Market Share and Enrollment of Largest Three Insurers - Large Group Market

2024

Location	Total Large Group Market - Enrollment	Largest Insurer - Insurer Name	Largest Insurer - Enrollment	Largest Insurer - Market Share	Second Largest Insurer - Insurer Name	Second Largest Insurer - Enrollment	Second Largest Insurer - Market Share	Third Largest Insurer - Insurer Name	Third Largest Insurer - Enrollment	Third Largest Insurer - Market Share
United States	38184283	KAISER FOUNDATION GRP	6825943	0.18	UNITEDHEALTH GRP	4497951	0.12	ELEVANCE HLTH INC GRP	3689983	0.1
Alabama	576084	BCBS OF AL GRP	546103	0.95	VIVA HLTH INC	21198	0.04	UNITEDHEALTH GRP	8767	0.02
Alaska	83812	PREMERA BLUE CROSS GRP	78501	0.94	OREGON DENTAL SERV GRP	2631	0.03	CVS GRP	2028	0.02
Arizona	428055	BCBS OF AZ INC	256824	0.6	UNITEDHEALTH GRP	87525	0.2	CIGNA HLTH GRP	42191	0.1
Arkansas	227157	ARKANSAS BCBS GRP	157461	0.69	CIGNA HLTH GRP	21367	0.09	UNITEDHEALTH GRP	20636	0.09
California	9559789	KAISER FOUNDATION GRP	5214056	0.55	ELEVANCE HLTH INC GRP	1167591	0.12	BLUE SHIELD OF CA GRP	1144228	0.12
Colorado	411623	KAISER FOUNDATION GRP	251375	0.61	CIGNA HLTH GRP	70634	0.17	UNITEDHEALTH GRP	63276	0.15
Connecticut	268290	ELEVANCE HLTH INC GRP	78120	0.29	UNITEDHEALTH GRP	73843	0.28	CIGNA HLTH GRP	66213	0.25
Delaware	61575	HIGHMARK GRP	48118	0.78	CIGNA HLTH GRP	8138	0.13	CVS GRP	3913	0.06
District of Columbia	616208	CVS GRP	198120	0.32	CAREFIRST INC GRP	147548	0.24	UNITEDHEALTH GRP	135835	0.22
Florida	2046984	GUIDEWELL MUT HOLDING GRP	943974	0.46	UNITEDHEALTH GRP	477801	0.23	CVS GRP	422097	0.21
Georgia	799261	ELEVANCE HLTH INC GRP	339790	0.43	KAISER FOUNDATION GRP	192367	0.24	CIGNA HLTH GRP	120584	0.15
Hawaii	621453	HAWAII MEDICAL SERV ASSN	398781	0.64	KAISER FOUNDATION GRP	151375	0.24	UNIVERSITY HLTH ALLIANCE	40397	0.07
Idaho	217692	BLUE CROSS OF ID GRP	103975	0.48	CAMBIA HEALTH SOLUTIONS INC	75904	0.35	PACIFICSOURCE HLTH PLAN GRP	16735	0.08
Illinois	1673724	HCSC GRP	1295181	0.77	UNITEDHEALTH GRP	220878	0.13	CARLE HOLDING CO GRP	86674	0.05
Indiana	305976	ELEVANCE HLTH INC GRP	217634	0.71	UNITEDHEALTH GRP	48846	0.16	COREWELL HLTH GRP	14910	0.05
Iowa	288503	WELLMARK INC GRP	246417	0.85	UNITEDHEALTH GRP	21234	0.07	HEALTHPARTNERS GRP	10020	0.03
Kansas	316342	BCBS OF KS GRP	167896	0.53	BCBS OF KC GRP	103201	0.33	UNITEDHEALTH GRP	21759	0.07
Kentucky	278570	ELEVANCE HLTH INC GRP	225666	0.81	UNITEDHEALTH GRP	35478	0.13	HUMANA GRP	7490	0.03
Louisiana	324487	LOUISIANA HLTH SERV GRP	247724	0.76	UNITEDHEALTH GRP	66035	0.2	CVS GRP	7397	0.02
Maine	158242	ELEVANCE HLTH INC GRP	110420	0.7	CIGNA HLTH GRP	17815	0.11	POINT32HEALTH INC GRP	15594	0.1
Maryland	984137	CAREFIRST INC GRP	573998	0.58	KAISER FOUNDATION GRP	236620	0.24	CIGNA HLTH GRP	82126	0.08
Massachusetts	990025	BCBS OF MA GRP	671920	0.68	POINT32HEALTH INC GRP	136017	0.14	UNITEDHEALTH GRP	52926	0.05
Michigan	1420843	BCBS OF MI GRP	974092	0.69	COREWELL HLTH GRP	298338	0.21	HENRY FORD HLTH SYSTEM GRP	94611	0.07
Minnesota	415248	BCBS OF MN GRP	237511	0.57	MEDICA GRP	118426	0.29	UNITEDHEALTH GRP	47308	0.11
Mississippi	191389	MISSISSIPPI INS GRP	160873	0.84	UNITEDHEALTH GRP	25941	0.14	CIGNA HLTH GRP	3413	0.02
Missouri	494599	BCBS OF KC GRP	157023	0.32	ELEVANCE HLTH INC GRP	143218	0.29	UNITEDHEALTH GRP	118368	0.24
Montana	77389	HCSC GRP	69769	0.9	PACIFICSOURCE HLTH PLAN GRP	4967	0.06	MONTANA HLTH COOPERATIVE	1628	0.02
Nebraska	213098	BCBS OF NE GRP	170454	0.8	UNITEDHEALTH GRP	19581	0.09	MEDICA GRP	15329	0.07
Nevada	238494	UNITEDHEALTH GRP	195110	0.82	CVS GRP	14044	0.06	RENOWN HLTH GRP	12745	0.05
New Hampshire	123370	ELEVANCE HLTH INC GRP	79767	0.65	POINT32HEALTH INC GRP	23313	0.19	CIGNA HLTH GRP	13608	0.11
New Jersey	753568	BCBS OF NJ GRP	449381	0.6	CIGNA HLTH GRP	109470	0.15	UNITEDHEALTH GRP	104493	0.14
New Mexico	101881	HCSC GRP	77819	0.76	PRESBYTERIAN HLTHCARE SERV GRP	12447	0.12	UNITEDHEALTH GRP	11615	0.11
New York	2216302	CVS GRP	394781	0.18	UNITEDHEALTH GRP	356615	0.16	ELEVANCE HLTH INC GRP	305613	0.14
North Carolina	604053	BCBS OF NC GRP	514249	0.85	UNITEDHEALTH GRP	50500	0.08	CIGNA HLTH GRP	23206	0.04
North Dakota	151216	BCBS OF ND	76143	0.5	SANFORD HLTH GRP	70135	0.46	MEDICA GRP	3268	0.02
Ohio	654274	ELEVANCE HLTH INC GRP	398349	0.61	UNITEDHEALTH GRP	130123	0.2	CVS GRP	49056	0.07
Oklahoma	378422	HCSC GRP	298062	0.79	COMMUNITYCARE GRP	38346	0.1	UNITEDHEALTH GRP	21100	0.06
Oregon	632410	KAISER FOUNDATION GRP	286273	0.45	CAMBIA HEALTH SOLUTIONS INC	151207	0.24	PROVIDENCE HLTH GRP	82519	0.13
Pennsylvania	1242231	HIGHMARK GRP	571489	0.46	INDEPENDENCE BLUE CROSS GRP	278467	0.22	UPMC HLTH SYSTEM GRP	105352	0.08
Rhode Island	98498	BCBS OF RI	82553	0.84	UNITEDHEALTH GRP	12719	0.13	POINT32HEALTH INC GRP	2700	0.03
South Carolina	293624	BCBS OF SC GRP	259891	0.89	UNITEDHEALTH GRP	17500	0.06	CIGNA HLTH GRP	11510	0.04
South Dakota	97678	WELLMARK INC GRP	75102	0.77	SANFORD HLTH GRP	12703	0.13	AVERA HLTH PLANS INC	8614	0.09
Tennessee	529342	BCBS OF TN GRP	373217	0.71	CIGNA HLTH GRP	82074	0.16	UNITEDHEALTH GRP	56064	0.11
Texas	2546957	HCSC GRP	1507388	0.59	UNITEDHEALTH GRP	712980	0.28	CIGNA HLTH GRP	134770	0.05
Utah	379717	IHC INC GRP	169069	0.45	CAMBIA HEALTH SOLUTIONS INC	115214	0.3	UNITEDHEALTH GRP	50091	0.13
Vermont	25096	BCBS OF MI GRP	20467	0.82	CIGNA HLTH GRP	3080	0.12	MVP GRP	1549	0.06
Virginia	1030088	ELEVANCE HLTH INC GRP	469238	0.46	CAREFIRST INC GRP	159056	0.15	CIGNA HLTH GRP	117065	0.11
Washington	1066513	PREMERA BLUE CROSS GRP	376947	0.35	KAISER FOUNDATION GRP	345425	0.32	CAMBIA HEALTH SOLUTIONS INC	191707	0.18
West Virginia	125743	HIGHMARK GRP	103230	0.82	HEALTH PLAN GRP	17408	0.14	CVS GRP	2044	0.02
Wisconsin	812251	UNIVERSITY HLTH CARE & GUNDERSEN LUTHERAN GRP	194359	0.24	MEDICA GRP	161256	0.2	ELEVANCE HLTH INC GRP	138319	0.17
Wyoming	31999	BCBS OF WY	29107	0.91	CVS GRP	1157	0.04	CIGNA HLTH GRP	923	0.03

