Top Health Plans

Top Health Plans (Payers – P1) of America

What is Health Plan or Health Insurance or P1 - Payers of America?

Health Plans of America is a broad term used to describe the various types of health insurance plans that are available to individuals and families in the United States. These plans can be provided by private insurance companies, government-sponsored programs, or a combination of both. The number of lives covered by health plans in the US varies depending on the type of plan and the population it serves. As of 2021, there were approximately 170 million people enrolled in employer-sponsored health plans, 60 million people enrolled in Medicaid, and 63 million people enrolled in Medicare. Additionally, over 11 million people were enrolled in QHPs through the health insurance exchanges.

Commercial Health Plans are provided by private insurance companies and are purchased by individuals or offered as benefits by employers. These plans can be further categorized into several lines of business (LOBs), including individual and family plans, small group plans, large group plans, and self-insured plans.

Government-sponsored Health Plans (Gov-Health) are funded and administered by the federal or state government and are designed to provide health coverage to specific populations. The main types of government-sponsored plans in the US include Medicare for seniors and certain disabled individuals, Medicaid for low-income individuals and families, and the Children's Health Insurance Program (CHIP) for children in families with low income.

Qualified Health Plans (QHPs) are a type of health plan that meets certain requirements under the Affordable Care Act (ACA). These plans must cover essential health benefits and meet other standards set by the ACA. QHPs are sold on state or federally facilitated health insurance exchanges and may be subsidized for individuals who meet certain income requirements.

One of the most well-known government-sponsored health plans is Medicare, which provides coverage to individuals aged 65 and older, as well as certain younger people with disabilities. Medicare is divided into several parts, including Part A, which covers hospital care, and Part B, which covers medical services such as doctor visits and preventive care. Medicare Advantage (MA) plans, also known as Part C, are offered by private insurance companies and provide an alternative to traditional Medicare. These plans often include additional benefits such as prescription drug coverage, vision and dental care, and fitness programs.

Another government-sponsored health plan is Medicaid, which provides health coverage to low-income individuals and families. Medicaid is administered by the states, and eligibility requirements vary by state. Some states also offer Managed Long-Term Care (MLTC) plans, which provide comprehensive care for individuals with chronic conditions or disabilities.

The Children's Health Insurance Program (CHIP) is another government-sponsored program that provides health coverage to children in families with low income. CHIP is administered by the states, and covers a wide range of health services, including doctor visits, hospital care, and prescription drugs.

In addition to government-sponsored programs, Health Plans of America also includes commercial health insurance plans. These plans can be further divided into several lines of business, including individual and family plans, small group plans, large group plans, and self-insured plans. Some commercial plans also offer Medicare Supplement Plans, which help cover the costs of services not covered by traditional Medicare.

Overall, Health Plans of America encompasses a wide range of health insurance options, each designed to meet the unique needs of different populations. Whether through government-sponsored programs like Medicare and Medicaid, or through commercial plans offered by private insurers, individuals and families have access to a variety of options for protecting themselves and their loved ones against the costs of medical care.

Leading Health Plans in the United States

• Amerigroup - Parent Company: Anthem - URL: www.amerigroup.com  - Revenue: N/A - HQ: Virginia Beach, VA

• Anthem, Inc. - Headquarters: 220 Virginia Avenue, Indianapolis, IN 46204. Revenue: $130.0 billion (2020). Plans/LOBs: Plans/LOBs: Anthem Blue Cross and Blue Shield, Anthem Medicare Advantage, Anthem Medicaid, Anthem Federal Employee, Empire BlueCross, Empire BlueCross Medicare. Lives Managed: 107 million. Website: https://www.antheminc.com/

• Arizona Complete Health -  Headquarters: 410 N 44th St, Suite 900, Phoenix, AZ 85008. Revenue: $4.8 billion (2020). Plans/LOBs: Arizona Complete Health-Complete Care Plan, Arizona Complete Health-Complete Care Plan Dual, Arizona Complete Health-Complete Care Plan LTC, Arizona Complete Health-Complete Care Plan CRS. Lives Managed: 466,000. Website: https://www.azcompletehealth.com/

