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 fourth-quarter 2024 status but includes first-quarter 2025 data for Medicare Advantage (MA), dual-eligibles and some Medicaid membership.

Most related in-app downloads and special reports now reflect the most recent data available. Keep an eye out in the next coming weeks for a detailed analysis of changes from the third quarter of 2024.

For this update, we added the following MCOs:

• ConnectiCare, Inc. (#110), a subsidiary of EmblemHealth acquired by Molina Healthcare earlier this year. Note: ConnectiCare is represented as its own MCO under the Molina parent (owner ID #28) as the two entities are still operating separately.
• Jordan Valley Senior Care (#2066), a PACE plan operating in Missouri
• Lawndale Christian Health Center (#2067), a PACE plan operating in Illinois
• Secur Health Plan (2068), a new Medicare plan operating in Florida
• UCLA Health Medicare Advantage Plan (#2069), a new Medicare plan operating in California
• Panorama PACE (#2070), a PACE plan operating in Illinois
• Healthy Mississippi, Inc. (#2071), a new Medicare plan operating in Mississippi
• Care Guide Partners PACE (#2072), a PACE plan operating in Kentucky

We discontinued the following MCOs:
• CCA Health Michigan (#1982), whose Medicare contract ended for 2025.
• Dignity Health Plan (#1984), whose Medicare contract ended for 2025.
• Georgia Health Advantage (#1999), which was consolidated into other Health Advantage records.
• Santa Fe Employe's Hospital Association-Coast Lines (#1389), whose Medicare contract ended for 2025.
• SpiriTrust Lutheran LIFE (1382), whose Medicare contract ended for 2025.
• Vitality Health Plan of California (#1943), whose Medicare contract ended for 2025.
We have not made any changes to the parent-MCO structure of Centene Corporation (#1543) and WellCare Health Plans (#206) as the entities continue to operate as separate brands.

Notable Enrollment Changes

States have completed their Medicaid disenrollments, and decreases in the Medicaid space are flattening. Medicaid HMO membership fell by 204 since December 2024, after decreasing 527K in the third quarter and 1.1M in the second quarter. Medicaid FFS membership 135K since the third-quarter update.

Notable insurer-level changes in the managed Medicaid space since the last update include the following:

• Humana (#1109) continued to make gains in the Medicaid space, adding more than 107K members since the last update.
• Aetna (#1359) lost the most Medicaid members (98K), largely due to a contract exit in Kansas that dropped 128K members.
• Elevance Health (#1264) lost 85K Medicaid members, largely due to a contract loss in Kentucky that was somewhat offset by a contract gain in Kansas.

The public health insurance exchange market saw modest gains, adding just under 88KK members. This market will see more increases in the first-quarter 2025 update, due to another record-breaking open enrollment season for this year.

The following insurers saw the highest shifts in the public exchange space:

• Molina continued to recover its exchange membership, adding 110K exchange lives since the third quarter, mostly due to gains in Essential Plan membership in New York.
• Centene Corporation saw minor losses (121K, representing under 3% of its exchange membership) since the third quarter.
• EmblemHealth (#2018) lost roughly 52K members due to the acquisition of its ConnectiCare subsidiary by Molina.

Commercial group enrollment again decreased since the third quarter; group risk dropped 510K members, largely fueled by losses in the small group market (575K). Meanwhile, ASO/self-funded plans gained nearly 118K members.

Notable changes include:

• UnitedHealthcare (#1263) lost 55K Commercial risk members; decreases on the group side were balanced by gains in individual enrollment increases.
• Humana completed its departure from Commercial risk; with only 300 commercial risk members remaining, whose service areas are undetermined, we removed all risk members from the insurer. Only 3,800 non-Tricare ASO members remain as of this update.
• This quarter’s biggest ASO/self-funded gainer was Cigna Corporation, which added 76K ASO members.

After a turbulent open enrollment season, Medicare Advantage (MA) and duals plans gained nearly 600K members; this is the only sector that entirely contains 2025 membership data for this release. Medicare FFS membership, which lags MA and is as of December 2024, increased by 135K.

Note: Health Care Service Corporation’s acquisition of Cigna’s Medicare business, which closed in March, is not reflected in this update as the companies are still working out the details of the deal.

Notable payer changes include:

• After exiting 13 counties for 2025, Humana lost nearly 294K Medicare members since the last update.
• Aetna also saw significant decreases, losing about 161K members.
• UnitedHealthcare and Elevance Health saw gains of 286K and 203K, respectively, perhaps scooping up members from other large national insurers.

Need more help? The Directory of Health Plans Onboarding training video provides a general overview and walkthrough of the tool. To get started, be sure to check out the training video located on the right side of the Dashboard, by choosing From the Editors section, then Directory of Health Plans Training.

In addition, you can 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.