Newspaper article Pittsburgh Post-Gazette (Pittsburgh, PA)

Highmark Membership Declines Western Pa. Insurer Loses Big Chunk of Medicare Subscribers

Newspaper article Pittsburgh Post-Gazette (Pittsburgh, PA)

Highmark Membership Declines Western Pa. Insurer Loses Big Chunk of Medicare Subscribers

Article excerpt

Highmark Inc. has fewer Medicare customers and employer-based subscribers than it did a year ago in Western Pennsylvania, in large part due to its ongoing, bruising battle with crosstown rival UPMC - but things could have been a lot worse, according to the Pittsburgh-based insurer's CEO.

"There have been no real surprises," said David Holmberg, Highmark's chief executive since May 2014. "It was pretty clear what the challenges were. ... The intensity of the competition [has] been fascinating. But what it's doing is helping us sharpen our pencils and be smarter about what we do."

Highmark, a Blue Cross Blue Shield insurer, released its 2015 enrollment figures Wednesday morning; it was the company's first annual enrollment update to be issued since the Jan. 1 split between Highmark and UPMC.

That means this is the first year that businesses and individual insurance buyers under the age of 65 were forced to leave Highmark - for UPMC Health Plan, United Healthcare, Cigna or Aetna (or its Coventry subsidiary) - if they wanted to keep in-network access to all of UPMC's hospitals.

For 2015, Highmark reported 1.14 million commercial members in the 29-county Western Pennsylvania market, down from 1.29 million in January 2014. And while the insurer added individual subscribers year over year, largely through the Affordable Care Act's online marketplace, it lost a substantial chunk of its over-65 Medicare Advantage subscribers in this part of the state.

"We lost about 10 percent of our enrollment," going from 203,000 to 182,000 Medicare subscribers, said Tim Lightner, vice president of senior markets and products. "The noise in the marketplace was probably a contributing factor, [but] we landed in a better place. We were ahead of plan."

Across all of its markets, Highmark says it has 5.3 million health plan members, including in West Virginia and Delaware. It will add about 272,000 new members this spring or summer, once its planned acquisition of Blue Cross of Northeastern Pennsylvania takes effect. …

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