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 2025 status but includes second-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 fourth quarter of 2024, as well as a Year-Over-Year report.

For this update, we added the following MCOs:

• Trinity Health PACE of Alexandria (#2073), a PACE plan in Louisiana.
• Trinity Health PACE of Pensacola (#2074), a PACE plan in Florida.
• CSC PACE Center (#2075), a PACE plan in California.
• Habitat Health (#2076), a PACE plan in California.
• PACE KC (#2077), a PACE plan in Missouri.
• Seen Health (#2078), a PACE plan in California.
• WelbeHealth (#2079), a PACE plan in California.
• Antidote Health Plan (#2080), an individual risk plan operating on the health exchanges in Arizona and Ohio.
• Blue Ridge Independence at Home (#2081), a PACE plan in Virginia.
• Heritage PACE (#2082), a PACE plan in California.
• Health Care Service Corporation Medicare (Non-Blues) (#2083), a record containing Medicare members HCSC acquired from Cigna Corporation. Note: Cigna will continue to manage the Medicare plans through 2025, but HCSC now owns the membership. It has not incorporated these members into its Blues-branded plans, however.

We discontinued the following MCOs:

• Centers Plan for Healthy Living (#1829), which was acquired by Elevance Health in 2025.
• Common Ground Healthcare Cooperative (#1745), which was acquired by CareSource in 2025.
• Indiana University Health Plans (#181), which was acquired by Elevance Health in January 2025.
• KelseyCare Advantage (#1294), which was consolidated into UnitedHealthcare post-acquisition.
• MemorialCare Select Health Plan (fka Seaside Health Plan) (#1810), which has ceased offering risk-based medical coverage.
• Paramount Insurance Company (#255), which was consolidated into its parent company, Medical Mutual of Ohio, in 2025.
• Piedmont Community Health Plan (#532), which left all markets for 2025.
• US Health and Life Insurance Company (#1584), which left the health exchange market in 2025.
• Yale University Health Plan (#1444), which is administered by Aetna; members are already reflected in that record’s ASO membership.

We renamed the following MCOs:

• Blue Cross and Blue Shield of Louisiana (Louisiana Blue) (#345), updated from Blue Cross and Blue Shield of Louisiana to reflect the insurer’s rebranding.
• Dean Health Plan by Medica (#433), updated from Dean Health Plan, to reflect the insurer's acquisition by Medica.

Notable Enrollment Changes

A robust individual market (fueled by a record-breaking public exchange open enrollment season), along with increases in ASO/self-funded membership contributed to a nearly 3.8M jump in insured lives in the first quarter of 2025. It should be noted that ASO membership can often duplicate other lives in the database; while we seek to avoid double-counting, our MCO sources are largely unable to provide ASO data at a level of granularity that would enable us to prevent this.

Decreases in the Medicaid space continue to be relatively modest. Medicaid HMO membership fell by 325K, while Medicaid FFS decreased by just under 55K lives since the fourth-quarter update.

The public health insurance exchange market saw significant gains, adding 1.9M members in 2025.

The following insurers saw the highest shifts in the public exchange space:
• Centene Corporation (#1543) continues to dominate public exchanges, adding nearly 1.2M exchange members in 2025.
• Oscar Health (#1785) also had a strong showing, adding roughly 405K members in the first quarter.
• Aetna (#1359), which announced that it will leave the public exchange market for 2026, took a hit in the exchanges, losing nearly 348K due to increased market competition in 2025.

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

• CareSource (#257) gained the most Medicaid members (78K), largely due to picking up a contract in Mississippi.
• Humana (#1109) continues to make gains in Medicaid space, adding more than 44K members since the last update due to its entry into the Virginia Medicaid program, replacing Molina.
• UnitedHealthcare (#1263) lost nearly 224K Medicaid members, after a contract loss in Mississippi.

Commercial group risk enrollment again decreased since the fourth quarter; group risk dropped nearly 783K members, fueled by losses in the large group market (718K). However, these decreases could be explained by a trend toward ASO/self-funded plans, which gained nearly a whopping 3.4M members, according to reports from our annual survey.

Notable changes in group risk include:

• Aetna lost 244K group risk members; decreases on the group risk side were balanced by large gains (more than 1M) in ASO/self-funded membership.
• Blue Cross and Blue Shield of Illinois (#412) lost nearly 183K group members in the first quarter.
• This quarter’s biggest commercial group risk gainer was UnitedHealthcare, which added nearly 120K group members.

Gains in ASO/self-funded were mostly fueled by large contract pick-ups, including:

• Blue Cross Blue Shield of Arizona (#708) and Blue Shield of California (#136), which began administering the TriWest Alliance contract in 2025; Centene was the previous administrator for the Western region of Tricare. In addition, several states changed regions, leading Humana to lose more than 1.4M ASO members.
• Blue Shield of California also picked up the contract for California Public Employees' Retirement System (CalPERS), which further augmented its ASO membership.
• Arkansas Blue Cross and Blue Shield (#9) added roughly 1M ASO members nationwide, representing its employer contract with Walmart; previous AIS survey contacts omitted this membership from responses.

Medicare Advantage (MA) and duals plans gained 192K members; because the plan year begins in January, this segment doesn’t see major quarterly shifts. However, UnitedHealthcare netted 93K new members from the last update, the largest increase overall.

Note: As stated above, we added a record, Health Care Service Corporation Medicare (Non-Blues) (#2083), which accounts for the nearly 612K Medicare members HCSC acquired from Cigna.

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.