Trends in Employer Group Medicare Advantage Enrollment

November 14, 2019

As of October 1, 2019, more than 23 million people were enrolled in Medicare Advantage (MA) plans, representing a growing share of the 67.1 million Americans eligible for Medicare. Individual MA policies, acquired through direct purchase policies, have historically dominated the MA market as 18.5 million beneficiaries purchased individual plans as of October 1, 2019. Concurrently, employer group retiree programs known as Medicare Advantage Employer Group Waiver Plans (MA-EGWP) experienced a steady increase in enrollment to nearly 4.5 million enrollees, or 19.5% of all MA plans. Employer group MA enrollment has increased by almost 321,000, a 7.7% increase, since December 2018. Moreover, group market enrollment has increased by approximately 1.3 million members since December 2016. In this brief, Mark Farrah Associates (MFA) compares the latest employer group MA enrollment reports with recent year-end enrollment reports from the Centers for Medicare and Medicaid Services (CMS) as aggregated in Medicare Business Online™.

Enrollment Trends by Carrier and State

The top 5 carriers of group Medicare Advantage measured by enrollment have remained unchanged over the past few years, despite increasing competition within this market segment.  As of October 2019, UnitedHealth persisted as the largest provider with nearly 1.4 million members. CVS/Aetna grew 31.5% from December 2018 to October 2019 in large part due to an increase in enrollment across all counties in New Jersey. Kaiser continues to command a sizable share of the employer group MA market with over 550,000 members. Lastly, Humana and BCBS of Michigan rounded out the top companies with nearly 511,000 and 379,000 members, respectively.

Top 5 Medicare Advantage Payers - Group Segment Membership Trend
Company	Dec-16	Dec-17	Dec-18	Oct-19
UnitedHealth	789,377	1,148,615	1,295,804	1,387,052
CVS/Aetna	563,938	547,618	694,752	913,490
Kaiser	486,115	525,711	538,304	550,331
Humana	341,926	428,240	484,402	510,956
BCBS of Michigan	302,207	318,675	371,745	378,890
Total	2,483,563	2,968,859	3,385,007	3,740,719

                                   Source: Medicare Business Online^TM, Mark Farrah Associates, presenting data from CMS enrollment reports

All 5 of the leading group MA health plans achieved double-digit growth in membership since December 2016. UnitedHealth added nearly 598,000 enrollees since December 2016, an increase of 76%. CVS/Aetna experienced the second largest growth rate of 62% since December 2016, with a gain of 350,000 members. Overall, the top five companies gained nearly 1.3 million beneficiaries equating to a 51% enrollment increase since 2016.  While not in the top 5, Anthem experienced triple digit growth since December 2016, growing to 152,000 members in October 2019, mainly from enrollment in California and Colorado.

Top 10 States Medicare Advantage - Group Segment Membership Trend
State	Dec-16	Dec-17	Dec-18	Oct-19
CA	522,411	552,221	588,811	622,404
MI	315,917	333,653	392,191	405,415
TX	211,098	244,097	315,669	323,527
NY	221,630	250,598	263,598	270,410
OH	191,397	204,936	235,889	238,235
PA	201,425	216,773	218,481	223,319
IL	162,023	189,044	198,894	204,825
NJ	58,434	117,771	122,375	199,765
NC	139,685	154,050	178,491	189,769
FL	110,619	139,670	163,111	179,147
Subtotal	2,134,639	2,402,813	2,677,510	2,856,816
All Other States	1,078,922	1,298,878	1,468,865	1,610,196
Total	3,213,561	3,701,691	4,146,375	4,467,012

                                    Source: Medicare Business Online^TM, Mark Farrah Associates, presenting data from CMS enrollment reports

Between December 2016 and October 2019, the United States and territories experienced a 39% overall growth rate in group MA market enrollment. While markets vary by state, trends mostly show gains in penetration since 2016. All the leading ten states by enrollment experienced membership increases with California topping the list at over 622,000 members. New Jersey experienced the largest percentage increases since December 2016 partly due to CVS/Aetna gains within the state.

About Mark Farrah Associates (MFA)

Mark Farrah Associates (MFA) is a leading data aggregator and publisher providing health plan market data and analysis tools for the healthcare industry.  Our product portfolio includes Health Coverage Portal™, County Health Coverage™, Medicare Business Online™, Medicare Benefits Analyzer™, and Health Plans USA™.  For more information about these products, refer to the informational videos and brochures available under the Our Products section of the website or call 724-338-4100.

https://www.markfarrah.com/mfa-briefs/trends-in-employer-group-medicare-advantage-enrollment/