2023

Location	Total Large Group Market - Enrollment	Largest Insurer - Insurer Name	Largest Insurer - Enrollment	Largest Insurer - Market Share	Second Largest Insurer - Insurer Name	Second Largest Insurer - Enrollment	Second Largest Insurer - Market Share	Third Largest Insurer - Insurer Name	Third Largest Insurer - Enrollment	Third Largest Insurer - Market Share
United States	38352127	KAISER FOUNDATION GRP	7020278	0.18	UNITEDHEALTH GRP	4709993	0.12	ELEVANCE HLTH INC GRP	3405588	0.09
Alabama	579622	BCBS OF AL GRP	546826	0.94	VIVA HLTH INC	21814	0.04	UNITEDHEALTH GRP	10708	0.02
Alaska	78404	PREMERA BLUE CROSS GRP	73405	0.94	OREGON DENTAL SERV GRP	2258	0.03	CVS GRP	2200	0.03
Arizona	441112	BCBS OF AZ INC	256211	0.58	UNITEDHEALTH GRP	97028	0.22	CVS GRP	47322	0.11
Arkansas	237972	ARKANSAS BCBS GRP	164744	0.69	UNITEDHEALTH GRP	28041	0.12	CIGNA HLTH GRP	19046	0.08
California	9775179	KAISER FOUNDATION GRP	5324282	0.54	ELEVANCE HLTH INC GRP	1261339	0.13	BLUE SHIELD OF CA GRP	1135395	0.12
Colorado	412821	KAISER FOUNDATION GRP	264759	0.64	CIGNA HLTH GRP	61763	0.15	UNITEDHEALTH GRP	56019	0.14
Connecticut	275892	UNITEDHEALTH GRP	85749	0.31	ELEVANCE HLTH INC GRP	75685	0.27	CIGNA HLTH GRP	57469	0.21
Delaware	58280	HIGHMARK GRP	47508	0.82	CIGNA HLTH GRP	6203	0.11	CVS GRP	3118	0.05
District of Columbia	614834	CVS GRP	200382	0.33	CAREFIRST INC GRP	145279	0.24	UNITEDHEALTH GRP	134988	0.22
Florida	2046427	GUIDEWELL MUT HOLDING GRP	912286	0.45	UNITEDHEALTH GRP	479366	0.23	CVS GRP	400628	0.20
Georgia	853025	ELEVANCE HLTH INC GRP	346926	0.41	KAISER FOUNDATION GRP	199287	0.23	CIGNA HLTH GRP	122812	0.14
Hawaii	619141	HAWAII MEDICAL SERV ASSN	400793	0.65	KAISER FOUNDATION GRP	148990	0.24	UNIVERSITY HLTH ALLIANCE	40402	0.07
Idaho	214678	BLUE CROSS OF ID GRP	135871	0.63	CAMBIA HEALTH SOLUTIONS INC	42503	0.20	PACIFICSOURCE HLTH PLAN GRP	15059	0.07
Illinois	1675056	HCSC GRP	1276555	0.76	UNITEDHEALTH GRP	237087	0.14	CARLE HOLDING CO GRP	92548	0.06
Indiana	309789	ELEVANCE HLTH INC GRP	210608	0.68	UNITEDHEALTH GRP	54362	0.18	PHP INDIANA GRP	14326	0.05
Iowa	288569	WELLMARK INC GRP	238612	0.83	UNITEDHEALTH GRP	28368	0.10	HEALTHPARTNERS GRP	10429	0.04
Kansas	324894	BCBS OF KS GRP	165101	0.51	BCBS OF KC GRP	106071	0.33	UNITEDHEALTH GRP	19897	0.06
Kentucky	305374	ELEVANCE HLTH INC GRP	214195	0.70	HUMANA GRP	58182	0.19	UNITEDHEALTH GRP	29107	0.10
Louisiana	352933	LOUISIANA HLTH SERV GRP	263958	0.75	UNITEDHEALTH GRP	61841	0.18	HUMANA GRP	14612	0.04
Maine	160260	ELEVANCE HLTH INC GRP	112169	0.70	POINT32HEALTH INC GRP	17898	0.11	CIGNA HLTH GRP	15927	0.10
Maryland	978019	CAREFIRST INC GRP	552400	0.56	KAISER FOUNDATION GRP	243192	0.25	UNITEDHEALTH GRP	86186	0.09
Massachusetts	1047454	BCBS OF MA GRP	675328	0.64	POINT32HEALTH INC GRP	188413	0.18	UNITEDHEALTH GRP	60513	0.06
Michigan	1440323	BCBS OF MI GRP	960407	0.67	COREWELL HLTH GRP	311161	0.22	HENRY FORD HLTH SYSTEM GRP	99849	0.07
Minnesota	281182	BCBS OF MN GRP	228133	0.81	UNITEDHEALTH GRP	42914	0.15	CVS GRP	4469	0.02
Mississippi	188531	MISSISSIPPI INS GRP	151984	0.81	UNITEDHEALTH GRP	30860	0.16	CIGNA HLTH GRP	4432	0.02
Missouri	521486	BCBS OF KC GRP	158984	0.30	ELEVANCE HLTH INC GRP	146720	0.28	UNITEDHEALTH GRP	134493	0.26
Montana	75613	HCSC GRP	65903	0.87	PACIFICSOURCE HLTH PLAN GRP	5067	0.07	MONTANA HLTH COOPERATIVE	2206	0.03
Nebraska	204923	BCBS OF NE GRP	174503	0.85	UNITEDHEALTH GRP	22950	0.11	CVS GRP	7284	0.04
Nevada	248043	UNITEDHEALTH GRP	200276	0.81	CVS GRP	18569	0.07	RENOWN HLTH GRP	13150	0.05
New Hampshire	126570	ELEVANCE HLTH INC GRP	79115	0.63	POINT32HEALTH INC GRP	27555	0.22	CIGNA HLTH GRP	12604	0.10
New Jersey	779036	BCBS OF NJ GRP	441850	0.57	CIGNA HLTH GRP	121466	0.16	UNITEDHEALTH GRP	106189	0.14
New Mexico	109888	HCSC GRP	80508	0.73	PRESBYTERIAN HLTHCARE SERV GRP	17760	0.16	UNITEDHEALTH GRP	11493	0.10
New York	2274389	CVS GRP	388744	0.17	UNITEDHEALTH GRP	358094	0.16	ELEVANCE HLTH INC GRP	331467	0.15
North Carolina	621602	BCBS OF NC GRP	509197	0.82	UNITEDHEALTH GRP	67289	0.11	CIGNA HLTH GRP	26927	0.04
North Dakota	142825	BCBS OF ND	70784	0.50	SANFORD HLTH GRP	70022	0.49	UNITEDHEALTH GRP	1812	0.01
Ohio	284771	UNITEDHEALTH GRP	140240	0.49	CVS GRP	59269	0.21	CIGNA HLTH GRP	32592	0.11
Oklahoma	376549	HCSC GRP	292912	0.78	COMMUNITYCARE GRP	37942	0.10	UNITEDHEALTH GRP	25497	0.07
Oregon	642670	KAISER FOUNDATION GRP	297474	0.46	CAMBIA HEALTH SOLUTIONS INC	150348	0.23	PROVIDENCE HLTH GRP	78724	0.12
Pennsylvania	1269014	HIGHMARK GRP	561614	0.44	INDEPENDENCE BLUE CROSS GRP	289948	0.23	CAPITAL BLUE CROSS GRP	110929	0.09
Rhode Island	104799	BCBS OF RI	86482	0.83	UNITEDHEALTH GRP	11671	0.11	POINT32HEALTH INC GRP	6119	0.06
South Carolina	304341	BCBS OF SC GRP	269073	0.88	UNITEDHEALTH GRP	19404	0.06	CIGNA HLTH GRP	9006	0.03
South Dakota	97816	WELLMARK INC GRP	72673	0.74	SANFORD HLTH GRP	14679	0.15	AVERA HLTH PLANS INC	9611	0.10
Tennessee	522037	BCBS OF TN GRP	355275	0.68	CIGNA HLTH GRP	87488	0.17	UNITEDHEALTH GRP	54463	0.10
Texas	2521172	HCSC GRP	1403246	0.56	UNITEDHEALTH GRP	741175	0.29	CVS GRP	162869	0.06
Utah	381757	IHC INC GRP	174778	0.46	CAMBIA HEALTH SOLUTIONS INC	110499	0.29	UNITEDHEALTH GRP	53624	0.14
Vermont	26493	BCBS OF MI GRP	21894	0.83	CIGNA HLTH GRP	3096	0.12	MVP GRP	1503	0.06
Virginia	1041666	ELEVANCE HLTH INC GRP	477582	0.46	CAREFIRST INC GRP	155746	0.15	CIGNA HLTH GRP	112524	0.11
Washington	1118126	KAISER FOUNDATION GRP	387457	0.35	PREMERA BLUE CROSS GRP	367534	0.33	CAMBIA HEALTH SOLUTIONS INC	206436	0.18
West Virginia	127422	HIGHMARK GRP	103536	0.81	HEALTH PLAN GRP	18449	0.14	CVS GRP	2025	0.02
Wisconsin	838780	UNIVERSITY HLTH CARE & GUNDERSEN LUTHERAN GRP	189034	0.23	MEDICA GRP	159321	0.19	UNITEDHEALTH GRP	136233	0.16
Wyoming	30569	BCBS OF WY	27959	0.91	CVS GRP	1155	0.04	CIGNA HLTH GRP	836	0.03

2022

Location	Total Large Group Market - Enrollment	Largest Insurer - Insurer Name	Largest Insurer - Enrollment	Largest Insurer - Market Share	Second Largest Insurer - Insurer Name	Second Largest Insurer - Enrollment	Second Largest Insurer - Market Share	Third Largest Insurer - Insurer Name	Third Largest Insurer - Enrollment	Third Largest Insurer - Market Share
United States	38376895	KAISER FOUNDATION GRP	7078617	0.18	UNITEDHEALTH GRP	4718739	0.12	ELEVANCE HLTH INC GRP	3385529	0.09
Alabama	580510	BCBS OF AL GRP	545761	0.94	VIVA HLTH INC	22854	0.04	UNITEDHEALTH GRP	11376	0.02
Alaska	74332	PREMERA BLUE CROSS GRP	70831	0.95	CVS GRP	2278	0.03	OREGON DENTAL SERV GRP	1186	0.02
Arizona	433028	BCBS OF AZ INC	249727	0.58	UNITEDHEALTH GRP	97990	0.23	CVS GRP	43758	0.10
Arkansas	236947	ARKANSAS BCBS GRP	164835	0.70	UNITEDHEALTH GRP	36398	0.15	CENTENE CORP GRP	13257	0.06
California	9768028	KAISER FOUNDATION GRP	5352298	0.55	ELEVANCE HLTH INC GRP	1278397	0.13	BLUE SHIELD OF CA GRP	1149002	0.12
Colorado	434938	KAISER FOUNDATION GRP	271810	0.62	CIGNA HLTH GRP	61443	0.14	UNITEDHEALTH GRP	58346	0.13
Connecticut	279073	ELEVANCE HLTH INC GRP	85369	0.31	UNITEDHEALTH GRP	77062	0.28	CIGNA HLTH GRP	51768	0.19
Delaware	56478	HIGHMARK GRP	46384	0.82	CIGNA HLTH GRP	5206	0.09	CVS GRP	4086	0.07
District of Columbia	605002	CVS GRP	206871	0.34	CAREFIRST INC GRP	142426	0.24	UNITEDHEALTH GRP	125300	0.21
Florida	2096444	GUIDEWELL MUT HOLDING GRP	932802	0.44	UNITEDHEALTH GRP	481872	0.23	CVS GRP	412233	0.20
Georgia	939670	ELEVANCE HLTH INC GRP	407002	0.43	KAISER FOUNDATION GRP	203616	0.22	CIGNA HLTH GRP	121871	0.13
Hawaii	621619	HAWAII MEDICAL SERV ASSN	406264	0.65	KAISER FOUNDATION GRP	147362	0.24	UNIVERSITY HLTH ALLIANCE	37880	0.06
Idaho	199214	BLUE CROSS OF ID GRP	136178	0.68	CAMBIA HEALTH SOLUTIONS INC	36543	0.18	PACIFICSOURCE HLTH PLAN GRP	13603	0.07
Illinois	1711159	HCSC GRP	1267778	0.74	UNITEDHEALTH GRP	267844	0.16	CARLE HOLDING CO GRP	99287	0.06
Indiana	101512	UNITEDHEALTH GRP	55135	0.54	PHP INDIANA GRP	14070	0.14	HUMANA GRP	9580	0.09
Iowa	298489	WELLMARK INC GRP	243386	0.82	UNITEDHEALTH GRP	31464	0.11	MEDICAL ASSOCIATES GRP	9034	0.03
Kansas	354320	BCBS OF KS GRP	178095	0.50	BCBS OF KC GRP	121671	0.34	CVS GRP	19442	0.05
Kentucky	320984	ELEVANCE HLTH INC GRP	226455	0.71	HUMANA GRP	67032	0.21	UNITEDHEALTH GRP	22276	0.07
Louisiana	370817	LOUISIANA HLTH SERV GRP	264282	0.71	UNITEDHEALTH GRP	67703	0.18	HUMANA GRP	23529	0.06
Maine	163781	ELEVANCE HLTH INC GRP	119258	0.73	POINT32HEALTH INC GRP	19758	0.12	CIGNA HLTH GRP	12210	0.07
Maryland	986026	CAREFIRST INC GRP	555206	0.56	KAISER FOUNDATION GRP	246446	0.25	UNITEDHEALTH GRP	89436	0.09
Massachusetts	1050141	BCBS OF MA GRP	656799	0.63	POINT32HEALTH INC GRP	212290	0.20	UNITEDHEALTH GRP	58215	0.06
Michigan	1420371	BCBS OF MI GRP	952676	0.67	COREWELL HLTH GRP	285857	0.20	HENRY FORD HLTH SYSTEM GRP	101766	0.07
Minnesota	283809	BCBS OF MN GRP	235380	0.83	UNITEDHEALTH GRP	28144	0.10	HEALTHPARTNERS GRP	12090	0.04
Mississippi	195151	MISSISSIPPI INS GRP	161408	0.83	UNITEDHEALTH GRP	28198	0.14	CIGNA HLTH GRP	3995	0.02
Missouri	533849	BCBS OF KC GRP	161545	0.30	ELEVANCE HLTH INC GRP	157700	0.30	UNITEDHEALTH GRP	133162	0.25
Montana	72157	HCSC GRP	61823	0.86	PACIFICSOURCE HLTH PLAN GRP	4889	0.07	MONTANA HLTH COOPERATIVE	2908	0.04
Nebraska	212114	BCBS OF NE GRP	181351	0.85	UNITEDHEALTH GRP	23875	0.11	CVS GRP	6860	0.03
Nevada	290795	UNITEDHEALTH GRP	219439	0.75	UNIVERSAL HLTH SERV INC GRP	22343	0.08	RENOWN HLTH GRP	16470	0.06
New Hampshire	131989	ELEVANCE HLTH INC GRP	80890	0.61	POINT32HEALTH INC GRP	30441	0.23	CIGNA HLTH GRP	12382	0.09
New Jersey	683293	BCBS OF NJ GRP	333931	0.49	CIGNA HLTH GRP	119492	0.17	UNITEDHEALTH GRP	109180	0.16
New Mexico	111814	HCSC GRP	78061	0.70	PRESBYTERIAN HLTHCARE SERV GRP	14693	0.13	UNITEDHEALTH GRP	10833	0.10
New York	2330849	CVS GRP	386031	0.17	ELEVANCE HLTH INC GRP	379093	0.16	UNITEDHEALTH GRP	339200	0.15
North Carolina	534256	BCBS OF NC GRP	404852	0.76	UNITEDHEALTH GRP	80638	0.15	CIGNA HLTH GRP	25866	0.05
North Dakota	141806	SANFORD HLTH GRP	71996	0.51	BCBS OF ND	65188	0.46	UNITEDHEALTH GRP	4547	0.03
Ohio	259577	UNITEDHEALTH GRP	134626	0.52	CVS GRP	40055	0.15	CIGNA HLTH GRP	27361	0.11
Oklahoma	366548	HCSC GRP	277526	0.76	COMMUNITYCARE GRP	35324	0.10	UNITEDHEALTH GRP	31267	0.09
Oregon	649210	KAISER FOUNDATION GRP	300882	0.46	CAMBIA HEALTH SOLUTIONS INC	147889	0.23	PROVIDENCE HLTH GRP	67501	0.10
Pennsylvania	1327681	HIGHMARK GRP	571726	0.43	INDEPENDENCE BLUE CROSS GRP	296067	0.22	CAPITAL BLUE CROSS GRP	130497	0.10
Rhode Island	104216	BCBS OF RI	86222	0.83	UNITEDHEALTH GRP	11569	0.11	POINT32HEALTH INC GRP	5795	0.06
South Carolina	306037	BCBS OF SC GRP	281764	0.92	UNITEDHEALTH GRP	11376	0.04	CIGNA HLTH GRP	9121	0.03
South Dakota	99249	WELLMARK INC GRP	67831	0.68	SANFORD HLTH GRP	16252	0.16	AVERA HLTH PLANS INC	13990	0.14
Tennessee	474654	BCBS OF TN GRP	296455	0.62	CIGNA HLTH GRP	83850	0.18	UNITEDHEALTH GRP	58389	0.12
Texas	2460721	HCSC GRP	1258502	0.51	UNITEDHEALTH GRP	765935	0.31	CVS GRP	198346	0.08
Utah	399528	IHC INC GRP	190409	0.48	CAMBIA HEALTH SOLUTIONS INC	110715	0.28	UNITEDHEALTH GRP	51863	0.13
Vermont	28568	BCBS OF VT GRP	23433	0.82	CIGNA HLTH GRP	3276	0.11	MVP GRP	1836	0.06
Virginia	1061658	ELEVANCE HLTH INC GRP	492273	0.46	CAREFIRST INC GRP	158734	0.15	UNITEDHEALTH GRP	110313	0.10
Washington	1133188	KAISER FOUNDATION GRP	398370	0.35	PREMERA BLUE CROSS GRP	383817	0.34	CAMBIA HEALTH SOLUTIONS INC	213512	0.19
West Virginia	128512	HIGHMARK GRP	104122	0.81	HEALTH PLAN GRP	19468	0.15	UNITEDHEALTH GRP	2059	0.02
Wisconsin	922242	UNIVERSITY HLTH CARE & GUNDERSEN LUTHERAN GRP	196519	0.21	MEDICA GRP	149098	0.16	ELEVANCE HLTH INC GRP	143470	0.16
Wyoming	30539	BCBS OF WY	27898	0.91	CVS GRP	1209	0.04	CIGNA HLTH GRP	823	0.03

