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Health Insurance Competition and Commercial Market Share in Washington State


March 17, 2022

Insurance companies provided medical coverage for approximately 301.2 million people as of September 30, 2021, based on enrollment as reported in Mark Farrah Associates’ County Health CoverageTM. Of those with medical coverage, more than 191.9 million people were enrolled in a commercial healthcare plan. Commercial business includes Individual, Group, Federal Employees Health Benefits (FEHB), and Administrative Services Only (ASO) plans. 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. In this brief, MFA analyzes enrollment figures from County Health CoverageTM for three MSAs in the state of Washington, with a focus on health plan market position.

Competition and Market Share

As of September 30, 2021, approximately 4.8 million people were enrolled in commercial health insurance plans in Washington MSAs. The graph below illustrates market share for the leading companies state-wide. Premera Blue Cross, Cambia Health Solutions, and Kaiser are the three largest health insurance companies in Washington.



The top three MSAs in Washington, based on enrollment in commercial plans, include the Seattle-Tacoma-Bellevue MSA, the Portland-Vancouver-Hillsboro MSA, and the Spokane-Spokane Valley MSA. For this report, the Portland-Vancouver-Hillsboro MSA includes data from counties in the state of Washington and excludes those from Oregon. The Seattle-Tacoma-Bellevue metropolitan region is the largest MSA in the state, with 2.8 million commercial enrollees.

The graph below shows market share for the top commercial carriers in the Seattle-Tacoma-Bellevue MSA, as of September 30, 2021 (3Q21). Premera Blue Cross provides coverage for over 50% of the market. The next largest carrier, Cambia Health Solutions, covers nearly 18%.



Representing over 1.4 million in total commercial enrollment, Portland-Vancouver-Hillsboro is the second largest MSA in the state and more competitively diverse. Kaiser leads in this area with roughly a quarter of the market. Cambia Health Solutions and Providence Health Group cover 21.3% and 12.9%, respectively.



The commercial market in the Spokane-Spokane Valley MSA is the third largest in the state, insuring over 362,000. As illustrated below, Premera Blue Cross, Cambia Health Solutions, and Kaiser are the commercial market leaders for this MSA and the state. Together they cover nearly 75% of the Spokane-Spokane Valley MSA.



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.

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 PortalTM, County Health CoverageTM, Medicare Business OnlineTM, Medicare Benefits AnalyzerTM, Health Plans USATM and 5500 Employer Health plus. 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.

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