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Florida Health Market Review 2011 Databook
Allan Baumgarten, May 2011
Key Findings in the new report:
- After a one-time increase in 2009, enrollment in Florida HMOs decreased slightly in 2010. Growth in Medicare, Medicaid and Healthy Kids plans was not enough to offset the continued decline of HMO enrollment by employer groups. (Exhibits 3 and 4; trend for Medicare in Exhibit 5 and Medicaid in Exhibit 6)
- The HMO market has become more consolidated as the result of a string of recent acquisitions. For example, Humana is the largest HMO in the state and has acquired Care Plus and the former MetCare HMO. Measured by enrollment, Humana has about 19% of the HMO market here. WellCare is the second largest, and operates as StayWell and HealthEase Florida. (Exhibit 2). A market share analysis by premium revenues across all health insurers would probably show Humana with even larger market share.
- Florida HMOs improved their net income in 2010, posting net income after taxes of $669.9 million, or 3.5% of underwriting revenues. That is up from 2009 results of $576.7 million, or 3.1% of premium revenues. (Exhibits 7 and 8)
- As in past years, Humana's Medicare plans account for more than half of the industry's profits. (Exhibit 9) The Humana HMOs had net underwriting income of $436.6 million on their Medicare plans; underwriting net income (before taxes or investments) was $780 million for all HMOs.
- Exhibit 11 is new this year and uses new reporting (required by the Affordable Care Act) to calculate medical loss ratios for the HMOs' lines of business. The new law requires HMOs and other insurers to maintain loss ratios of at least 80% for individual and small group plans and 85% for large group plans.
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