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Health Insurance Competition and Market Share in Wisconsin

 

May 12, 2022

Insurance companies provided medical coverage for 5.2 million people in Wisconsin, as of December 31, 2021, based on enrollment reported in Mark Farrah Associates’ (MFA’s) County Health CoverageTM. With a mix of national, regional, and local insurance carriers, Wisconsin, a mid-sized state with a population dispersed across 72 counties, is an ideal location to use MFA’s County Health CoverageTM. The focus of this brief, Dane County, is home to the state capital, Madison, the fastest growing and second-most populated city in the state. *

 

Wisconsin Total Enrollment and Market Share, December 31, 2021
Company  Wisconsin   State Share   Dane County   County Share 
 UNITEDHEALTH GRP 1,142,733 22% 80,348 12%
 ANTHEM INC GRP 1,118,782 22% 44,009 7%
 MEDICA GRP 500,851 10% 178,567 28%
 UNIVERSITY HC & GUNDERSEN LUTHERAN GRP  338,917 7% 161,924 25%
 Other Plans 2,053,699 39% 181,862 28%
 Total 5,154,982 100% 646,710 100%
 Source: County Health Coverage, Mark Farrah Associates

 

Competition and Market Share

In Wisconsin (WI), large national insurance carriers, UnitedHealthcare and Anthem, combined cover 44% of the state’s health insurance market. Much of the national carriers’ enrollment is focused in the Milwaukee area, the largest metropolitan area in the state.  Less than 80 miles away from Milwaukee, a very different competitive landscape emerges, with regional carriers such as Medica Group and University Health Care/Gundersen Lutheran Group leading the Dane County market.

  • Medica Group, headquartered in Minnesota, first entered counties in western Wisconsin in 1998. Medica offers individual and family, employer-provided, Medicaid, and Medicare health insurance plans in IA, MN, KS, MO, NE, ND, OK, SD, and WI. On December 1, 2021, Medica merged with Wisconsin-based Dean Health Plans. Medica is now the largest health insurer in Dane County with a total share of 28%. Statewide Medica covers 10% of the people insured in WI.
  • University Health Care/Gundersen Lutheran Group, majority owners of Quartz Health Plan Corporation (QHPC), markets managed healthcare products in 38 counties covering south central and southwestern Wisconsin, 5 counties in northeastern Iowa, and 7 counties in northern Illinois. The group provides coverage to 25% of the insured in Dane County Wisconsin, but only 7% of those covered statewide.
  • In Dane County, UnitedHealthcare and Anthem combined, cover less than 20% of the market.
  • Local plans, including Group Health Cooperative of South-Central Wisconsin − Dane County’s first health maintenance organization (HMO) − are among the other plans serving the Dane County area.

* "Census: Madison, suburbs top list of fastest-growing cities in Wisconsin". Wisconsin State Journal, July 25, 2020.

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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