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Saturday, Sep 24, 2022

Kaiser Dominates Competitors in Commercial Health Insurance Arena

Kaiser Permanente leads in the commercial health insurance market share both statewide and in San Diego, according to recent data. But its market share on a state level exceeds that in San Diego, where the insurance pool is slightly more competitive.

The nonprofit insurer had a 40 percent share of California’s $58.8 billion commercial health insurance market, according to a report from Citigroup Inc. based on 2011 data.

The report found that 14.6 million are insured in the state — and 5.5 million are Kaiser patients. The runner-up is WellPoint Inc., the for-profit managed care conglomerate that owns Anthem BlueCross. The company insures about 3.4 million statewide, with a 23.3 percent market share.

It’s followed by Blue Shield of California at 14 percent, Health Net of California at 8.6 percent, UnitedHealth Group at 5.3 percent and Aetna Inc. at 5 percent.

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Close Competition Locally

The breakdown is slightly different in San Diego, however — with more insurers at a more even level of competition, said Alice Campbell, a principal at San Diego insurance brokerage Barney & Barney LLP.

“The issue that comes into play is that there are certain carriers that fit with certain industries — and we’ve seen that many San Diego employers often choose Aetna, in addition to giving employees the option to join Kaiser,” Campbell said.

Kaiser has about 34 percent share of San Diego’s health insurance pool of about 1.2 million people, according to data from HealthLeaders, a Nashville-based data-mining company that analyzes health care markets. The study examined the commercial insurance market breakdown in 2012.

Locally, Wellpoint has a 13.3 percent share, Aetna an 11.5 percent share, Blue Shield of California at 10 percent, and Health Net and United Health Group both at 9 percent.

A comparison of the Citigroup and HealthLeaders studies is valid, Campbell said — and that from year to year, these market percentages vary very little — though insurance companies are trying to shake up the balance.

“It seems as though the insurance carriers feel as though the ones with the most membership are going to win in the race toward health care reform,” Campbell said. “They’re all trying to build market share in advance of the new health insurance exchanges — and though San Diego isn’t a huge market, the insurance distribution here is interesting when compared to the statewide numbers.”


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