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Employer-Group Medicare Advantage Year-to-Date Enrollment Increase of 6%


November 23, 2021


Nearly 28 million people were enrolled in Medicare Advantage (MA) plans as of November 1, 2021, representing a growing share of the 63.6 million Americans eligible for Medicare. Individual MA policies, acquired through direct purchase, covered approximately 22.7 million members, as of November 1, 2021. While individual policies dominate the MA market, MA employer-group retiree programs, also known as Medicare Advantage Employer Group Waiver Plans (MA-EGWP, EGHP or Group MA), continue to experience steady enrollment increases. Group MA currently encompasses 18% of the total MA market.



Employer-group MA enrollment has grown to over 4.9 million members, an increase of over 279,000, or 6%, since December of 2020. Furthermore, group market enrollment has grown by approximately 817,000 members since December of 2018. In this brief, Mark Farrah Associates (MFA) analyzes previous yearend employer Group MA enrollment reports with recent enrollment reports from the Centers for Medicare and Medicaid Services (CMS).

Group MA Enrollment Trends by Carrier and State

As employers, unions and government agencies continue to move retirees from self-insured Medicare Supplement (Medicare Wrap or Medigap) plans to fully insured MA plans, competition within the Group MA market segment remains strong. All five leading Group MA health insurers achieved significant growth in membership over the past four years. Overall, the top five companies gained over 800,000 beneficiaries, equating to a 24% enrollment increase when 2021 data is compared to 2018.


Top 5 Medicare Advantage Payers - Group Segment 
Company Dec-18 Dec-19 Dec-20 Nov-21
 UnitedHealth 1,295,804  1,388,312  1,327,816  1,523,671 
 CVS/Aetna 694,752  913,661  1,004,168  1,115,078 
 Kaiser  538,304  552,150  560,193  565,065 
 Humana 484,402  511,964  600,182  549,411 
 BCBS of Michigan 371,745  378,427  441,858  445,439 
 Total 3,385,007  3,744,514  3,974,217  4,198,664 
 Source: Medicare Business Online™, Mark Farrah Associates, presenting data from   CMS enrollment reports


  • UnitedHealth has maintained its position as the Group MA segment leader with over 1.5 million members, as of November 2021. It added nearly 196,000 new enrollees since yearend 2020, a 15% growth rate.
  • CVS/Aetna grew to over 1.1 million enrollees, gaining 7% year to date (YTD) in 2021. CVS/Aetna added nearly 219,000 new enrollees between 2018 and 2019, due in part to the conversion of the New Jersey (NJ) state employee retirees’ account to Aetna’s MA plans.
  • Kaiser experienced a slight YTD growth of 0.9%, or approximately 5,000 members. The company has continued to see moderate gains since 2018.
  • Humana was the only top Group MA insurer to experience an enrollment decrease, from year-end 2020, losing approximately 51,000 members, or -8.5%. However, from December of 2018 through November of 2021, the insurer has increased MA group enrollment by 65,000 enrollees (13%).
  • Blue Cross Blue Shield (BCBS) of Michigan’s Group MA enrollment was over 445,000, as of November 2021, a 0.8% YTD growth. Since December of 2018, the company experienced an overall Group MA membership increase of 20%.
Top 10 Medicare Advantage States - Group Segment
State Dec-18 Dec-19 Dec-20 Nov-21
 CA 588,811  624,279  647,697  666,942 
 MI 392,191  404,719  461,539  471,142 
 TX 315,669  324,287  334,568  375,815 
 NY 263,598  270,706  280,514  285,271 
 OH 235,889  237,570  245,810  248,370 
 PA 218,481  223,159  226,126  228,227 
 IL 198,894  203,552  209,313  224,656 
 NJ 122,375  200,281  208,923  214,617 
 FL 163,111  179,954  191,130  204,507 
 NC 178,491  190,236  194,485  199,543 
 Subtotal 2,677,510  2,858,743  3,000,105  3,119,090 
 All Other States
1,468,865  1,611,517  1,684,117  1,844,542 
 Total 4,146,375  4,470,260  4,684,222  4,963,632 
 Source: Medicare Business Online™, Mark Farrah Associates, presenting data from   CMS enrollment reports


As per the chart above, between December 2018 and November 2021, the U.S and its territories experienced a 19.7% overall growth rate in Group MA market enrollment. All the leading ten states, by enrollment, experienced membership increases, with California (CA) continuing to top the list, at nearly 667,000 members. New Jersey (NJ) had the largest increase in Group MA enrollment, at 75%, between December 2018 and November 2021. This was primarily due to the conversion of many NJ state and union retirees to MA products.

About this Data

This brief is based on an analysis of employer-group enrollment data for Medicare Advantage plans released by the Centers for Medicare & Medicaid Services (CMS). Mark Farrah Associates’ Medicare Business Online™ simplifies the tracking of monthly Medicare Advantage and PDP enrollment by competitor. Enrollment data is updated monthly as soon as CMS releases new data.

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™, 5500 Employer Health  PLUS , 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.

Healthcare Business Strategy is a FREE monthly brief that presents analysis of important issues and developments affecting healthcare business today. If you would like to be added to our email distribution list, please submit your email address to the " Subscribe to MFA Briefs " section at the bottom of this page. Mark Farrah Associates will continue to analyze and report on important health insurance segment performance and related topics. Stay tuned for future analysis briefs with valuable insights about the health care industry. 

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