• Asuris Northwest Health - Headquarters: 1201 3rd Ave, Seattle, WA 98101. Revenue: $1.1 billion (2020). Plans/LOBs: Asuris Northwest Health, Asuris Northwest Health (Idaho). Lives Managed: 650,000. Website: https://www.asuris.com/

• Avera Health Plans - URL: www.averahealthplans.com  - Revenue: N/A - HQ: Sioux Falls, SD

• Baylor Scott & White Health - Headquarters: 3500 Gaston Ave, Dallas, TX 75246. Revenue: $14.4 billion (2020). Plans/LOBs: Scott and White Health Plan, Baylor Scott & White Quality Alliance, Baylor Scott & White Accountable Care Organization. Lives Managed: 400,000. Website: https://www.bswhealth.com/

• Blue Cross & Blue Shield of Rhode Island (BCBSRI) - Headquarters: 500 Exchange Street, Providence, RI 02903.Revenue: $1.7 billion (2020). Plans/LOBs: Blue Cross & Blue Shield of Rhode Island. Lives Managed: 400,000. Website: https://www.bcbsri.com/

• Blue Cross and Blue Shield of North Carolina (BCBSNC) - Headquarters: 4615 University Drive, Durham, NC 27707. Revenue: $9.5 billion (2020). Plans/LOBs: Blue Medicare, Blue Advantage, Blue Premier, Blue Options HAS. Lives Managed: 3.8 million. Website: https://www.bluecrossnc.com/

• Blue Cross and Blue Shield of Texas (BCBSTX) - Headquarters: 1001 E. Lookout Drive, Richardson, TX 75082. Revenue: $15.9 billion (2020). Plans/LOBs: Blue Advantage HMO, Blue Essentials HMO, Blue Premier PPO, Blue Choice PPO. Lives Managed: 5 million. Website: https://www.bcbstx.com/

• Blue Cross Blue Shield of Massachusetts (BCBSMA) - https://www.bluecrossma.org/. Blue Cross Blue Shield of Massachusetts is a non-profit health plan that provides medical insurance products and related services to individuals, employer groups, and Medicare and Medicaid beneficiaries. The company's headquarters is located in Boston, Massachusetts, and its focus plans/LOBs include commercial health plans, Medicare Advantage plans, and Medicaid managed care plans.

• Blue Shield of California (BSC) - URL: www.blueshieldca.com . HQ: San Francisco, CA

• BlueCross BlueShield of Michigan (BCBSMI) - URL: www.bcbsm.com  - Revenue: N/A - HQ: Detroit, MI

• BlueCross BlueShield of North Carolina (BCBSNC) - URL: www.bluecrossnc.com  - Revenue: N/A - HQ: Durham, NC

• BlueCross BlueShield of Texas (BCBSTX) - URL: www.bcbstx.com  - Revenue: N/A - HQ: Richardson, TX

• CareFirst BlueCross BlueShield - Headquarters: 840 First Street NE, Washington, DC 20065. Revenue: $12.7 billion (2020). Plans/LOBs: CareFirst BlueChoice Advantage, CareFirst BluePreferred, CareFirst BlueCross BlueShield, CareFirst HealthyBlue. Lives Managed: 3.4 million. Website: https://www.carefirst.com/

• CareSource - URL: www.caresource.com  - Revenue: N/A - HQ: Dayton, OH

• Centene Corporation - Headquarters: 7700 Forsyth Blvd., St. Louis, MO 63105. Revenue: $111.1 billion (2020). Plans/LOBs: Ambetter, Peach State Health Plan, Sunshine Health, Superior HealthPlan. Lives Managed: 25.2 million. Website: https://www.centene.com/ . Centene - WellCare Health Plans, Inc. (a subsidiary of Centene Corporation). Headquarters: 8735 Henderson Road, Renaissance One, Tampa, FL 33634. Revenue: $26.5 billion (2020). Plans/LOBs: WellCare Medicare, WellCare Medicaid, WellCare Marketplace, WellCare PDP. Lives Managed: 6.3 million. Website: https://www.wellcare.com/