2021

Location	Total Large Group Market - Enrollment	Largest Insurer - Insurer Name	Largest Insurer - Enrollment	Largest Insurer - Market Share	Second Largest Insurer - Insurer Name	Second Largest Insurer - Enrollment	Second Largest Insurer - Market Share	Third Largest Insurer - Insurer Name	Third Largest Insurer - Enrollment	Third Largest Insurer - Market Share
United States	39286559	KAISER FOUNDATION GRP	7119254	0.18	UNITEDHEALTH GRP	4715620	0.12	ELEVANCE HLTH INC GRP	3907428	0.10
Alabama	582887	BCBS OF AL GRP	554626	0.95	VIVA HLTH INC	22804	0.04	UNITEDHEALTH GRP	4971	0.01
Alaska	73518	PREMERA BLUE CROSS GRP	70773	0.96	CVS GRP	2127	0.03	OREGON DENTAL SERV GRP	524	0.01
Arizona	427892	BCBS OF AZ INC	242504	0.57	UNITEDHEALTH GRP	99009	0.23	CVS GRP	39899	0.09
Arkansas	236366	ARKANSAS BCBS GRP	162483	0.69	UNITEDHEALTH GRP	41450	0.18	CENTENE CORP GRP	14046	0.06
California	10060073	KAISER FOUNDATION GRP	5352000	0.53	ELEVANCE HLTH INC GRP	1562182	0.16	BLUE SHIELD OF CA GRP	1143753	0.11
Colorado	450818	KAISER FOUNDATION GRP	283848	0.63	CIGNA HLTH GRP	64369	0.14	UNITEDHEALTH GRP	59926	0.13
Connecticut	274842	ELEVANCE HLTH INC GRP	90918	0.33	UNITEDHEALTH GRP	65938	0.24	CIGNA HLTH GRP	50373	0.18
Delaware	56431	HIGHMARK GRP	44111	0.78	CVS GRP	5863	0.10	CIGNA HLTH GRP	5230	0.09
District of Columbia	619217	CVS GRP	222287	0.36	CAREFIRST INC GRP	144262	0.23	UNITEDHEALTH GRP	127890	0.21
Florida	2116648	GUIDEWELL MUT HOLDING GRP	973516	0.46	UNITEDHEALTH GRP	478158	0.23	CVS GRP	383328	0.18
Georgia	966988	ELEVANCE HLTH INC GRP	423700	0.44	KAISER FOUNDATION GRP	209776	0.22	CIGNA HLTH GRP	120777	0.12
Hawaii	613587	HAWAII MEDICAL SERV ASSN	405213	0.66	KAISER FOUNDATION GRP	146238	0.24	UNIVERSITY HLTH ALLIANCE	36694	0.06
Idaho	196435	BLUE CROSS OF ID GRP	136898	0.70	CAMBIA HEALTH SOLUTIONS INC	34585	0.18	PACIFICSOURCE HLTH PLAN GRP	10767	0.05
Illinois	1770291	HCSC GRP	1322368	0.75	UNITEDHEALTH GRP	259453	0.15	CARLE HOLDING CO GRP	101088	0.06
Indiana	324160	ELEVANCE HLTH INC GRP	223232	0.69	UNITEDHEALTH GRP	55325	0.17	PHP INDIANA GRP	17086	0.05
Iowa	305010	WELLMARK INC GRP	243936	0.80	UNITEDHEALTH GRP	33386	0.11	HEALTHPARTNERS GRP	8969	0.03
Kansas	377134	BCBS OF KS GRP	185969	0.49	BCBS OF KC GRP	134863	0.36	CVS GRP	20997	0.06
Kentucky	325846	ELEVANCE HLTH INC GRP	221853	0.68	HUMANA GRP	75486	0.23	UNITEDHEALTH GRP	21308	0.07
Louisiana	382852	LOUISIANA HLTH SERV GRP	268029	0.70	UNITEDHEALTH GRP	69035	0.18	HUMANA GRP	34438	0.09
Maine	166542	ELEVANCE HLTH INC GRP	121280	0.73	POINT32HEALTH INC GRP	22531	0.14	CIGNA HLTH GRP	9892	0.06
Maryland	990571	CAREFIRST INC GRP	546638	0.55	KAISER FOUNDATION GRP	254007	0.26	UNITEDHEALTH GRP	94052	0.09
Massachusetts	1060175	BCBS OF MA GRP	661216	0.62	POINT32HEALTH INC GRP	226606	0.21	UNITEDHEALTH GRP	45665	0.04
Michigan	1426580	BCBS OF MI GRP	942104	0.66	COREWELL HLTH GRP	291486	0.20	HENRY FORD HLTH SYSTEM GRP	105701	0.07
Minnesota	239453	BCBS OF MN GRP	212854	0.89	UNITEDHEALTH GRP	19101	0.08	CVS GRP	5351	0.02
Mississippi	198931	MISSISSIPPI INS GRP	168581	0.85	UNITEDHEALTH GRP	26788	0.13	CIGNA HLTH GRP	2385	0.01
Missouri	589551	BCBS OF KC GRP	203355	0.34	ELEVANCE HLTH INC GRP	170469	0.29	UNITEDHEALTH GRP	135170	0.23
Montana	70551	HCSC GRP	59528	0.84	PACIFICSOURCE HLTH PLAN GRP	5903	0.08	MONTANA HLTH COOPERATIVE	2504	0.04
Nebraska	214407	BCBS OF NE GRP	179057	0.84	UNITEDHEALTH GRP	24023	0.11	CVS GRP	11292	0.05
Nevada	299327	UNITEDHEALTH GRP	232489	0.78	RENOWN HLTH GRP	19599	0.07	UNIVERSAL HLTH SERV INC GRP	18428	0.06
New Hampshire	135799	ELEVANCE HLTH INC GRP	81355	0.60	POINT32HEALTH INC GRP	34420	0.25	CIGNA HLTH GRP	10940	0.08
New Jersey	769629	BCBS OF NJ GRP	391420	0.51	CVS GRP	116224	0.15	CIGNA HLTH GRP	113155	0.15
New Mexico	113401	HCSC GRP	77910	0.69	PRESBYTERIAN HLTHCARE SERV GRP	15621	0.14	UNITEDHEALTH GRP	10421	0.09
New York	2309964	CVS GRP	350372	0.15	UNITEDHEALTH GRP	349525	0.15	ELEVANCE HLTH INC GRP	348808	0.15
North Carolina	536930	BCBS OF NC GRP	402382	0.75	UNITEDHEALTH GRP	86741	0.16	CIGNA HLTH GRP	23421	0.04
North Dakota	143589	SANFORD HLTH GRP	73183	0.51	BCBS OF ND	67882	0.47	UNITEDHEALTH GRP	2442	0.02
Ohio	268087	UNITEDHEALTH GRP	142076	0.53	CVS GRP	43061	0.16	CIGNA HLTH GRP	22944	0.09
Oklahoma	382926	HCSC GRP	280252	0.73	UNITEDHEALTH GRP	38951	0.10	COMMUNITYCARE GRP	35363	0.09
Oregon	664216	KAISER FOUNDATION GRP	308141	0.46	CAMBIA HEALTH SOLUTIONS INC	146236	0.22	PROVIDENCE HLTH GRP	67433	0.10
Pennsylvania	1398771	HIGHMARK GRP	568870	0.41	INDEPENDENCE BLUE CROSS GRP	306952	0.22	CAPITAL BLUE CROSS GRP	150167	0.11
Rhode Island	111710	BCBS OF RI	90664	0.81	UNITEDHEALTH GRP	13725	0.12	POINT32HEALTH INC GRP	6574	0.06
South Carolina	303216	BCBS OF SC GRP	277440	0.91	UNITEDHEALTH GRP	14248	0.05	CIGNA HLTH GRP	9293	0.03
South Dakota	97627	WELLMARK INC GRP	65825	0.67	SANFORD HLTH GRP	17140	0.18	AVERA HLTH PLANS INC	13814	0.14
Tennessee	523521	BCBS OF TN GRP	348665	0.67	CIGNA HLTH GRP	83828	0.16	UNITEDHEALTH GRP	53027	0.10
Texas	2414787	HCSC GRP	1259152	0.52	UNITEDHEALTH GRP	727372	0.30	CVS GRP	184545	0.08
Utah	405341	IHC INC GRP	184115	0.45	CAMBIA HEALTH SOLUTIONS INC	120713	0.30	UNITEDHEALTH GRP	47988	0.12
Vermont	28334	BCBS OF VT GRP	22227	0.78	CIGNA HLTH GRP	3998	0.14	MVP GRP	2103	0.07
Virginia	1078642	ELEVANCE HLTH INC GRP	493756	0.46	CAREFIRST INC GRP	162920	0.15	UNITEDHEALTH GRP	118100	0.11
Washington	1064324	KAISER FOUNDATION GRP	407522	0.38	PREMERA BLUE CROSS GRP	320561	0.30	CAMBIA HEALTH SOLUTIONS INC	211801	0.20
West Virginia	132501	HIGHMARK GRP	107441	0.81	HEALTH PLAN GRP	19740	0.15	UNITEDHEALTH GRP	1898	0.01
Wisconsin	954896	UNIVERSITY HLTH CARE & GUNDERSEN LUTHERAN GRP	205094	0.21	ELEVANCE HLTH INC GRP	154863	0.16	MEDICA GRP	145834	0.15
Wyoming	31265	BCBS OF WY	28716	0.92	CVS GRP	1235	0.04	CIGNA HLTH GRP	861	0.03

