CHA News Article

New Report Establishes Performance Baseline for Health Plans and Insurers
California Healthcare Foundation studies marketplace before ACA takes effect

A report released yesterday by the California Healthcare Foundation provides a reference point for health plans and insurers in the state before changes from the Affordable Care Act (ACA) take effect. The report uses data primarily from the California Department of Managed Health Care (DMHC) and the California Department of Insurance (CDI) to examine market share, enrollment, financial performance, share of premiums devoted to medical care and consumer satisfaction. Some highlights from the report include:

  • Six insurance carriers accounted for three-fourths of the $111 billion in health insurance revenues in California in 2011.
  • Commercial enrollment did not change. Individual enrollment declined by 9.1 percent since 2010, and group enrollment grew by less than 1 percent.
  • Public sector enrollment grew, mainly due to increased sign-ups for managed care Medi-Cal.
  • Companies regulated by DMHC insure the largest share of consumers, with the exception of the individual market, whereas CDI-regulated carriers insure two-thirds of enrollees.
  • Most of the largest carriers, under both DMHC and CDI, reported positive net income.
  • ACA requires insurers to spend a minimum share of premium dollars on medical care or pay a rebate to consumers. In 2012, the first rebates totaling $74 million were paid to approximately 1.1 million Californians.

To view the complete report and interactive graphics showing commercial enrollment with California’s largest health insurance carriers, visit