Last week I took the briefest of looks at the health insurance market and how this controversial empire is carved up amongst the top five power players: Aetna, Anthem, Cigna, Kaiser, and United. Now I want to spend the next few blogs going in depth on these carriers, taking a careful look at them one-by-one.
But where to start?
My first thought was to go from smallest to largest, but how do you define the size of a carrier? Is it by premiums collected (Kaiser)? Lives covered (Cigna)? Commissions paid out (United)? Total policies (also Kaiser)?
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There doesn't seem to be a good system, so I'll just go with the old standby: alphabetical.
Aetna
Aetna was named for Sicily's Mount Etna in the early 19th Century when it specifically offered fire insurance – I suppose a magma-spewing behemoth would conjure up the right image for their customers.
Geography
Aetna's strongest states in terms of market share are Tennessee, Connecticut, and California, where combined they control 14.1% of the market in those three states. Of particular note is their almost complete absence from Texas.
Lives Covered
Of all the carriers, Aetna has one of the steadiest holds across all policy sizes, with particularly robust share (almost 9%) in the lucrative 500 to 1,000 participant range.
Premiums
Just like lives covered, their control of the market in terms of premiums collected is fairly flat. In a nutshell, Aetna has excellent penetration amongst health plans of all shapes and sizes.
Commissions
Aetna's average commission paid was just under $40,000, or around 3 cents on the premium dollar. Given their relatively even spread across sizes, this sits pretty well in the middle of things (the average commission amongst all five carriers was also just under $40k).
All in all, I'm glad I started with Aetna. They're very representative of your "average" health carrier.
Next week: Anthem plays with the big boys.
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