2020

Location	Total Large Group Market - Enrollment	Largest Insurer - Insurer Name	Largest Insurer - Enrollment	Largest Insurer - Market Share	Second Largest Insurer - Insurer Name	Second Largest Insurer - Enrollment	Second Largest Insurer - Market Share	Third Largest Insurer - Insurer Name	Third Largest Insurer - Enrollment	Third Largest Insurer - Market Share
United States	39415602	KAISER FOUNDATION GRP	7248708	0.18	UNITEDHEALTH GRP	4731472	0.12	ELEVANCE HLTH INC GRP	3328858	0.08
Alabama	570460	BCBS OF AL GRP	542871	0.95	VIVA HLTH INC	23175	0.04	UNITEDHEALTH GRP	3797	0.01
Alaska	71903	PREMERA BLUE CROSS GRP	69082	0.96	CVS GRP	2032	0.03	OREGON DENTAL SERV GRP	582	0.01
Arizona	432487	BCBS OF AZ INC	248172	0.57	UNITEDHEALTH GRP	97669	0.23	CVS GRP	42979	0.10
Arkansas	222592	ARKANSAS BCBS GRP	140073	0.63	UNITEDHEALTH GRP	46863	0.21	CENTENE CORP GRP	16489	0.07
California	9847231	KAISER FOUNDATION GRP	5421077	0.55	ELEVANCE HLTH INC GRP	1236283	0.13	BLUE SHIELD OF CA GRP	1182536	0.12
Colorado	476804	KAISER FOUNDATION GRP	302795	0.64	UNITEDHEALTH GRP	62535	0.13	CIGNA HLTH GRP	62284	0.13
Connecticut	277196	ELEVANCE HLTH INC GRP	84730	0.31	UNITEDHEALTH GRP	71482	0.26	EMBLEM HLTH GRP	53785	0.19
Delaware	59641	HIGHMARK GRP	43990	0.74	CVS GRP	7963	0.13	CIGNA HLTH GRP	5856	0.10
District of Columbia	632495	CVS GRP	236407	0.37	CAREFIRST INC GRP	142997	0.23	UNITEDHEALTH GRP	120580	0.19
Florida	2151702	GUIDEWELL MUT HOLDING GRP	992928	0.46	UNITEDHEALTH GRP	467388	0.22	CVS GRP	387839	0.18
Georgia	1013088	ELEVANCE HLTH INC GRP	434727	0.43	KAISER FOUNDATION GRP	218461	0.22	CIGNA HLTH GRP	119147	0.12
Hawaii	633681	HAWAII MEDICAL SERV ASSN	419162	0.66	KAISER FOUNDATION GRP	151910	0.24	UNIVERSITY HLTH ALLIANCE	37779	0.06
Idaho	197293	BLUE CROSS OF ID GRP	138887	0.70	CAMBIA HEALTH SOLUTIONS INC	34882	0.18	IHC INC GRP	11022	0.06
Illinois	1785200	HCSC GRP	1329426	0.74	UNITEDHEALTH GRP	257639	0.14	CARLE HOLDING CO GRP	102408	0.06
Indiana	106426	UNITEDHEALTH GRP	60522	0.57	PHP INDIANA GRP	17847	0.17	HUMANA GRP	12331	0.12
Iowa	313804	WELLMARK INC GRP	247157	0.79	UNITEDHEALTH GRP	35745	0.11	HEALTHPARTNERS GRP	10068	0.03
Kansas	396071	BCBS OF KS GRP	193048	0.49	BCBS OF KC GRP	143404	0.36	CVS GRP	22765	0.06
Kentucky	336934	ELEVANCE HLTH INC GRP	228814	0.68	HUMANA GRP	81164	0.24	UNITEDHEALTH GRP	20715	0.06
Louisiana	396229	LOUISIANA HLTH SERV GRP	277583	0.70	UNITEDHEALTH GRP	67782	0.17	HUMANA GRP	39343	0.10
Maine	170428	ELEVANCE HLTH INC GRP	124642	0.73	HARVARD PILGRIM HLTH CARE GRP	23487	0.14	CIGNA HLTH GRP	10283	0.06
Maryland	1001778	CAREFIRST INC GRP	546052	0.55	KAISER FOUNDATION GRP	260263	0.26	UNITEDHEALTH GRP	98502	0.10
Massachusetts	1070977	BCBS OF MA GRP	669395	0.63	HARVARD PILGRIM HLTH CARE GRP	121217	0.11	TUFTS GRP	114813	0.11
Michigan	1483800	BCBS OF MI GRP	989674	0.67	COREWELL HLTH GRP	284950	0.19	HENRY FORD HLTH SYSTEM GRP	111504	0.08
Minnesota	246315	BCBS OF MN GRP	213932	0.87	HEALTHPARTNERS GRP	13727	0.06	UNITEDHEALTH GRP	11781	0.05
Mississippi	206140	MISSISSIPPI INS GRP	172272	0.84	UNITEDHEALTH GRP	26796	0.13	CVS GRP	4962	0.02
Missouri	604348	BCBS OF KC GRP	201791	0.33	ELEVANCE HLTH INC GRP	180379	0.30	UNITEDHEALTH GRP	138592	0.23
Montana	70035	HCSC GRP	58643	0.84	PACIFICSOURCE HLTH PLAN GRP	7064	0.10	CIGNA HLTH GRP	2576	0.04
Nebraska	217379	BCBS OF NE GRP	175170	0.81	UNITEDHEALTH GRP	28461	0.13	CVS GRP	13568	0.06
Nevada	312243	UNITEDHEALTH GRP	246024	0.79	RENOWN HLTH GRP	23509	0.08	CVS GRP	17172	0.05
New Hampshire	134834	ELEVANCE HLTH INC GRP	79365	0.59	HARVARD PILGRIM HLTH CARE GRP	36525	0.27	CIGNA HLTH GRP	10913	0.08
New Jersey	848877	BCBS OF NJ GRP	442337	0.52	CVS GRP	136768	0.16	UNITEDHEALTH GRP	113562	0.13
New Mexico	117321	HCSC GRP	81756	0.70	PRESBYTERIAN HLTHCARE SERV GRP	17091	0.15	UNITEDHEALTH GRP	9363	0.08
New York	2339814	UNITEDHEALTH GRP	351464	0.15	CVS GRP	346462	0.15	EMBLEM HLTH GRP	324243	0.14
North Carolina	534083	BCBS OF NC GRP	389939	0.73	UNITEDHEALTH GRP	96171	0.18	CVS GRP	24116	0.05
North Dakota	147167	BCBS OF ND	73872	0.50	SANFORD HLTH GRP	71305	0.48	UNITEDHEALTH GRP	1884	0.01
Ohio	271061	UNITEDHEALTH GRP	145427	0.54	CVS GRP	39965	0.15	AULTMAN HLTH FOUNDATION GRP	23939	0.09
Oklahoma	388292	HCSC GRP	271443	0.70	UNITEDHEALTH GRP	45465	0.12	COMMUNITYCARE GRP	34869	0.09
Oregon	676849	KAISER FOUNDATION GRP	313397	0.46	CAMBIA HEALTH SOLUTIONS INC	144528	0.21	PROVIDENCE HLTH GRP	72226	0.11
Pennsylvania	1476457	HIGHMARK GRP	595139	0.40	INDEPENDENCE BLUE CROSS GRP	303877	0.21	CAPITAL BLUE CROSS GRP	161248	0.11
Rhode Island	116932	BCBS OF RI	92860	0.79	UNITEDHEALTH GRP	16922	0.14	TUFTS GRP	6376	0.05
South Carolina	318781	BCBS OF SC GRP	293017	0.92	UNITEDHEALTH GRP	14011	0.04	CIGNA HLTH GRP	9220	0.03
South Dakota	98665	WELLMARK INC GRP	65643	0.67	SANFORD HLTH GRP	17826	0.18	AVERA HLTH PLANS INC	14642	0.15
Tennessee	532652	BCBS OF TN GRP	368784	0.69	CIGNA HLTH GRP	76327	0.14	UNITEDHEALTH GRP	50339	0.09
Texas	2378683	HCSC GRP	1202615	0.51	UNITEDHEALTH GRP	718370	0.30	CVS GRP	174755	0.07
Utah	409168	IHC INC GRP	181255	0.44	CAMBIA HEALTH SOLUTIONS INC	123788	0.30	UNITEDHEALTH GRP	48036	0.12
Vermont	28522	BCBS OF VT GRP	22887	0.80	CIGNA HLTH GRP	3672	0.13	MVP GRP	1963	0.07
Virginia	1093416	ELEVANCE HLTH INC GRP	484067	0.44	CAREFIRST INC GRP	163485	0.15	CIGNA HLTH GRP	125092	0.11
Washington	1070613	KAISER FOUNDATION GRP	411535	0.38	PREMERA BLUE CROSS GRP	311756	0.29	CAMBIA HEALTH SOLUTIONS INC	223133	0.21
West Virginia	137517	HIGHMARK GRP	108934	0.79	HEALTH PLAN GRP	20885	0.15	CVS GRP	4530	0.03
Wisconsin	959834	UNIVERSITY HLTH CARE & GUNDERSEN LUTHERAN GRP	203021	0.21	ELEVANCE HLTH INC GRP	154479	0.16	DEAN HLTH GRP	146864	0.15
Wyoming	31382	BCBS OF WY	28718	0.92	CVS GRP	1221	0.04	CIGNA HLTH GRP	879	0.03

2019

Location	Total Large Group Market - Enrollment	Largest Insurer - Insurer Name	Largest Insurer - Enrollment	Largest Insurer - Market Share	Second Largest Insurer - Insurer Name	Second Largest Insurer - Enrollment	Second Largest Insurer - Market Share	Third Largest Insurer - Insurer Name	Third Largest Insurer - Enrollment	Third Largest Insurer - Market Share
United States	42193604	KAISER FOUNDATION GRP	7175187	0.17	UNITEDHEALTH GRP	5239301	0.12	ELEVANCE HLTH INC GRP	4415669	0.10
Alabama	545941	BCBS OF AL GRP	516289	0.95	VIVA HLTH INC	23743	0.04	UNITEDHEALTH GRP	5369	0.01
Alaska	69191	PREMERA BLUE CROSS GRP	65451	0.95	CVS GRP	2707	0.04	UNITEDHEALTH GRP	625	0.01
Arizona	447260	BCBS OF AZ INC	242952	0.54	UNITEDHEALTH GRP	113106	0.25	CVS GRP	41371	0.09
Arkansas	253194	ARKANSAS BCBS GRP	175727	0.69	UNITEDHEALTH GRP	41185	0.16	CENTENE CORP GRP	20381	0.08
California	10112126	KAISER FOUNDATION GRP	5354825	0.53	ELEVANCE HLTH INC GRP	1384979	0.14	BLUE SHIELD OF CA GRP	1186434	0.12
Colorado	651989	KAISER FOUNDATION GRP	317162	0.49	ELEVANCE HLTH INC GRP	159263	0.24	UNITEDHEALTH GRP	76464	0.12
Connecticut	296541	UNITEDHEALTH GRP	82343	0.28	ELEVANCE HLTH INC GRP	73319	0.25	EMBLEM HLTH GRP	67938	0.23
Delaware	64841	HIGHMARK GRP	47754	0.74	CVS GRP	9886	0.15	CIGNA HLTH GRP	5108	0.08
District of Columbia	659324	CVS GRP	264116	0.40	CAREFIRST INC GRP	143420	0.22	UNITEDHEALTH GRP	115861	0.18
Florida	2197450	GUIDEWELL MUT HOLDING GRP	1008408	0.46	UNITEDHEALTH GRP	502890	0.23	CVS GRP	396992	0.18
Georgia	1070500	ELEVANCE HLTH INC GRP	434693	0.41	KAISER FOUNDATION GRP	221485	0.21	UNITEDHEALTH GRP	158618	0.15
Hawaii	632465	HAWAII MEDICAL SERV ASSN	418044	0.66	KAISER FOUNDATION GRP	146287	0.23	UNIVERSITY HLTH ALLIANCE	38499	0.06
Idaho	200879	BLUE CROSS OF ID GRP	141895	0.71	CAMBIA HEALTH SOLUTIONS INC	36442	0.18	IHC INC GRP	11002	0.05
Illinois	1792891	HCSC GRP	1311365	0.73	UNITEDHEALTH GRP	273268	0.15	CARLE HOLDING CO GRP	104462	0.06
Indiana	354642	ELEVANCE HLTH INC GRP	237413	0.67	UNITEDHEALTH GRP	72213	0.20	PHP INDIANA GRP	17602	0.05
Iowa	314821	WELLMARK INC GRP	245618	0.78	UNITEDHEALTH GRP	36392	0.12	CVS GRP	11823	0.04
Kansas	438339	BCBS OF KS GRP	212950	0.49	BCBS OF KC GRP	161938	0.37	CVS GRP	27065	0.06
Kentucky	342624	ELEVANCE HLTH INC GRP	232923	0.68	HUMANA GRP	81225	0.24	UNITEDHEALTH GRP	25379	0.07
Louisiana	405984	LOUISIANA HLTH SERV GRP	281707	0.69	UNITEDHEALTH GRP	70174	0.17	HUMANA GRP	40852	0.10
Maine	189509	ELEVANCE HLTH INC GRP	131237	0.69	HARVARD PILGRIM HLTH CARE GRP	36304	0.19	CIGNA HLTH GRP	10974	0.06
Maryland	1005428	CAREFIRST INC GRP	553854	0.55	KAISER FOUNDATION GRP	260627	0.26	UNITEDHEALTH GRP	94830	0.09
Massachusetts	1129987	BCBS OF MA GRP	699811	0.62	HARVARD PILGRIM HLTH CARE GRP	143254	0.13	TUFTS GRP	118931	0.11
Michigan	1506383	BCBS OF MI GRP	991762	0.66	COREWELL HLTH GRP	279013	0.19	HENRY FORD HLTH SYSTEM GRP	122234	0.08
Minnesota	716316	HEALTHPARTNERS GRP	339666	0.47	BCBS OF MN GRP	208455	0.29	MEDICA GRP	135185	0.19
Mississippi	209970	MISSISSIPPI INS GRP	175166	0.83	UNITEDHEALTH GRP	25008	0.12	CVS GRP	5726	0.03
Missouri	707102	ELEVANCE HLTH INC GRP	252537	0.36	BCBS OF KC GRP	211068	0.30	UNITEDHEALTH GRP	148319	0.21
Montana	67640	HCSC GRP	56949	0.84	PACIFICSOURCE HLTH PLAN GRP	6180	0.09	CIGNA HLTH GRP	3496	0.05
Nebraska	225285	BCBS OF NE GRP	173544	0.77	UNITEDHEALTH GRP	32619	0.14	CVS GRP	18835	0.08
Nevada	387841	UNITEDHEALTH GRP	251681	0.65	ELEVANCE HLTH INC GRP	74022	0.19	RENOWN HLTH GRP	23134	0.06
New Hampshire	142051	ELEVANCE HLTH INC GRP	79673	0.56	HARVARD PILGRIM HLTH CARE GRP	42508	0.30	CIGNA HLTH GRP	11302	0.08
New Jersey	891138	BCBS OF NJ GRP	460488	0.52	CVS GRP	149358	0.17	UNITEDHEALTH GRP	128614	0.14
New Mexico	127971	HCSC GRP	79234	0.62	PRESBYTERIAN HLTHCARE SERV GRP	29664	0.23	UNITEDHEALTH GRP	9707	0.08
New York	2379177	CVS GRP	382203	0.16	UNITEDHEALTH GRP	368847	0.16	EMBLEM HLTH GRP	328944	0.14
North Carolina	557782	BCBS OF NC GRP	391548	0.70	UNITEDHEALTH GRP	111548	0.20	CVS GRP	29905	0.05
North Dakota	156186	BCBS OF ND	80208	0.51	SANFORD HLTH GRP	69100	0.44	MEDICA GRP	5975	0.04
Ohio	955666	ELEVANCE HLTH INC GRP	435888	0.46	MEDICAL MUT OF OH GRP	222831	0.23	UNITEDHEALTH GRP	158700	0.17
Oklahoma	387470	HCSC GRP	247662	0.64	UNITEDHEALTH GRP	51926	0.13	COMMUNITYCARE GRP	37604	0.10
Oregon	694269	KAISER FOUNDATION GRP	313200	0.45	CAMBIA HEALTH SOLUTIONS INC	142382	0.21	PROVIDENCE HLTH GRP	83928	0.12
Pennsylvania	1551875	HIGHMARK GRP	611154	0.39	INDEPENDENCE BLUE CROSS GRP	308106	0.20	CAPITAL BLUE CROSS GRP	173219	0.11
Rhode Island	124155	BCBS OF RI	97726	0.79	UNITEDHEALTH GRP	18706	0.15	TUFTS GRP	6892	0.06
South Carolina	324688	BCBS OF SC GRP	296412	0.91	UNITEDHEALTH GRP	15067	0.05	CIGNA HLTH GRP	9457	0.03
South Dakota	98922	WELLMARK INC GRP	64196	0.65	SANFORD HLTH GRP	18018	0.18	AVERA HLTH PLANS INC	15194	0.15
Tennessee	540880	BCBS OF TN GRP	389930	0.72	CIGNA HLTH GRP	69020	0.13	UNITEDHEALTH GRP	49230	0.09
Texas	2364884	HCSC GRP	1092069	0.46	UNITEDHEALTH GRP	789699	0.33	CVS GRP	175040	0.07
Utah	415096	IHC INC GRP	177275	0.43	CAMBIA HEALTH SOLUTIONS INC	122474	0.30	UNITEDHEALTH GRP	53732	0.13
Vermont	37481	BCBS OF VT GRP	34093	0.91	MVP GRP	1876	0.05	CIGNA HLTH GRP	1512	0.04
Virginia	1149233	ELEVANCE HLTH INC GRP	480617	0.42	CAREFIRST INC GRP	172282	0.15	UNITEDHEALTH GRP	145600	0.13
Washington	1128454	KAISER FOUNDATION GRP	388445	0.34	PREMERA BLUE CROSS GRP	310637	0.28	CAMBIA HEALTH SOLUTIONS INC	234040	0.21
West Virginia	139460	HIGHMARK GRP	109000	0.78	HEALTH PLAN GRP	22461	0.16	CVS GRP	5024	0.04
Wisconsin	999444	UNIVERSITY HLTH CARE & GUNDERSEN LUTHERAN GRP	200566	0.20	ELEVANCE HLTH INC GRP	157949	0.16	DEAN HLTH GRP	157318	0.16
Wyoming	30864	BCBS OF WY	28085	0.91	CVS GRP	1264	0.04	UNITEDHEALTH GRP	990	0.03

