The AIS Data Team has posted new data to the subscriber dashboard Online Search Tool and In-App Download Enrollment Data Spreadsheets. This data primarily reflects first-quarter 2022 status but includes some second-quarter 2022 data for Medicare Advantage (MA), dual-eligibles and Medicaid membership.

Most related in-app downloads and special reports now reflect the most recent data available. Keep an eye out in the coming weeks for two detailed analyses of changes from the fourth quarter and from first quarter of 2021.

Note: Due to timing issues involving the auditing of quarterly data, the data in the monthly Public-Sector Plan Enrollment report will be more current in many cases than the membership figures in the quarterly reports. For the most updated and granular public-sector membership figures, always consult the monthly public-sector report.

For this update, we added two new MCOs and revived a third that returned to the primary care marketplace in 2022:

• US Health and Life Insurance Company (USHL) (#1584), which returned to the individual market in 2022, after ceasing to offer primary care a few years ago;
• Point32Health, Inc. (#2031), which consolidated its Harvard Pilgrim and Tufts Health Plan (#171 and #172, respectively) operations in 2022; and
• Angle Insurance Company of Utah (#2032), a Utah-based commercial plan offering large and small group products.

We discontinued the following MCOs:

• Harvard Pilgrim Health Care, Inc., Tufts Health Plan and CarePartners of Connecticut (#171, #172 and #1946, respectively), were consolidated into Point32Health (#2031) (see above);
• Florida MHS, Inc. dba Magellan Complete Care (#1795), a Medicaid plan now consolidated under Molina Healthcare (#1545) post-merger; and
• Great Plains Medicare Advantage, (#1925), consolidated into Sanford Health Group (#354).

For clarity, we updated 19 MCO names to remove parentheticals referencing a former name. Name changes reflecting our MCO source preference include the following:

• Sanford Health Group (#354) was updated from Sanford Health Plan to reflect recent acquisitions.
• WellSense Health Plan (fka Boston Medical Center HealthNet Plan), MCO #196, was updated from Boston Medical Center HealthNet Plan at the request of our source at the company, to reflect new branding.

We would like to note that Anthem, Inc., has announced that it has rebranded to Elevance Health; this is not yet reflected in the data. We are tracking this development as the company transitions to the new name and will update it in the database at a later time.

We have not made any changes to the parent-MCO structure of Centene Corporation (#1543) and WellCare Health Plans (#206) for this update as the entities continue to operate separate brands.

While Medicaid increased, its gain of 180K members marked a smaller uptick than in recent quarters, although it’s important to note that the gap between the 4Q and 1Q releases is less than two months. Meanwhile state Medicaid gained over 431K members.

Notable gains in the Medicaid space since the last update include the following:

• California Medicaid plans saw some of the largest increases over last quarter, with Inland Empire leading the way with 65K new members; four other MCOs saw gains of greater than 30K.
• Texas Medicaid HMOs also saw gains, increasing over 134K since last quarter.
• Anthem, Inc. (#1264) gained nearly 320K Medicaid members in Puerto Rico after its acquisition of InnovaCare Health Solutions (#1132).

We also want to draw attention to changes in Virginia’s managed Medicaid sourcing – the state introduced a new dashboard that radically shifted the balance of membership between Medicaid HMO and SCHIP plans. A decrease of 773,474 in Medicaid HMO is offset by corresponding increases in SCHIP and Medicaid FFS membership. Sources at the Virginia Department of Medical Assistance Services (DMAS) state that the official numbers are correct on the dashboard, but we’ll continue to monitor these reports in case of additional shifts.

The public health insurance exchange market increased by more than 1.4M from last quarter, due to a robust open enrollment period. Notable shifts in the public exchange space include:

• Bright Health (#1894) saw the largest gains, jumping over 522K in exchange lives due to its expansion in several markets.
• Oscar Insurance (#1785) and Friday Health Plans (#1879) also saw huge increases, adding almost 430K and 211K public exchange members, respectively.
• Pickups by the aforementioned MCOs resulted in a staggering drop in Molina’s public exchange presence; the insurer lost over 400K members since last quarter, the bulk of the members in Texas.

Commercial risk group enrollment decreased sharply, losing nearly 820K members from the fourth quarter, most likely due to shifts to ASO/self-funded plans, public exchange, and Medicaid plans. Notable changes include:

• Centene Corporation (#1543) lost more than 200K group members, mostly due to ceasing to report members from its Centurion Health Services prison contracts.
• Florida Blue (#11) reported a group risk decrease of 90K members.
• UnitedHealthcare (#1263) group membership decreased by 255K, only a 3.4% reduction, however.
• EMI Health (#1308) increased by 76K its commercial risk membership due to reclassifying members previously in the ASO/self-funded category.

Medicare Advantage (MA) plans gained just under 50K members; because the plan year begins in January, this segment doesn’t see major quarterly shifts.

Administrative services only/self-funded membership increased overall by nearly 500K, mainly due to shifts from fully funded to self-funded plans. Cigna Corporation and Anthem both reported jumps of over 765K members, while Highmark Health and Aetna also saw large increases.

However, some insurers did see sharp reductions in ASO, including Blue Cross and Blue Shield of North Carolina (#126), which lost 590K ASO members, and Medical Mutual of Ohio (#267), whose decrease of nearly 270K represented a 26% drop.

Need more help? Contact support@aishealth.com with questions about how to use or interpret the information provided to you in AIS’s Directory of Health Plans. A member of AIS Health’s support staff would be happy to provide a free demonstration of the website for clients needing more guidance on how to best use this tool.