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2007 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 2006 and 2007.
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, 2007 and the change from December 31, 2006 for Maine’s largest companies.
Overall, the number of people enrolled in a health insurance plan through small employers and the number of individuals buying their own health insurance has decreased over the past year. There was some offset in the amount of decrease in the individual market by the change Mega made from no longer selling small group policies to selling individual policies.
| Enrollees 2007 |
| |
Large Group |
Small Group |
Individual |
| Insurers |
12/31/2007 |
Change
% |
12/31/2007 |
Change
% |
12/31/2007 |
Change
% |
| Aetna (Aetna Health Inc + Aetna Life Ins Co) |
32,620 |
10% |
32,676 |
11% |
69 |
-8% |
| Anthem Health Plans of ME Inc |
143,480 |
-1% |
63,921 |
-23% |
30,456 |
-12% |
| CIGNA (Cigna Healthcare of Me Inc + Connecticut General Life Ins Co) |
29,707 |
-11% |
0 |
0% |
15 |
-6% |
| Harvard Pilgrim Health Care Inc. |
13,618 |
53% |
10,071 |
95% |
6 |
-57% |
| Mega Life & Health Ins Co |
0 |
-100% |
2,561 |
-19% |
9,757 |
44% |
| United Healthcare Ins Co |
1,812 |
104% |
571 |
483% |
0 |
0% |
| Total |
221,237 |
2% |
109,800 |
-9% |
40,303 |
-3% |
Premiums:
Premiums are the dollars paid by employers and individuals for insurance coverage. Overall, the premium increase was most significant for individuals. This reflects the increasing cost of health insurance.
| Premiums Earned 2007 & Change % from 2006 |
| |
Large Group |
Small Group |
Individual |
| Aetna |
27% |
$136,329,980 |
-13% |
$101,100,176 |
-25% |
$104,911 |
| Anthem |
1% |
$615,333,056 |
-3% |
$282,150,157 |
15% |
$108,526,567 |
| CIGNA |
-10% |
$126,169,087 |
0% |
$0 |
-66% |
$77,643 |
| Harvard Pilgrim Health Care Inc. |
78% |
$50,241,490 |
245% |
$36,721,885 |
-7% |
$169,620 |
| Mega Life & Health Insurance Co. |
-100% |
$0 |
-22% |
$7,281,554 |
49% |
$16,418,568 |
| United Healthcare Insurance Co. |
114% |
$6,879,162 |
547% |
$1,165,258 |
0% |
$0 |
| All other Companies |
-18% |
$5,815,240 |
-52% |
$1,712,030 |
13% |
$4,437,726 |
| Total |
5% |
$940,768,015 |
0% |
$430,131,060 |
18% |
$129,735,035 |
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 2006 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 2007 & % Change since 2006 |
| |
Large Group |
Small Group |
Individual |
| |
Change
% |
2007 |
Change
% |
2007 |
Change
% |
2007 |
| Aetna (Aetna Health Inc + Aetna Life Ins Co) |
9% |
$354 |
-1% |
$294 |
12% |
$134 |
| Anthem Health Plans of ME Inc |
2% |
$360 |
6% |
$318 |
38% |
$313 |
| CIGNA (Cigna Healthcare of Me Inc + Connecticut General Life Ins Co) |
-1% |
$333 |
0% |
$0 |
-66% |
$422 |
| Harvard Pilgrim Health Care Inc. |
8% |
$318 |
-3% |
$329 |
-1% |
$1,131 |
| Mega Life & Health Ins Co |
-100% |
$0 |
0% |
$220 |
1% |
$168 |
| United Healthcare Ins Co |
-6% |
$344 |
150% |
$333 |
0% |
$0 |
| Total |
2% |
$353 |
4% |
$308 |
28% |
$281 |
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 231% shows that the company paid healthcare providers 231% more than 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 dropped out of the small group market and United Healthcare dropped out of the individual market which is why their results are 0.