2018

Location	Total Large Group Market - Enrollment	Largest Insurer - Insurer Name	Largest Insurer - Enrollment	Largest Insurer - Market Share	Second Largest Insurer - Insurer Name	Second Largest Insurer - Enrollment	Second Largest Insurer - Market Share	Third Largest Insurer - Insurer Name	Third Largest Insurer - Enrollment	Third Largest Insurer - Market Share
United States	42114731	KAISER FOUNDATION GRP	6994438	0.17	UNITEDHEALTH GRP	5488628	0.13	ELEVANCE HLTH INC GRP	4188049	0.10
Alabama	528341	BCBS OF AL GRP	497056	0.94	VIVA HLTH INC	24402	0.05	UNITEDHEALTH GRP	6375	0.01
Alaska	67913	PREMERA BLUE CROSS GRP	62922	0.93	CVS GRP	3486	0.05	UNITEDHEALTH GRP	926	0.01
Arizona	462290	BCBS OF AZ INC	230398	0.50	UNITEDHEALTH GRP	119978	0.26	CVS GRP	44473	0.10
Arkansas	256944	ARKANSAS BCBS GRP	194446	0.76	UNITEDHEALTH GRP	33801	0.13	CATHOLIC HLTH INITIATIVES GRP	19405	0.08
California	9977473	KAISER FOUNDATION GRP	5204055	0.52	ELEVANCE HLTH INC GRP	1262626	0.13	BLUE SHIELD OF CA GRP	1208229	0.12
Colorado	660099	KAISER FOUNDATION GRP	317915	0.48	ELEVANCE HLTH INC GRP	156386	0.24	UNITEDHEALTH GRP	83233	0.13
Connecticut	320420	UNITEDHEALTH GRP	85703	0.27	ELEVANCE HLTH INC GRP	77553	0.24	EMBLEM HLTH GRP	70464	0.22
Delaware	72916	HIGHMARK GRP	50101	0.69	CIGNA HLTH GRP	10544	0.14	CVS GRP	10434	0.14
District of Columbia	667118	CVS GRP	279906	0.42	CAREFIRST INC GRP	147957	0.22	UNITEDHEALTH GRP	109425	0.16
Florida	2187384	GUIDEWELL MUT HOLDING GRP	1020781	0.47	UNITEDHEALTH GRP	490842	0.22	CVS GRP	407780	0.19
Georgia	1035439	ELEVANCE HLTH INC GRP	382722	0.37	KAISER FOUNDATION GRP	212819	0.21	UNITEDHEALTH GRP	183520	0.18
Hawaii	652036	HAWAII MEDICAL SERV ASSN	435486	0.67	KAISER FOUNDATION GRP	147789	0.23	UNIVERSITY HLTH ALLIANCE	38462	0.06
Idaho	200601	BLUE CROSS OF ID GRP	136126	0.68	CAMBIA HEALTH SOLUTIONS INC	42773	0.21	IHC INC GRP	9321	0.05
Illinois	1761577	HCSC GRP	1244574	0.71	UNITEDHEALTH GRP	291364	0.17	CARLE HOLDING CO GRP	107657	0.06
Indiana	367607	ELEVANCE HLTH INC GRP	241620	0.66	UNITEDHEALTH GRP	80649	0.22	PHP INDIANA GRP	17758	0.05
Iowa	321269	WELLMARK INC GRP	254639	0.79	UNITEDHEALTH GRP	38327	0.12	CVS GRP	12257	0.04
Kansas	437438	BCBS OF KS GRP	203739	0.47	BCBS OF KC GRP	158102	0.36	CVS GRP	34759	0.08
Kentucky	346815	ELEVANCE HLTH INC GRP	232844	0.67	HUMANA GRP	75856	0.22	UNITEDHEALTH GRP	32696	0.09
Louisiana	409599	LOUISIANA HLTH SERV GRP	270940	0.66	UNITEDHEALTH GRP	66072	0.16	HUMANA GRP	41623	0.10
Maine	185100	ELEVANCE HLTH INC GRP	127579	0.69	HARVARD PILGRIM HLTH CARE GRP	35449	0.19	CVS GRP	11979	0.06
Maryland	1030739	CAREFIRST INC GRP	568336	0.55	KAISER FOUNDATION GRP	266515	0.26	UNITEDHEALTH GRP	105880	0.10
Massachusetts	1187999	BCBS OF MA GRP	715868	0.60	HARVARD PILGRIM HLTH CARE GRP	155788	0.13	TUFTS GRP	123677	0.10
Michigan	1490715	BCBS OF MI GRP	964882	0.65	COREWELL HLTH GRP	268480	0.18	HENRY FORD HLTH SYSTEM GRP	132828	0.09
Minnesota	741893	HEALTHPARTNERS GRP	360111	0.49	BCBS OF MN GRP	227977	0.31	MEDICA GRP	133530	0.18
Mississippi	205318	MISSISSIPPI INS GRP	173418	0.84	UNITEDHEALTH GRP	25474	0.12	CIGNA HLTH GRP	3640	0.02
Missouri	705279	ELEVANCE HLTH INC GRP	253996	0.36	BCBS OF KC GRP	207182	0.29	UNITEDHEALTH GRP	134294	0.19
Montana	64561	HCSC GRP	53100	0.82	PACIFICSOURCE HLTH PLAN GRP	6480	0.10	CIGNA HLTH GRP	3614	0.06
Nebraska	237939	BCBS OF NE GRP	175369	0.74	UNITEDHEALTH GRP	43570	0.18	CVS GRP	16966	0.07
Nevada	379678	UNITEDHEALTH GRP	252392	0.66	ELEVANCE HLTH INC GRP	69348	0.18	RENOWN HLTH GRP	25934	0.07
New Hampshire	142914	ELEVANCE HLTH INC GRP	79462	0.56	HARVARD PILGRIM HLTH CARE GRP	45306	0.32	CIGNA HLTH GRP	9524	0.07
New Jersey	907737	BCBS OF NJ GRP	487409	0.54	CVS GRP	165298	0.18	UNITEDHEALTH GRP	124414	0.14
New Mexico	137934	HCSC GRP	76097	0.55	PRESBYTERIAN HLTHCARE SERV GRP	39554	0.29	UNITEDHEALTH GRP	12587	0.09
New York	2347290	UNITEDHEALTH GRP	382039	0.16	EMBLEM HLTH GRP	355364	0.15	CVS GRP	348396	0.15
North Carolina	575481	BCBS OF NC GRP	382404	0.66	UNITEDHEALTH GRP	127126	0.22	CVS GRP	38422	0.07
North Dakota	152676	BCBS OF ND	78349	0.51	SANFORD HLTH GRP	68478	0.45	MEDICA GRP	5693	0.04
Ohio	960697	ELEVANCE HLTH INC GRP	406673	0.42	MEDICAL MUT OF OH GRP	212617	0.22	UNITEDHEALTH GRP	178724	0.19
Oklahoma	380347	HCSC GRP	206359	0.54	UNITEDHEALTH GRP	57579	0.15	COMMUNITYCARE GRP	43375	0.11
Oregon	696903	KAISER FOUNDATION GRP	303731	0.44	CAMBIA HEALTH SOLUTIONS INC	142347	0.20	PROVIDENCE HLTH GRP	90826	0.13
Pennsylvania	1558929	HIGHMARK GRP	618681	0.40	INDEPENDENCE BLUE CROSS GRP	303462	0.19	CAPITAL BLUE CROSS GRP	161077	0.10
Rhode Island	130879	BCBS OF RI	101126	0.77	UNITEDHEALTH GRP	20642	0.16	TUFTS GRP	8643	0.07
South Carolina	313337	BCBS OF SC GRP	285892	0.91	UNITEDHEALTH GRP	15576	0.05	CIGNA HLTH GRP	7736	0.02
South Dakota	102071	WELLMARK INC GRP	66283	0.65	SANFORD HLTH GRP	17412	0.17	AVERA HLTH PLANS INC	16075	0.16
Tennessee	542424	BCBS OF TN GRP	390116	0.72	CIGNA HLTH GRP	62047	0.11	UNITEDHEALTH GRP	51616	0.10
Texas	2297976	HCSC GRP	991763	0.43	UNITEDHEALTH GRP	767560	0.33	CVS GRP	201965	0.09
Utah	426060	IHC INC GRP	177865	0.42	CAMBIA HEALTH SOLUTIONS INC	121906	0.29	UNITEDHEALTH GRP	54905	0.13
Vermont	32193	BCBS OF VT GRP	29173	0.91	MVP GRP	2230	0.07	CIGNA HLTH GRP	790	0.02
Virginia	1143832	ELEVANCE HLTH INC GRP	476068	0.42	CAREFIRST INC GRP	173421	0.15	UNITEDHEALTH GRP	143724	0.13
Washington	1122602	KAISER FOUNDATION GRP	382246	0.34	PREMERA BLUE CROSS GRP	302507	0.27	CAMBIA HEALTH SOLUTIONS INC	243487	0.22
West Virginia	135904	HIGHMARK GRP	108939	0.80	HEALTH PLAN GRP	22242	0.16	CVS GRP	2524	0.02
Wisconsin	1012834	UNIVERSITY HLTH CARE & GUNDERSEN LUTHERAN GRP	209215	0.21	DEAN HLTH GRP	152890	0.15	ELEVANCE HLTH INC GRP	150436	0.15
Wyoming	31212	BCBS OF WY	26829	0.86	UNITEDHEALTH GRP	2746	0.09	CVS GRP	1321	0.04

