As always, this year’s managed care report card from CT’s Insurance Dept. is fascinating. Anthem has 44% of total enrollment. Anthem is seeking to buy CIGNA for $54 billion; together they have 64% of CT enrollment. Aetna has 18.5% of enrollment, ConnectiCare has 9.2%, and Oxford/United Health Care has 6.8%. Enrollment is very low in CT’s two nonprofit insurers — Healthy CT has only 0.3% of enrollment, and Harvard Pilgrim’s enrollment is less than a thousand people so far. The report includes 2014 medical loss ratios (MLRs) for each plan, including federal calculations and the more rigorous state MLR. The MLR is the percent of premiums that go to pay for medical care (and quality improvement in the federal calculation). Anthem’s HMO plans and all Oxford/United Health Care plans are below 80% on the state’s MLR calculation.
The report also has a wealth of useful information for consumers including customer service info, NCQA accreditation level, and number of providers by county and type. The report includes several quality measures including performance on cancer screenings, controlling high blood pressure and cholesterol levels, prenatal and postpartum care, drug utilization with costs, behavioral health, and member satisfaction.