Small Health Plans Making Inroads In Florida Marketplace

Florida health plans are looking to make inroads in state's health plan marketplace through acquisitions and stronger networks. According to the latest Florida Health Plan Analysis, Coventry Health Care and Great-West Healthcare are poised to move up the ranks of Florida's largest insurers, showing two successful ways to gain share in a hyper-competitive market.

"Florida is the third-largest state with more than 18 million residents, so its population size is attractive to insurers," states Roy Moore, market analyst for HealthLeaders-InterStudy and author of the report. "Carriers see the state as full of opportunity."

Coventry Health Care's recent purchase of Florida Health Plan Administrators has made Coventry the state's fourth-largest commercial HMO provider. Through Vista, the product name of Florida Health Plan Holdings, the insurer will bring additional products to the market, boosting its competitive strength and expand in the small-group and individual business. The company's national infrastructure will also allow Vista to better compete against the giant Florida insurers Blue Cross, UnitedHealthcare, Humana and Aetna.

After realizing they were behind the competition, new leadership for Great-West Healthcare placed a major focus on expanding the company's provider networks and boosting membership. The insurer's has expanded its networks significantly with the addition of 30 new hospitals and 4,000 physicians, providing access to more than 30,000 network providers.

In January 2008, Great-West will roll out a program called Level Funded. Instead of paying the actual claims cost each month, employers in this model pay a fixed monthly maximum claim liability. At the end of the year, Great-West reconciles the difference between the total monthly payments and actual claim costs. If actual claim costs are less than the total monthly payments, the employer retains two-thirds of the claims savings. With a large number of small businesses in the state that need insurance and for companies looking for a self-funded insurance approach, Great-West could offer an alternative to the market leaders and give smaller employers a break on healthcare costs by using a self-funded model. This week's announcement by CIGNA to acquire Great-West further consolidates this dynamic market and will help the insurer to gain additional market share.