2017

Location	Total Large Group Market - Enrollment	Largest Insurer - Insurer Name	Largest Insurer - Enrollment	Largest Insurer - Market Share	Second Largest Insurer - Insurer Name	Second Largest Insurer - Enrollment	Second Largest Insurer - Market Share	Third Largest Insurer - Insurer Name	Third Largest Insurer - Enrollment	Third Largest Insurer - Market Share
United States	42991429	KAISER FOUNDATION GRP	6855441	0.16	UNITEDHEALTH GRP	5865444	0.14	ELEVANCE HLTH INC GRP	4506611	0.10
Alabama	519388	BCBS OF AL GRP	484976	0.93	VIVA HLTH INC	24762	0.05	UNITEDHEALTH GRP	8746	0.02
Alaska	67678	PREMERA BLUE CROSS GRP	59491	0.88	AETNA GRP	4556	0.07	UNITEDHEALTH GRP	2862	0.04
Arizona	547548	BCBS OF AZ INC	218195	0.40	UNITEDHEALTH GRP	210472	0.38	AETNA GRP	48726	0.09
Arkansas	253856	ARKANSAS BCBS GRP	196995	0.78	UNITEDHEALTH GRP	35821	0.14	CATHOLIC HLTH INITIATIVES GRP	15941	0.06
California	9986858	KAISER FOUNDATION GRP	5067744	0.51	ELEVANCE HLTH INC GRP	1386960	0.14	BLUE SHIELD OF CA GRP	1109150	0.11
Colorado	659976	KAISER FOUNDATION GRP	319046	0.48	ELEVANCE HLTH INC GRP	167158	0.25	UNITEDHEALTH GRP	88865	0.13
Connecticut	338770	ELEVANCE HLTH INC GRP	99473	0.29	EMBLEM HLTH GRP	77154	0.23	UNITEDHEALTH GRP	75987	0.22
Delaware	83717	HIGHMARK GRP	52047	0.62	CIGNA HLTH GRP	15532	0.19	AETNA GRP	11704	0.14
District of Columbia	665219	AETNA GRP	295676	0.44	CAREFIRST INC GRP	153663	0.23	UNITEDHEALTH GRP	100818	0.15
Florida	2218816	GUIDEWELL MUT HOLDING GRP	1031592	0.46	UNITEDHEALTH GRP	478958	0.22	AETNA GRP	442340	0.20
Georgia	1101827	ELEVANCE HLTH INC GRP	452601	0.41	KAISER FOUNDATION GRP	216482	0.20	UNITEDHEALTH GRP	175269	0.16
Hawaii	649362	HAWAII MEDICAL SERV ASSN	436264	0.67	KAISER FOUNDATION GRP	151703	0.23	UNIVERSITY HLTH ALLIANCE	32449	0.05
Idaho	203171	BLUE CROSS OF ID GRP	136516	0.67	CAMBIA HEALTH SOLUTIONS INC	45039	0.22	IHC INC GRP	9320	0.05
Illinois	1824172	HCSC GRP	1221062	0.67	UNITEDHEALTH GRP	321766	0.18	CARLE HOLDING CO GRP	112871	0.06
Indiana	402340	ELEVANCE HLTH INC GRP	250832	0.62	UNITEDHEALTH GRP	106378	0.26	PHP INDIANA GRP	17252	0.04
Iowa	331987	WELLMARK INC GRP	259141	0.78	UNITEDHEALTH GRP	48817	0.15	AETNA GRP	12535	0.04
Kansas	438942	BCBS OF KS GRP	201323	0.46	BCBS OF KC GRP	153829	0.35	AETNA GRP	36768	0.08
Kentucky	359958	ELEVANCE HLTH INC GRP	235386	0.65	HUMANA GRP	63041	0.18	UNITEDHEALTH GRP	35424	0.10
Louisiana	421587	LOUISIANA HLTH SERV GRP	270251	0.64	UNITEDHEALTH GRP	66326	0.16	HUMANA GRP	48222	0.11
Maine	187665	ELEVANCE HLTH INC GRP	128456	0.68	HARVARD PILGRIM HLTH CARE GRP	32632	0.17	AETNA GRP	16903	0.09
Maryland	1054029	CAREFIRST INC GRP	581210	0.55	KAISER FOUNDATION GRP	269196	0.26	UNITEDHEALTH GRP	115510	0.11
Massachusetts	1229994	BCBS OF MA GRP	716616	0.58	HARVARD PILGRIM HLTH CARE GRP	159388	0.13	TUFTS GRP	132987	0.11
Michigan	1549096	BCBS OF MI GRP	963045	0.62	COREWELL HLTH GRP	254697	0.16	HENRY FORD HLTH SYSTEM GRP	204375	0.13
Minnesota	723207	HEALTHPARTNERS GRP	334966	0.46	BCBS OF MN GRP	226060	0.31	MEDICA GRP	140312	0.19
Mississippi	204876	MISSISSIPPI INS GRP	169585	0.83	UNITEDHEALTH GRP	29449	0.14	CIGNA HLTH GRP	3032	0.01
Missouri	720722	ELEVANCE HLTH INC GRP	262823	0.36	BCBS OF KC GRP	213370	0.30	UNITEDHEALTH GRP	137098	0.19
Montana	69466	HCSC GRP	56318	0.81	PACIFICSOURCE HLTH PLAN GRP	6697	0.10	CIGNA HLTH GRP	4647	0.07
Nebraska	250995	BCBS OF NE GRP	185328	0.74	UNITEDHEALTH GRP	49493	0.20	AETNA GRP	14163	0.06
Nevada	391067	UNITEDHEALTH GRP	255414	0.65	ELEVANCE HLTH INC GRP	70301	0.18	RENOWN HLTH GRP	28803	0.07
New Hampshire	143795	ELEVANCE HLTH INC GRP	80543	0.56	HARVARD PILGRIM HLTH CARE GRP	47585	0.33	CIGNA HLTH GRP	8442	0.06
New Jersey	916562	BCBS OF NJ GRP	497956	0.54	AETNA GRP	170839	0.19	UNITEDHEALTH GRP	121952	0.13
New Mexico	142409	HCSC GRP	77713	0.55	PRESBYTERIAN HLTHCARE SERV GRP	43407	0.30	UNITEDHEALTH GRP	11640	0.08
New York	2412285	UNITEDHEALTH GRP	378182	0.16	EMBLEM HLTH GRP	374182	0.16	LIFETIME HLTHCARE GRP	335121	0.14
North Carolina	614756	BCBS OF NC GRP	389458	0.63	UNITEDHEALTH GRP	150509	0.24	AETNA GRP	44025	0.07
North Dakota	149629	BCBS OF ND	73272	0.49	SANFORD HLTH GRP	69555	0.46	MEDICA GRP	6787	0.05
Ohio	992052	ELEVANCE HLTH INC GRP	438909	0.44	UNITEDHEALTH GRP	208426	0.21	MEDICAL MUT OF OH GRP	177882	0.18
Oklahoma	395147	HCSC GRP	200549	0.51	UNITEDHEALTH GRP	65729	0.17	COMMUNITYCARE GRP	49580	0.13
Oregon	704903	KAISER FOUNDATION GRP	298500	0.42	CAMBIA HEALTH SOLUTIONS INC	146736	0.21	PROVIDENCE HLTH GRP	100487	0.14
Pennsylvania	1678531	HIGHMARK GRP	590663	0.35	INDEPENDENCE BLUE CROSS GRP	344438	0.21	CAPITAL BLUE CROSS GRP	219385	0.13
Rhode Island	138093	BCBS OF RI	108152	0.78	UNITEDHEALTH GRP	19144	0.14	TUFTS GRP	9316	0.07
South Carolina	317552	BCBS OF SC GRP	278977	0.88	UNITEDHEALTH GRP	23814	0.07	CIGNA HLTH GRP	9404	0.03
South Dakota	104564	WELLMARK INC GRP	64574	0.62	SANFORD HLTH GRP	17641	0.17	AVERA HLTH PLANS INC	17351	0.17
Tennessee	557746	BCBS OF TN GRP	394304	0.71	UNITEDHEALTH GRP	64862	0.12	CIGNA HLTH GRP	55070	0.10
Texas	2319774	HCSC GRP	967411	0.42	UNITEDHEALTH GRP	769782	0.33	AETNA GRP	229120	0.10
Utah	442790	IHC INC GRP	178378	0.40	CAMBIA HEALTH SOLUTIONS INC	126158	0.28	UNITEDHEALTH GRP	66322	0.15
Vermont	33599	BCBS OF VT GRP	30935	0.92	MVP GRP	2113	0.06	CIGNA HLTH GRP	551	0.02
Virginia	1145093	ELEVANCE HLTH INC GRP	508202	0.44	CAREFIRST INC GRP	179063	0.16	UNITEDHEALTH GRP	125822	0.11
Washington	1103660	KAISER FOUNDATION GRP	377732	0.34	PREMERA BLUE CROSS GRP	332065	0.30	CAMBIA HEALTH SOLUTIONS INC	238892	0.22
West Virginia	140466	HIGHMARK GRP	109633	0.78	HEALTH PLAN GRP	22853	0.16	UNITEDHEALTH GRP	4583	0.03
Wisconsin	1046594	UNIVERSITY HLTH CARE & GUNDERSEN LUTHERAN GRP	193863	0.19	UNITEDHEALTH GRP	193565	0.18	ELEVANCE HLTH INC GRP	145617	0.14
Wyoming	35141	BCBS OF WY	25028	0.71	UNITEDHEALTH GRP	6971	0.20	CIGNA HLTH GRP	1675	0.05

2016

Location	Total Large Group Market - Enrollment	Largest Insurer - Insurer Name	Largest Insurer - Enrollment	Largest Insurer - Market Share	Second Largest Insurer - Insurer Name	Second Largest Insurer - Enrollment	Second Largest Insurer - Market Share	Third Largest Insurer - Insurer Name	Third Largest Insurer - Enrollment	Third Largest Insurer - Market Share
United States	42389271	KAISER FOUNDATION GRP	6593100	0.16	UNITEDHEALTH GRP	5170079	0.12	ELEVANCE HLTH INC GRP	4391001	0.10
Alabama	531682	BCBS OF AL GRP	493811	0.93	VIVA HLTH INC	25587	0.05	UNITEDHEALTH GRP	11215	0.02
Alaska	70367	PREMERA BLUE CROSS GRP	59005	0.84	AETNA GRP	8142	0.12	UNITEDHEALTH GRP	2141	0.03
Arizona	566898	BCBS OF AZ INC	217997	0.38	UNITEDHEALTH GRP	206717	0.36	AETNA GRP	56353	0.10
Arkansas	240791	ARKANSAS BCBS GRP	189677	0.79	UNITEDHEALTH GRP	33641	0.14	CATHOLIC HLTH INITIATIVES GRP	13985	0.06
California	9971004	KAISER FOUNDATION GRP	4852385	0.49	ELEVANCE HLTH INC GRP	1342342	0.13	BLUE SHIELD OF CA GRP	1254825	0.13
Colorado	657549	KAISER FOUNDATION GRP	319145	0.49	ELEVANCE HLTH INC GRP	165541	0.25	UNITEDHEALTH GRP	74448	0.11
Connecticut	341799	ELEVANCE HLTH INC GRP	101824	0.30	EMBLEM HLTH GRP	79694	0.23	UNITEDHEALTH GRP	61107	0.18
Delaware	83576	HIGHMARK GRP	58321	0.70	AETNA GRP	12551	0.15	CIGNA HLTH GRP	10352	0.12
District of Columbia	793601	AETNA GRP	296922	0.37	KAISER FOUNDATION GRP	190029	0.24	CAREFIRST INC GRP	158533	0.20
Florida	2026343	GUIDEWELL MUT HOLDING GRP	1002023	0.49	AETNA GRP	435053	0.21	UNITEDHEALTH GRP	345502	0.17
Georgia	1014915	ELEVANCE HLTH INC GRP	448284	0.44	KAISER FOUNDATION GRP	205457	0.20	UNITEDHEALTH GRP	142019	0.14
Hawaii	635176	HAWAII MEDICAL SERV ASSN	437490	0.69	KAISER FOUNDATION GRP	140228	0.22	UNIVERSITY HLTH ALLIANCE	31933	0.05
Idaho	202371	BLUE CROSS OF ID GRP	133393	0.66	CAMBIA HEALTH SOLUTIONS INC	49355	0.24	IHC INC GRP	8650	0.04
Illinois	1909258	HCSC GRP	1299740	0.68	UNITEDHEALTH GRP	317342	0.17	CARLE HOLDING CO GRP	120247	0.06
Indiana	388238	ELEVANCE HLTH INC GRP	240923	0.62	UNITEDHEALTH GRP	93745	0.24	PHP INDIANA GRP	18041	0.05
Iowa	330502	WELLMARK INC GRP	257058	0.78	UNITEDHEALTH GRP	47298	0.14	AETNA GRP	14385	0.04
Kansas	459557	BCBS OF KS GRP	237694	0.52	BCBS OF KC GRP	141285	0.31	AETNA GRP	40908	0.09
Kentucky	355434	ELEVANCE HLTH INC GRP	240039	0.68	HUMANA GRP	59550	0.17	UNITEDHEALTH GRP	27155	0.08
Louisiana	431911	LOUISIANA HLTH SERV GRP	281515	0.65	UNITEDHEALTH GRP	64212	0.15	HUMANA GRP	46681	0.11
Maine	187943	ELEVANCE HLTH INC GRP	132157	0.70	HARVARD PILGRIM HLTH CARE GRP	31707	0.17	AETNA GRP	16843	0.09
Maryland	902595	CAREFIRST INC GRP	590999	0.65	KAISER FOUNDATION GRP	129837	0.14	UNITEDHEALTH GRP	101703	0.11
Massachusetts	1231476	BCBS OF MA GRP	715329	0.58	HARVARD PILGRIM HLTH CARE GRP	172437	0.14	TUFTS GRP	138997	0.11
Michigan	1593701	BCBS OF MI GRP	994155	0.62	COREWELL HLTH GRP	237794	0.15	HENRY FORD HLTH SYSTEM GRP	237344	0.15
Minnesota	694225	HEALTHPARTNERS GRP	319305	0.46	BCBS OF MN GRP	217341	0.31	MEDICA GRP	133185	0.19
Mississippi	202789	MISSISSIPPI INS GRP	167868	0.83	UNITEDHEALTH GRP	29857	0.15	HUMANA GRP	2108	0.01
Missouri	668327	BCBS OF KC GRP	196512	0.29	ELEVANCE HLTH INC GRP	194413	0.29	UNITEDHEALTH GRP	149380	0.22
Montana	69892	HCSC GRP	58319	0.83	PACIFICSOURCE HLTH PLAN GRP	6127	0.09	CIGNA HLTH GRP	4051	0.06
Nebraska	235769	BCBS OF NE GRP	182855	0.78	UNITEDHEALTH GRP	35095	0.15	AETNA GRP	17578	0.07
Nevada	390994	UNITEDHEALTH GRP	255837	0.65	ELEVANCE HLTH INC GRP	71440	0.18	RENOWN HLTH GRP	26175	0.07
New Hampshire	138128	ELEVANCE HLTH INC GRP	78747	0.57	HARVARD PILGRIM HLTH CARE GRP	48260	0.35	CIGNA HLTH GRP	8691	0.06
New Jersey	930222	BCBS OF NJ GRP	505979	0.54	AETNA GRP	162798	0.18	UNITEDHEALTH GRP	130460	0.14
New Mexico	132256	HCSC GRP	81703	0.62	PRESBYTERIAN HLTHCARE SERV GRP	32604	0.25	UNITEDHEALTH GRP	11414	0.09
New York	2527090	LIFETIME HLTHCARE GRP	436714	0.17	EMBLEM HLTH GRP	396562	0.16	UNITEDHEALTH GRP	341602	0.14
North Carolina	606886	BCBS OF NC GRP	417306	0.69	UNITEDHEALTH GRP	123966	0.20	AETNA GRP	43889	0.07
North Dakota	148714	BCBS OF ND	73851	0.50	SANFORD HLTH GRP	69994	0.47	MEDICA GRP	4773	0.03
Ohio	796483	ELEVANCE HLTH INC GRP	353887	0.44	UNITEDHEALTH GRP	169857	0.21	MEDICAL MUT OF OH GRP	118111	0.15
Oklahoma	418769	HCSC GRP	219738	0.52	UNITEDHEALTH GRP	63513	0.15	COMMUNITYCARE GRP	54278	0.13
Oregon	696576	KAISER FOUNDATION GRP	291602	0.42	CAMBIA HEALTH SOLUTIONS INC	154194	0.22	PROVIDENCE HLTH GRP	101568	0.15
Pennsylvania	1762297	HIGHMARK GRP	618365	0.35	INDEPENDENCE BLUE CROSS GRP	396137	0.22	CAPITAL BLUE CROSS GRP	199521	0.11
Rhode Island	143152	BCBS OF RI	111690	0.78	UNITEDHEALTH GRP	20439	0.14	TUFTS GRP	8636	0.06
South Carolina	305257	BCBS OF SC GRP	270762	0.89	UNITEDHEALTH GRP	23968	0.08	CIGNA HLTH GRP	7991	0.03
South Dakota	108331	WELLMARK INC GRP	59649	0.55	AVERA HLTH PLANS INC	21972	0.20	SANFORD HLTH GRP	21583	0.20
Tennessee	465038	BCBS OF TN GRP	337356	0.73	UNITEDHEALTH GRP	42581	0.09	CIGNA HLTH GRP	38184	0.08
Texas	2191767	HCSC GRP	1013867	0.46	UNITEDHEALTH GRP	599676	0.27	AETNA GRP	233224	0.11
Utah	435167	IHC INC GRP	184734	0.42	CAMBIA HEALTH SOLUTIONS INC	120567	0.28	AETNA GRP	54177	0.12
Vermont	36900	BCBS OF VT GRP	32715	0.89	MVP GRP	3155	0.09	CIGNA HLTH GRP	1029	0.03
Virginia	1144969	ELEVANCE HLTH INC GRP	553288	0.48	CAREFIRST INC GRP	192869	0.17	UNITEDHEALTH GRP	119026	0.10
Washington	1038968	KAISER FOUNDATION GRP	383485	0.37	PREMERA BLUE CROSS GRP	327920	0.32	CAMBIA HEALTH SOLUTIONS INC	220466	0.21
West Virginia	145275	HIGHMARK GRP	113708	0.78	HEALTH PLAN GRP	22388	0.15	AETNA GRP	4222	0.03
Wisconsin	993724	ELEVANCE HLTH INC GRP	150802	0.15	UNIVERSITY HLTH CARE & GUNDERSEN LUTHERAN GRP	150416	0.15	DEAN HLTH GRP	140058	0.14
Wyoming	34618	BCBS OF WY	25741	0.74	UNITEDHEALTH GRP	5572	0.16	CIGNA HLTH GRP	1745	0.05