| Dollar Amount Spent on Claims and % of Premium 2007 |
| |
Large Group |
Small Group |
Individual |
| |
Prem
% |
Claims |
Prem
% |
Claims |
Prem
% |
Claims |
| Aetna (Aetna Health Inc + Aetna Life Ins Co) |
80% |
$108,453,706 |
80% |
$81,291,086 |
231% |
$242,192 |
| Anthem Health Plans of ME Inc |
87% |
$532,649,829 |
79% |
$223,493,550 |
88% |
$95,656,592 |
| CIGNA (Cigna Healthcare of Me Inc + Connecticut General Life Ins Co) |
84% |
$106,219,635 |
0% |
$0 |
149% |
$115,944 |
| Harvard Pilgrim Health Care Inc. |
87% |
$43,830,206 |
92% |
$33,655,657 |
298% |
$505,841 |
| Mega Life & Health Ins Co |
0% |
$0 |
55% |
$4,007,361 |
53% |
$8,708,246 |
| United Healthcare Ins Co |
81% |
$5,572,002 |
79% |
$919,863 |
0% |
$0 |
| All other companies |
80% |
$4,677,554 |
103% |
$1,762,301 |
65% |
$2,898,343 |
| Total |
85% |
$801,402,932 |
80% |
$345,129,818 |
83% |
$108,127,158 |
Average Monthly Claims per Person:
In the following chart, looking at the difference between 2007 and 2006 average claims per person 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 2007 & % Change since 2006 |
| |
Large Group |
Small Group |
Individual |
| |
Change
% |
2007 |
Change
% |
2007 |
Change
% |
2007 |
| Aetna (Aetna Health Inc + Aetna Life Ins Co) |
12% |
$282 |
1% |
$236 |
-6% |
$310 |
| Anthem Health Plans of ME Inc |
-1% |
$312 |
6% |
$252 |
35% |
$276 |
| CIGNA (Cigna Healthcare of Me Inc + Connecticut General Life Ins Co) |
-7% |
$281 |
0% |
$0 |
-34% |
$630 |
| Harvard Pilgrim Health Care Inc. |
2% |
$277 |
-2% |
$301 |
32% |
$3,372 |
| Mega Life & Health Ins Co |
0% |
$0 |
25% |
$121 |
44% |
$89 |
| United Healthcare Ins Co |
-6% |
$278 |
13% |
$263 |
0% |
$0 |
| Total |
-1% |
$301 |
6% |
$247 |
27% |
$236 |
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 premiums written.
| % of Premiums
Paid and Representative Dollar Amount for Administrative Expenses:
2007 |
| |
Large Group |
Small Group |
Individual |
| Aetna |
12% |
$16,042,874 |
14% |
$13,667,350 |
13% |
$14,105 |
| Anthem Health Plans of ME Inc. |
4% |
$25,015,875 |
11% |
$32,035,552 |
11% |
$12,292,280 |
| CIGNA |
9% |
$11,516,714 |
0 |
0 |
8% |
$6,165 |
| Harvard Pilgrim Health Care Inc. |
16% |
$7,818,739 |
15% |
$5,522,315 |
4% |
$7,239 |
| Mega Life & Health Insurance Co. |
0% |
$0 |
40% |
$2,878,305 |
39% |
$6,413,699 |
| United Healthcare Insurance Co. |
16% |
$1,096,582 |
24% |
$279,662 |
0 |
0 |
| All other Companies |
25% |
$1,397,602 |
29% |
$444,879 |
26% |
$1,172,739 |
| Total |
7% |
$62,888,386 |
13% |
$54,828,063 |
15% |
$19,906,227 |
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.
| Underwriting Gain/Loss: 2007 |
| |
Large Group |
Small Group |
Individual |
| Aetna |
9% |
$11,833,400 |
6% |
$6,141,740 |
-68% |
($71,784) |
| Anthem Health Plans of ME Inc. |
9% |
$57,667,352 |
9% |
$26,621,055 |
1% |
$577,695 |
| CIGNA |
7% |
$9,247,739 |
0% |
$0 |
57% |
$44,466 |
| Harvard Pilgrim Health Care Inc. |
-3% |
($1,407,455) |
-7% |
($2,456,087) |
-202% |
($343,459) |
| Mega Life & Health Insurance Co. |
0% |
$0 |
19% |
$1,375,856 |
-1% |
($163,634) |
| United Healthcare Insurance Co. |
2% |
$127,908 |
-4% |
($47,676) |
0% |
$0 |
| All other Companies |
0% |
($6,711) |
-30% |
($505,897) |
19% |
$838,720 |
| Total |
8% |
$77,462,233 |
7% |
$31,128,992 |
1% |
$882,004 |
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Last Updated:
June 24, 2009
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