Elevance Health says it has secured its place as the largest insurer in the U.S., covering more people than UnitedHealthcare.
For the past six quarters, Elevance’s financial reports show it has provided medical coverage to more people in the U.S. than UnitedHealthcare, a longstanding giant in the health sector.
CEO Gail Boudreaux said Wednesday the latest count “solidifies” Elevance’s position as the largest insurance carrier by U.S.-based medical membership.
Elevance reports it insures more people in the U.S. than UnitedHealthcare
But some analysts aren’t crowning Elevance with the No. 1 title just yet. Which company should be considered the largest insurer carrier depends on how members are counted, they say.
Elevance Health ended the third quarter with 47.2 million members, including BlueCard members, while UnitedHealthcare covered 45.9 million people in the U.S.
Elevance has 6.5 million BlueCard members. Dean Ungar, a senior analyst at Moody’s Investors Service, doesn’t count these members to Elevance’s total enrollment.
“It is double counting — in a way,” Ungar told Healthcare Dive.
Brad Ellis, an analyst at Fitch Ratings, doesn’t count BlueCard members either because the members belong to Elevance’s member Blue Cross Blue Shield plans.
Elevance is still the nation’s second-largest insurer when excluding BlueCard members
Elevance’s BlueCard system allows members of one Blue Cross Blue Shield plan access to provider networks of BCBS plans in other states. Members may live in Ohio but are employed by a company that holds a plan written in Florida, Ellis said. In that example, they use the BlueCard network but are a member and considered a policyholder of the Florida plan.
Elevance counts these members because they perform administrative functions for the member plans such as claims pricing. Elevance also collects fees from BlueCard members’ home plan.
The Indianapolis-based insurer’s “membership growth continues to be impressive, having eclipsed [UnitedHealthcare] in total members in the last 12 months.” Jefferies Analyst David Windley said in a recent note.
Either way — BlueCard members included or not — it’s a win for Elevance.
“Nevertheless, it's good news for them,” Ungar said. “They're more dynamic. They're much more of a competitor. [CEO Gail Boudreaux] deserves a lot of credit for that.”
The nation's six largest insurance carriers
Elevance, formerly known as Anthem, first exceeded UnitedHealthcare’s domestic medical enrollment in the second quarter of 2021 as the country was coming out of a winter surge of COVID-19 cases and hospitalizations.
Insurers have seen enrollment swell amid the pandemic thanks to federal policies designed to protect Americans from losing coverage amid the public health emergency.
Growth in Medicaid has swelled since 2020. States are forbidden from kicking Medicaid enrollees off the program during the public health emergency.
About 82 million people had Medicaid coverage in June 2022, a 30% increase since February 2020, according to the CMS.
Many insurers contract with states to cover their Medicaid enrollees and many insurers have seen their Medicaid rolls increase throughout the pandemic.
Elevance now insurers about 11 million Medicaid members, a 49% increase since the first quarter of 2020.
However, analysts expect enrollment figures will fall for insurers once the public health emergency ends and states can resume removing ineligible Medicaid members.
Plus, with a recession potentially on the horizon in the U.S., resulting job losses could cut into commercial enrollment for insurers who generate revenue from selling health coverage to employers of all sizes. About half of the U.S. population relies on employer-based insurance for coverage.
Boudreaux said Wednesday the company is bracing for a possible recession.