2015

Location	Total Large Group Market - Enrollment	Largest Insurer - Insurer Name	Largest Insurer - Enrollment	Largest Insurer - Market Share	Second Largest Insurer - Insurer Name	Second Largest Insurer - Enrollment	Second Largest Insurer - Market Share	Third Largest Insurer - Insurer Name	Third Largest Insurer - Enrollment	Third Largest Insurer - Market Share
United States	42988622	KAISER FOUNDATION GRP	6508760	0.15	ELEVANCE HLTH INC GRP	4985172	0.12	UNITEDHEALTH GRP	4970798	0.12
Alabama	523880	BCBS OF AL GRP	490196	0.94	VIVA HLTH INC	24542	0.05	UNITEDHEALTH GRP	8511	0.02
Alaska	59267	PREMERA BLUE CROSS GRP	49890	0.84	AETNA GRP	6387	0.11	UNITEDHEALTH GRP	1665	0.03
Arizona	565391	BCBS OF AZ INC	219481	0.39	UNITEDHEALTH GRP	183697	0.32	AETNA GRP	63387	0.11
Arkansas	202552	ARKANSAS BCBS GRP	163706	0.81	UNITEDHEALTH GRP	29798	0.15	CATHOLIC HLTH INITIATIVES GRP	8398	0.04
California	10258738	KAISER FOUNDATION GRP	4777576	0.47	ELEVANCE HLTH INC GRP	1560897	0.15	BLUE SHIELD OF CA GRP	1426228	0.14
Colorado	698355	KAISER FOUNDATION GRP	321770	0.46	ELEVANCE HLTH INC GRP	174240	0.25	UNITEDHEALTH GRP	96339	0.14
Connecticut	349560	ELEVANCE HLTH INC GRP	111216	0.32	EMBLEM HLTH GRP	74593	0.21	AETNA GRP	55891	0.16
Delaware	95352	HIGHMARK GRP	63908	0.67	AETNA GRP	16186	0.17	CIGNA HLTH GRP	13010	0.14
District of Columbia	819872	AETNA GRP	325333	0.40	KAISER FOUNDATION GRP	190206	0.23	CAREFIRST INC GRP	162971	0.20
Florida	1902522	GUIDEWELL MUT HOLDING GRP	1014259	0.53	AETNA GRP	382018	0.20	UNITEDHEALTH GRP	270252	0.14
Georgia	861992	ELEVANCE HLTH INC GRP	397047	0.46	KAISER FOUNDATION GRP	192523	0.22	UNITEDHEALTH GRP	108477	0.13
Hawaii	631763	HAWAII MEDICAL SERV ASSN	439577	0.70	KAISER FOUNDATION GRP	136742	0.22	UNIVERSITY HLTH ALLIANCE	28876	0.05
Idaho	215847	BLUE CROSS OF ID GRP	147265	0.68	CAMBIA HEALTH SOLUTIONS INC	52126	0.24	IHC INC GRP	6224	0.03
Illinois	2175942	HCSC GRP	1489399	0.68	UNITEDHEALTH GRP	390938	0.18	CARLE HOLDING CO GRP	132555	0.06
Indiana	331091	ELEVANCE HLTH INC GRP	203135	0.61	UNITEDHEALTH GRP	65498	0.20	ADVANTAGE HLTH SOLUTIONS INC	30876	0.09
Iowa	335687	WELLMARK INC GRP	260038	0.77	UNITEDHEALTH GRP	44556	0.13	AETNA GRP	18531	0.06
Kansas	359745	BCBS OF KS GRP	206114	0.57	BCBS OF KC GRP	59994	0.17	AETNA GRP	54831	0.15
Kentucky	361381	ELEVANCE HLTH INC GRP	255006	0.71	HUMANA GRP	52663	0.15	UNITEDHEALTH GRP	26349	0.07
Louisiana	374345	LOUISIANA HLTH SERV GRP	238657	0.64	UNITEDHEALTH GRP	60123	0.16	HUMANA GRP	30586	0.08
Maine	187762	ELEVANCE HLTH INC GRP	131342	0.70	HARVARD PILGRIM HLTH CARE GRP	32798	0.17	AETNA GRP	15410	0.08
Maryland	915453	CAREFIRST INC GRP	606631	0.66	KAISER FOUNDATION GRP	127060	0.14	UNITEDHEALTH GRP	93109	0.10
Massachusetts	1244288	BCBS OF MA GRP	718032	0.58	HARVARD PILGRIM HLTH CARE GRP	174438	0.14	TUFTS GRP	151851	0.12
Michigan	1607675	BCBS OF MI GRP	993613	0.62	HENRY FORD HLTH SYSTEM GRP	217358	0.14	COREWELL HLTH GRP	212061	0.13
Minnesota	670645	HEALTHPARTNERS GRP	330260	0.49	BCBS OF MN GRP	176353	0.26	MEDICA GRP	133983	0.20
Mississippi	199751	MISSISSIPPI INS GRP	165335	0.83	UNITEDHEALTH GRP	30116	0.15	AETNA GRP	2130	0.01
Missouri	613635	ELEVANCE HLTH INC GRP	197244	0.32	UNITEDHEALTH GRP	163532	0.27	BCBS OF KC GRP	123660	0.20
Montana	70825	HCSC GRP	58753	0.83	CIGNA HLTH GRP	5708	0.08	PACIFICSOURCE HLTH PLAN GRP	5152	0.07
Nebraska	240456	BCBS OF NE GRP	191259	0.80	UNITEDHEALTH GRP	33602	0.14	AETNA GRP	14426	0.06
Nevada	400369	UNITEDHEALTH GRP	266367	0.67	ELEVANCE HLTH INC GRP	68295	0.17	RENOWN HLTH GRP	25441	0.06
New Hampshire	135126	ELEVANCE HLTH INC GRP	77646	0.57	HARVARD PILGRIM HLTH CARE GRP	47947	0.35	CIGNA HLTH GRP	8638	0.06
New Jersey	941852	BCBS OF NJ GRP	539238	0.57	AETNA GRP	145224	0.15	UNITEDHEALTH GRP	117854	0.13
New Mexico	146249	HCSC GRP	88519	0.61	PRESBYTERIAN HLTHCARE SERV GRP	44098	0.30	UNITEDHEALTH GRP	11279	0.08
New York	2774742	LIFETIME HLTHCARE GRP	504640	0.18	EMBLEM HLTH GRP	415415	0.15	UNITEDHEALTH GRP	399732	0.14
North Carolina	604173	BCBS OF NC GRP	436772	0.72	UNITEDHEALTH GRP	104948	0.17	AETNA GRP	39345	0.07
North Dakota	154949	BCBS OF ND	113630	0.73	SANFORD HLTH GRP	35885	0.23	MEDICA GRP	5148	0.03
Ohio	819981	ELEVANCE HLTH INC GRP	353851	0.43	UNITEDHEALTH GRP	178616	0.22	MEDICAL MUT OF OH GRP	102863	0.13
Oklahoma	442268	HCSC GRP	238844	0.54	UNITEDHEALTH GRP	64015	0.14	COMMUNITYCARE GRP	60419	0.14
Oregon	683971	KAISER FOUNDATION GRP	287953	0.42	CAMBIA HEALTH SOLUTIONS INC	159453	0.23	PROVIDENCE HLTH GRP	98063	0.14
Pennsylvania	1823423	HIGHMARK GRP	655372	0.36	INDEPENDENCE BLUE CROSS GRP	430319	0.24	AETNA GRP	235848	0.13
Rhode Island	143709	BCBS OF RI	111968	0.78	UNITEDHEALTH GRP	18813	0.13	TUFTS GRP	10690	0.07
South Carolina	306751	BCBS OF SC GRP	279914	0.91	UNITEDHEALTH GRP	17546	0.06	CIGNA HLTH GRP	5853	0.02
South Dakota	109143	WELLMARK INC GRP	63589	0.58	SANFORD HLTH GRP	23520	0.22	SOUTH DAKOTA STATE MED HOLDING CO	10616	0.10
Tennessee	449382	BCBS OF TN GRP	352618	0.78	UNITEDHEALTH GRP	42046	0.09	CIGNA HLTH GRP	27602	0.06
Texas	1920069	HCSC GRP	936879	0.49	UNITEDHEALTH GRP	542025	0.28	AETNA GRP	157011	0.08
Utah	423894	IHC INC GRP	184277	0.43	CAMBIA HEALTH SOLUTIONS INC	133035	0.31	UNITEDHEALTH GRP	44400	0.10
Vermont	51703	BCBS OF VT GRP	43882	0.85	MVP GRP	5730	0.11	CIGNA HLTH GRP	2090	0.04
Virginia	1570826	ELEVANCE HLTH INC GRP	961586	0.61	CAREFIRST INC GRP	205452	0.13	UNITEDHEALTH GRP	113457	0.07
Washington	1073858	KAISER FOUNDATION GRP	389452	0.36	PREMERA BLUE CROSS GRP	324696	0.30	CAMBIA HEALTH SOLUTIONS INC	241695	0.23
West Virginia	142732	HIGHMARK GRP	111024	0.78	HEALTH PLAN GRP	24015	0.17	AETNA GRP	5574	0.04
Wisconsin	961107	DEAN HLTH GRP	139919	0.15	ELEVANCE HLTH INC GRP	124176	0.13	UNITEDHEALTH GRP	118147	0.12
Wyoming	34573	BCBS OF WY	25077	0.73	WINHEALTH PARTNERS	3682	0.11	UNITEDHEALTH GRP	3393	0.10

