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Health Insurance Competition and Commercial Market Share in Florida State


October 4, 2022


Florida may be best known to insurers for its retiree population and as an attractive market for Medicare Advantage and Medicare Supplement products; however, its economy is the fourth-largest of any U.S. state and the 16th-largest in the world[i], which means it has a dynamic commercially insured market as well. Commercial business includes Individual, Group, Federal Employees Health Benefits (FEHB), and Administrative Services Only (ASO) plans. Insurance companies provided medical coverage through commercial healthcare plans in Florida to nearly 12.1 million people, as of June 30, 2022, over 62% of the 19.2 million insured in the state, based on enrollment as reported in Mark Farrah Associates’ (MFA’s) County Health CoverageTM. Over 30% of Florida’s commercial enrollment is in three counties. In this brief, MFA analyzes enrollment figures from County Health CoverageTM for Miami-Dade (DA), Broward (BW), and Hillsborough (HB) Counties in Florida, with a focus on health plan market position.



Competition and Market Share

As of June 30, 2022, approximately 12.1 million people were enrolled in commercial healthcare plans in Florida. Eight companies cover over 11.5 million people. The graph below illustrates market share for the five leading companies state-wide. Guidewell (BCBS of FL), UnitedHealth, and CVS Health (Aetna) are the three largest health insurance companies in Florida, covering 78% of commercially insured Floridians.



The top three counties in Florida, based on enrollment in commercial plans, are Miami-Dade, Broward, and Hillsborough. Miami-Dade is the largest county in the state, with 1.6 million commercial enrollees. The graph below shows market share for the top commercial carriers in Miami-Dade County, as of June 30, 2022 (2Q22). Guidewell provides coverage for over 40% of the market. For 2Q22, AVMED continued to hold its fourth place ranking in Miami-Dade County, but both Cigna and Oscar Health are increasing enrollment at a faster rate.



Representing nearly 1.3 million in total commercial enrollment, Broward, part of the Miami metropolitan area, is the second largest county in the state. Guidewell continues to lead in this area with 43% share of the market. UnitedHealth and CVS cover 18% and 12%, respectively. Oscar Health has gained enough enrollment in Broward County to move into the top five plans in the area.



Hillsborough County, the location of Tampa on Florida’s west coast, is the third largest in the state, with over 963,000 commercially insured residents. As in Miami-Dade and Broward Counties, Guidewell, UnitedHealth, and CVS are the commercial market leaders for this area and the state. Together they cover 75% of Hillsborough County.



It is important to note that, in some cases, estimates were based on enrollment reported by employer contract location (situs) rather than state of member residence.

Considering the size of the commercial market, evaluating market share at the county and Metropolitan Statistical Area (MSA) level is an important measure of competitive positioning and health plan performance for insurers. County-level assessment of commercial market share is often challenging, as insurance companies are generally not required to report local market membership except when mandated by state or federal regulations. However, Mark Farrah Associates’ (MFA’s) County Health CoverageTM, integrating highly relevant sources, provides reliable estimates of health insurance market share at these levels.

About County Health CoverageTM

County Health CoverageTM provides reliable estimates of health insurance enrollment and market share at the state, county, and Metropolitan Statistical Area (MSA) level. Product features include company market share by county, company, and state for the Private Risk, Private ASO, Managed Medicaid, Medicare Advantage, and PDP segments. Breakdowns by product type (HMO, PPO, etc.) are also presented, as well as population demographics and interactive, visual mapping tools. To learn more, visit the product page - County Health CoverageTM.

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.


[i] GDP by State | U.S. Bureau of Economic Analysis (BEA). Bureau of Economic Analysis. Retrieved 10 April 2022.

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