |
$146 |
-19% |
$220 |
-25% |
$166 |
| United Healthcare Ins Co |
22% |
$366 |
-6% |
$133 |
0% |
$0 |
| Total |
11% |
$345 |
1% |
$297 |
15% |
$219 |
Claims:
Claims are the amount of money paid by insurance companies to health care providers and hospitals for medical services received by their members. In the charts below, claims paid are shown as a percentage of premiums paid to the insurers. For example, Aetna’s individual percentage of 216% shows that the company paid healthcare providers more than twice what they collected in premiums from individual health insurance policies.
The first three charts show results by companies for each line of insurance (large group, small group, and individual. The next chart is a combination of the results for all three lines of insurance grouped by company. Note that Cigna is not in the small group market and United Healthcare is not in the individual market which is why their results are 0.
Average Monthly Claims per Person:
In the following chart, looking at the difference between 2006 and 2005 average claims may be like comparing “apples and oranges”. If employers and individuals choose plans with higher deductibles or fewer benefits to minimize increases in premiums, then their claims costs will only show part of the picture of their healthcare costs. The table below does not include companies writing less than $2.0 million in health insurance premium. Enrollee numbers are used to calculate this amount along with claims incurred, and Enrollee data is not required to be submitted by those companies writing less than $2.0 million in premium. The change is the trend indicated from the prior year to current year.
| Average Monthly
Claims per Person |
| |
Large Group |
Small Group |
Individual |
| Insurers |
2006 |
Change since
2005 |
2006 |
Change since
2005 |
2006 |
Change since
2005 |
| Aetna |
$251 |
16% |
$234 |
4% |
$331 |
-95% |
| Anthem |
$316 |
15% |
$237 |
3% |
$204 |
21% |
| CIGNA |
$301 |
11% |
0 |
0 |
$948 |
44% |
| Harvard Pilgrim Health Care Inc. |
$271 |
-15% |
$309 |
58% |
$2,560 |
-27% |
| Mega Life & Health Insurance Co. |
$76 |
-49% |
$96 |
-44% |
$62 |
-35% |
| United Healthcare Insurance Co. |
$297 |
22% |
$232 |
-63% |
0 |
0 |
| Total Average |
$304 |
14% |
$232 |
2% |
$186 |
12% |
Administrative Expenses
Administrative expenses include all expenses other than claims, like office space, salaries, office supplies, marketing, taxes, (other than federal income tax), lobbying expenses, and cost containment expenses (which reduce the amount of healthcare services provided, including utilization review, fraud detection, disease management programs, and case management). The lobbying expenses are less than 1% of the overall earned premiums written.
| % of Premiums
Paid and Representative Dollar Amount for Administrative Expenses:
2006 |
| |
Large Group |
Small Group |
Individual |
| Aetna |
16% |
$16,771,266 |
16% |
$18,276,200 |
18% |
$25,089 |
| Anthem Health Plans of ME Inc. |
7% |
$43,688,644 |
11% |
$31,553,192 |
15% |
$14,002,035 |
| CIGNA |
13% |
$18,885,943 |
0 |
0 |
7% |
$16,218 |
| Harvard Pilgrim Health Care Inc. |
18% |
$4,953,068 |
15% |
$1,603,576 |
4% |
$8,030 |
| Mega Life & Health Insurance Co. |
21% |
$9,744 |
38% |
$3,560,193 |
38% |
$4,199,643 |
| United Healthcare Insurance Co. |
16% |
$516,306 |
24% |
$43,210 |
0 |
0 |
| All other Companies |
5% |
$325,242 |
7% |
$248,136 |
1% |
$55,980 |
| Total |
9% |
$85,150,213 |
13% |
$55,284,507 |
17% |
$18,306,995 |
| Underwriting
Gain/Loss: 2006 |
| |
Large Group |
Small Group |
Individual |
| Aetna |
7% |
$7,799,493 |
5% |
$6,219,394 |
-134% |
($187,030) |
| Anthem Health Plans of ME Inc. |
3% |
$18,861,560 |
10% |
$28,607,917 |
-5% |
($4,762,906) |
| CIGNA |
-3% |
($4,353,088) |
0% |
$0 |
17% |
$38,394 |
| Harvard Pilgrim Health Care Inc. |
-10% |
($2,710,638) |
-6% |
($622,754) |
-129% |
($235,399) |
| Mega Life & Health Insurance Co. |
27% |
$12,437 |
33% |
$3,047,354 |
12% |
$1,361,625 |
| United Healthcare Insurance Co. |
2% |
$57,113 |
-101% |
($181,686) |
0% |
$0 |
| All other Companies |
10% |
$609,748 |
13% |
$470,653 |
-8% |
($323,321) |
| Total |
2% |
$20,276,625 |
9% |
$37,540,878 |
-4% |
($4,108,637) |
Underwriting Gain/Loss:
This is the amount of premium dollars left (or the shortfall) after claims and administrative expenses are paid. A negative number means that the company lost money on the particular line of business.
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Last Updated:
July 16, 2008
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