2014

Location	Total Large Group Market - Enrollment	Largest Insurer - Insurer Name	Largest Insurer - Enrollment	Largest Insurer - Market Share	Second Largest Insurer - Insurer Name	Second Largest Insurer - Enrollment	Second Largest Insurer - Market Share	Third Largest Insurer - Insurer Name	Third Largest Insurer - Enrollment	Third Largest Insurer - Market Share
United States	43380328	KAISER FOUNDATION GRP	6310253	0.15	UNITEDHEALTH GRP	4705923	0.11	ELEVANCE HLTH INC GRP	4664245	0.11
Alabama	497671	BCBS OF AL GRP	460634	0.93	VIVA HLTH INC	23799	0.05	UNITEDHEALTH GRP	12857	0.03
Alaska	51904	PREMERA BLUE CROSS GRP	44385	0.86	AETNA GRP	6248	0.12	UNITEDHEALTH GRP	1106	0.02
Arizona	535833	BCBS OF AZ INC	201768	0.38	UNITEDHEALTH GRP	166389	0.31	AETNA GRP	55826	0.10
Arkansas	208690	ARKANSAS BCBS GRP	166334	0.80	UNITEDHEALTH GRP	26504	0.13	CATHOLIC HLTH INITIATIVES GRP	14926	0.07
California	10242326	KAISER FOUNDATION GRP	4626784	0.45	ELEVANCE HLTH INC GRP	1643346	0.16	BLUE SHIELD OF CA GRP	1449037	0.14
Colorado	686662	KAISER FOUNDATION GRP	321625	0.47	ELEVANCE HLTH INC GRP	169732	0.25	UNITEDHEALTH GRP	92289	0.13
Connecticut	372480	ELEVANCE HLTH INC GRP	123902	0.33	AETNA GRP	80611	0.22	EMBLEM HLTH GRP	72341	0.19
Delaware	85554	HIGHMARK GRP	60517	0.71	AETNA GRP	18172	0.21	CIGNA HLTH GRP	3896	0.05
District of Columbia	850488	AETNA GRP	338629	0.40	KAISER FOUNDATION GRP	188296	0.22	CAREFIRST INC GRP	172984	0.20
Florida	1871999	GUIDEWELL MUT HOLDING GRP	1016488	0.54	AETNA GRP	358621	0.19	UNITEDHEALTH GRP	244354	0.13
Georgia	813005	ELEVANCE HLTH INC GRP	355107	0.44	KAISER FOUNDATION GRP	177127	0.22	UNITEDHEALTH GRP	105006	0.13
Hawaii	601996	HAWAII MEDICAL SERV ASSN	416587	0.69	KAISER FOUNDATION GRP	133568	0.22	UNIVERSITY HLTH ALLIANCE	25404	0.04
Idaho	226001	BLUE CROSS OF ID GRP	155044	0.69	CAMBIA HEALTH SOLUTIONS INC	55475	0.25	PACIFICSOURCE HLTH PLAN GRP	6563	0.03
Illinois	2207812	HCSC GRP	1540954	0.70	UNITEDHEALTH GRP	369890	0.17	CARLE HOLDING CO GRP	135263	0.06
Indiana	336286	ELEVANCE HLTH INC GRP	201580	0.60	UNITEDHEALTH GRP	58975	0.18	ADVANTAGE HLTH SOLUTIONS INC	40182	0.12
Iowa	341397	WELLMARK INC GRP	263348	0.77	UNITEDHEALTH GRP	44360	0.13	AETNA GRP	18286	0.05
Kansas	365639	BCBS OF KS GRP	199399	0.55	AETNA GRP	69857	0.19	BCBS OF KC GRP	55832	0.15
Kentucky	372425	ELEVANCE HLTH INC GRP	257221	0.69	HUMANA GRP	51336	0.14	UNITEDHEALTH GRP	32816	0.09
Louisiana	361812	LOUISIANA HLTH SERV GRP	224345	0.62	UNITEDHEALTH GRP	52552	0.15	AETNA GRP	43812	0.12
Maine	188713	ELEVANCE HLTH INC GRP	135698	0.72	HARVARD PILGRIM HLTH CARE GRP	30251	0.16	AETNA GRP	13473	0.07
Maryland	937023	CAREFIRST INC GRP	630480	0.67	KAISER FOUNDATION GRP	119660	0.13	UNITEDHEALTH GRP	90830	0.10
Massachusetts	1244516	BCBS OF MA GRP	708435	0.57	HARVARD PILGRIM HLTH CARE GRP	183141	0.15	TUFTS GRP	164329	0.13
Michigan	1684216	BCBS OF MI GRP	1004342	0.60	HENRY FORD HLTH SYSTEM GRP	262739	0.16	COREWELL HLTH GRP	226900	0.13
Minnesota	696284	HEALTHPARTNERS GRP	324790	0.47	BCBS OF MN GRP	201402	0.29	MEDICA GRP	137303	0.20
Mississippi	201685	MISSISSIPPI INS GRP	162316	0.80	UNITEDHEALTH GRP	34355	0.17	AETNA GRP	2535	0.01
Missouri	629601	ELEVANCE HLTH INC GRP	207278	0.33	UNITEDHEALTH GRP	151991	0.24	AETNA GRP	117260	0.19
Montana	76623	HCSC GRP	63622	0.83	CIGNA HLTH GRP	8961	0.12	PACIFICSOURCE HLTH PLAN GRP	3367	0.04
Nebraska	223943	BCBS OF NE GRP	175838	0.79	UNITEDHEALTH GRP	28291	0.13	AETNA GRP	15126	0.07
Nevada	397068	UNITEDHEALTH GRP	262033	0.66	ELEVANCE HLTH INC GRP	68821	0.17	RENOWN HLTH GRP	25891	0.07
New Hampshire	140318	ELEVANCE HLTH INC GRP	78054	0.56	HARVARD PILGRIM HLTH CARE GRP	47334	0.34	CIGNA HLTH GRP	12100	0.09
New Jersey	886720	BCBS OF NJ GRP	485916	0.55	AETNA GRP	154279	0.17	UNITEDHEALTH GRP	106119	0.12
New Mexico	165111	HCSC GRP	104235	0.63	PRESBYTERIAN HLTHCARE SERV GRP	49481	0.30	UNITEDHEALTH GRP	10703	0.06
New York	3382772	EMBLEM HLTH GRP	908335	0.27	LIFETIME HLTHCARE GRP	547901	0.16	UNITEDHEALTH GRP	409015	0.12
North Carolina	586054	BCBS OF NC GRP	437668	0.75	UNITEDHEALTH GRP	83557	0.14	AETNA GRP	43288	0.07
North Dakota	159535	BCBS OF ND	152562	0.96	SANFORD HLTH GRP	3798	0.02	MEDICA GRP	2777	0.02
Ohio	852553	ELEVANCE HLTH INC GRP	365426	0.43	UNITEDHEALTH GRP	176024	0.21	MEDICAL MUT OF OH GRP	111547	0.13
Oklahoma	486432	HCSC GRP	263895	0.54	COMMUNITYCARE GRP	79937	0.16	UNITEDHEALTH GRP	60674	0.12
Oregon	677877	KAISER FOUNDATION GRP	283555	0.42	CAMBIA HEALTH SOLUTIONS INC	164601	0.24	PROVIDENCE HLTH GRP	93293	0.14
Pennsylvania	2003370	HIGHMARK GRP	685359	0.34	INDEPENDENCE BLUE CROSS GRP	491988	0.25	AETNA GRP	265392	0.13
Rhode Island	155456	BCBS OF RI	118564	0.76	UNITEDHEALTH GRP	24701	0.16	TUFTS GRP	9226	0.06
South Carolina	328241	BCBS OF SC GRP	301647	0.92	UNITEDHEALTH GRP	14978	0.05	AETNA GRP	7462	0.02
South Dakota	107703	WELLMARK INC GRP	63396	0.59	SANFORD HLTH GRP	23686	0.22	AVERA HLTH PLANS INC	9922	0.09
Tennessee	477793	BCBS OF TN GRP	373013	0.78	UNITEDHEALTH GRP	53660	0.11	CIGNA HLTH GRP	22861	0.05
Texas	1860976	HCSC GRP	918125	0.49	UNITEDHEALTH GRP	479477	0.26	AETNA GRP	181580	0.10
Utah	426909	IHC INC GRP	184372	0.43	CAMBIA HEALTH SOLUTIONS INC	124799	0.29	AETNA GRP	59382	0.14
Vermont	55367	BCBS OF VT GRP	44502	0.80	MVP GRP	8090	0.15	CIGNA HLTH GRP	2772	0.05
Virginia	1180649	ELEVANCE HLTH INC GRP	559498	0.47	CAREFIRST INC GRP	208239	0.18	AETNA GRP	93752	0.08
Washington	1121748	KAISER FOUNDATION GRP	372881	0.33	PREMERA BLUE CROSS GRP	340399	0.30	CAMBIA HEALTH SOLUTIONS INC	279717	0.25
West Virginia	150229	HIGHMARK GRP	115493	0.77	HEALTH PLAN GRP	24160	0.16	AETNA GRP	9029	0.06
Wisconsin	830567	WEA GRP	119398	0.14	UNITY HLTH PLANS INS CORP	115706	0.14	UNITEDHEALTH GRP	115520	0.14
Wyoming	34297	BCBS OF WY	24396	0.71	WINHEALTH PARTNERS	3886	0.11	UNITEDHEALTH GRP	3351	0.10

2013

Location	Total Large Group Market - Enrollment	Largest Insurer - Insurer Name	Largest Insurer - Enrollment	Largest Insurer - Market Share	Second Largest Insurer - Insurer Name	Second Largest Insurer - Enrollment	Second Largest Insurer - Market Share	Third Largest Insurer - Insurer Name	Third Largest Insurer - Enrollment	Third Largest Insurer - Market Share
United States	45605020	KAISER FOUNDATION GRP	6251810	0.14	WELLPOINT INC GRP	5884545	0.13	UNITEDHEALTH GRP	5791741	0.13
Alabama	493039	BCBS OF AL GRP	450758	0.91	VIVA HLTH INC	24006	0.05	UNITEDHEALTH GRP	16948	0.03
Alaska	49640	PREMERA BLUE CROSS GRP	42185	0.85	AETNA GRP	7057	0.14	UNITEDHEALTH GRP	263	0.01
Arizona	550328	BCBS OF AZ INC	182098	0.33	UNITEDHEALTH GRP	177548	0.32	HEALTH NET INC GRP	72064	0.13
Arkansas	203032	ARKANSAS BCBS GRP	156955	0.77	UNITEDHEALTH GRP	26424	0.13	QCA HLTH PLAN INC	16754	0.08
California	8476076	KAISER FOUNDATION GRP	4553270	0.54	WELLPOINT INC GRP	1771971	0.21	UNITEDHEALTH GRP	928288	0.11
Colorado	694466	KAISER FOUNDATION GRP	324275	0.47	WELLPOINT INC GRP	164596	0.24	UNITEDHEALTH GRP	100866	0.15
Connecticut	403934	WELLPOINT INC GRP	137009	0.34	EMBLEM HLTH GRP	80385	0.20	AETNA GRP	69517	0.17
Delaware	116423	HIGHMARK GRP	59653	0.51	AETNA GRP	47335	0.41	CIGNA HLTH GRP	6132	0.05
District of Columbia	803053	AETNA GRP	273049	0.34	KAISER FOUNDATION GRP	188281	0.23	CAREFIRST INC GRP	180932	0.23
Florida	1887803	GUIDEWELL MUT HOLDING GRP	1000379	0.53	AETNA GRP	337401	0.18	UNITEDHEALTH GRP	260424	0.14
Georgia	843495	WELLPOINT INC GRP	365095	0.43	KAISER FOUNDATION GRP	168285	0.20	UNITEDHEALTH GRP	104007	0.12
Hawaii	601924	HAWAII MEDICAL SERV ASSN	451392	0.75	KAISER FOUNDATION GRP	130468	0.22	HAWAII MGMT ALLIANCE ASSN	18860	0.03
Idaho	231604	BLUE CROSS OF ID GRP	155417	0.67	CAMBIA HEALTH SOLUTIONS INC	60087	0.26	PACIFICSOURCE HLTH PLAN GRP	9432	0.04
Illinois	2062415	HCSC GRP	1516344	0.74	UNITEDHEALTH GRP	245007	0.12	CARLE HOLDING CO GRP	142450	0.07
Indiana	363628	WELLPOINT INC GRP	225406	0.62	UNITEDHEALTH GRP	54640	0.15	ADVANTAGE HLTH SOLUTIONS INC	44296	0.12
Iowa	350529	WELLMARK INC GRP	266228	0.76	UNITEDHEALTH GRP	50611	0.14	AETNA GRP	19642	0.06
Kansas	401649	BCBS OF KS GRP	184872	0.46	AETNA GRP	107821	0.27	BCBS OF KC GRP	62058	0.15
Kentucky	380681	WELLPOINT INC GRP	250492	0.66	HUMANA GRP	61943	0.16	UNITEDHEALTH GRP	33141	0.09
Louisiana	363401	LOUISIANA HLTH SERV GRP	229212	0.63	UNITEDHEALTH GRP	58861	0.16	AETNA GRP	37018	0.10
Maine	189652	WELLPOINT INC GRP	138345	0.73	HARVARD PILGRIM HLTH CARE GRP	26947	0.14	AETNA GRP	13605	0.07
Maryland	975930	CAREFIRST INC GRP	657910	0.67	KAISER FOUNDATION GRP	117022	0.12	UNITEDHEALTH GRP	90102	0.09
Massachusetts	1264847	BCBS OF MA GRP	704336	0.56	HARVARD PILGRIM HLTH CARE GRP	197646	0.16	TUFTS GRP	170047	0.13
Michigan	1743888	BCBS OF MI GRP	1009911	0.58	HENRY FORD HLTH SYSTEM GRP	302536	0.17	COREWELL HLTH GRP	235583	0.14
Minnesota	720062	HEALTHPARTNERS GRP	324338	0.45	BCBS OF MN GRP	212844	0.30	MEDICA GRP	146309	0.20
Mississippi	197008	MISSISSIPPI INS GRP	163187	0.83	UNITEDHEALTH GRP	29414	0.15	AETNA GRP	2390	0.01
Missouri	708311	WELLPOINT INC GRP	251815	0.36	UNITEDHEALTH GRP	161886	0.23	BCBS OF KC GRP	139247	0.20
Montana	83827	HCSC GRP	67241	0.80	CIGNA HLTH GRP	14354	0.17	PACIFICSOURCE HLTH PLAN GRP	1623	0.02
Nebraska	209368	BCBS OF NE GRP	172251	0.82	AETNA GRP	21946	0.10	UNITEDHEALTH GRP	14222	0.07
Nevada	404639	UNITEDHEALTH GRP	266522	0.66	WELLPOINT INC GRP	62807	0.16	RENOWN HLTH GRP	26848	0.07
New Hampshire	147504	WELLPOINT INC GRP	84585	0.57	HARVARD PILGRIM HLTH CARE GRP	41866	0.28	CIGNA HLTH GRP	14129	0.10
New Jersey	1025422	BCBS OF NJ GRP	583774	0.57	AETNA GRP	169680	0.17	UNITEDHEALTH GRP	129298	0.13
New Mexico	169543	HCSC GRP	68497	0.40	PRESBYTERIAN HLTHCARE SERV GRP	53689	0.32	ARDENT HLTH SERV GRP	37623	0.22
New York	6113859	EMBLEM HLTH GRP	1373306	0.22	UNITEDHEALTH GRP	1361553	0.22	WELLPOINT INC GRP	1289763	0.21
North Carolina	602940	BCBS OF NC GRP	447828	0.74	UNITEDHEALTH GRP	76130	0.13	AETNA GRP	44760	0.07
North Dakota	155116	BCBS OF ND	150248	0.97	MEDICA GRP	2284	0.01	SANFORD HLTH GRP	2211	0.01
Ohio	968963	WELLPOINT INC GRP	390307	0.40	UNITEDHEALTH GRP	206875	0.21	MEDICAL MUT OF OH GRP	170509	0.18
Oklahoma	489222	HCSC GRP	264787	0.54	COMMUNITYCARE GRP	82473	0.17	UNITEDHEALTH GRP	54112	0.11
Oregon	686890	KAISER FOUNDATION GRP	283234	0.41	CAMBIA HEALTH SOLUTIONS INC	165249	0.24	PROVIDENCE HLTH GRP	89500	0.13
Pennsylvania	2159543	HIGHMARK GRP	783577	0.36	INDEPENDENCE BLUE CROSS GRP	504187	0.23	AETNA GRP	267908	0.12
Rhode Island	183912	BCBS OF RI	139992	0.76	UNITEDHEALTH GRP	25132	0.14	TUFTS GRP	9154	0.05
South Carolina	332897	BCBS OF SC GRP	302838	0.91	UNITEDHEALTH GRP	15515	0.05	AETNA GRP	6583	0.02
South Dakota	106799	WELLMARK INC GRP	64231	0.60	SANFORD HLTH GRP	21659	0.20	SOUTH DAKOTA STATE MED HOLDING CO	9763	0.09
Tennessee	509157	BCBS OF TN GRP	387241	0.76	UNITEDHEALTH GRP	49576	0.10	CIGNA HLTH GRP	43838	0.09
Texas	1875322	HCSC GRP	869477	0.46	UNITEDHEALTH GRP	477140	0.25	AETNA GRP	186495	0.10
Utah	444958	IHC INC GRP	199841	0.45	CAMBIA HEALTH SOLUTIONS INC	121061	0.27	AETNA GRP	69641	0.16
Vermont	73781	BCBS OF VT GRP	58569	0.79	MVP GRP	9880	0.13	CIGNA HLTH GRP	5331	0.07
Virginia	1427821	WELLPOINT INC GRP	627260	0.44	UNITEDHEALTH GRP	231798	0.16	CAREFIRST INC GRP	211230	0.15
Washington	1191119	KAISER FOUNDATION GRP	398844	0.33	PREMERA BLUE CROSS GRP	351801	0.30	CAMBIA HEALTH SOLUTIONS INC	327229	0.27
West Virginia	133124	HIGHMARK GRP	112461	0.84	HEALTH PLAN GRP	10000	0.08	AETNA GRP	8513	0.06
Wisconsin	1000019	DEAN HLTH GRP	144272	0.14	WELLPOINT INC GRP	125092	0.13	UNITEDHEALTH GRP	118682	0.12
Wyoming	32453	BCBS OF WY	24893	0.77	WINHEALTH PARTNERS	4137	0.13	AETNA GRP	2170	0.07

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