• Cigna - Revenue: $160.4 billion (2020) - HQ: Bloomfield, CT. Plans/LOBs: Cigna Healthcare, Express Scripts, Cigna International, Cigna Health and Life Insurance Company, Cigna Healthcare of Texas, Cigna-HealthSpring, Cigna Dental, Plans/LOBs: Cigna Medicare Advantage, Cigna Medicaid, Cigna International, Cigna Healthcare, Express Scripts (PBM). Lives Managed: 170 million. Lives Managed: 190 million. Website: https://www.cigna.com/ .

• Columbia Pacific CCO - Headquarters: 401 9th Ave, Suite 2300, Seattle, WA 98104. Revenue: $800 million (2020). Plans/LOBs: Columbia Pacific CCO. Lives Managed: 23,000. Website: https://www.colpachealth.org/

• Community Health Plan of Washington - Headquarters: 1111 3rd Ave, Seattle, WA 98101. Revenue: $1.2 billion (2020). Plans/LOBs: Community Health Plan of Washington. Lives Managed: 350,000. Website: https://www.chpw.org/

• ConnectiCare - Headquarters: 175 Scott Swamp Road, Farmington, CT 06032. Revenue: $2.5 billion (2020). Plans/LOBs: ConnectiCare, ConnectiCare Medicare, ConnectiCare VIP. Lives Managed: 262,000. Website: https://www.connecticare.com/

• CVS – Aetna - Headquarters: 151 Farmington Avenue, Hartford, CT 06156. Plans/LOBs: Aetna Medicare, Aetna Commercial, Aetna Medicaid, Aetna International. Lives Managed: 22.1 million. Website: https://www.aetna.com/. CVS Health - Headquarters: One CVS Drive, Woonsocket, RI 02895. Revenue: $268.7 billion (2020). Plans/LOBs: Aetna, Caremark, MinuteClinic. CVS Health. Plans/LOBs: Aetna, Caremark, MinuteClinic. Lives Managed: 46.7 million. Website: https://cvshealth.com/ .

• Excellus BlueCross BlueShield - Headquarters: 165 Court Street, Rochester, NY 14647. Revenue: $7.4 billion (2020). Plans/LOBs: Excellus BlueCross BlueShield, Univera Healthcare. Lives Managed: 1.5 million. Website: https://www.excellusbcbs.com/

• Florida Blue - Headquarters: 4800 Deerwood Campus Parkway, Jacksonville, FL 32246. Revenue: $16.7 billion (2020). Plans/LOBs: BlueMedicare, BlueSelect, BlueCare, Florida Blue HMO. Lives Managed: 5.5 million. Website: https://www.floridablue.com/

• Group Health Cooperative of South-Central Wisconsin - Headquarters: 1265 John Q. Hammons Dr, Madison, WI 53717. Revenue: $1.5 billion (2020). Plans/LOBs: GHC-SCW, Quartz Health Benefit Plans Corporation. Lives Managed: 80,000. Website: https://www.ghcscw.com/

• Harvard Pilgrim Health Care - Headquarters: 93 Worcester Street, Wellesley, MA 02481. Revenue: $5.3 billion (2020). Lives Managed: 3 million. Plans/LOBs: Harvard Pilgrim, HPHConnect, UnitedHealthcare StudentResources. Lives Managed: 3 million. Website: https://www.harvardpilgrim.org/

• Health Care Service Corporation (HCSC) - Headquarters: 300 E. Randolph St, Chicago, IL 60601. Revenue: $35 billion (2020). Plans/LOBs: Blue Cross Blue Shield of Texas, Blue Cross Blue Shield of Oklahoma, Blue Cross Blue Shield of Illinois, Blue Cross Blue Shield of Montana, Blue Cross Blue Shield of New Mexico. Lives Managed: 16 million. Website: https://www.hcsc.com/

• Health Net of California, Inc - Headquarters: 21281 Burbank Blvd, Suite 100, Woodland Hills, CA 91367. Revenue: $15.1 billion (2020). Plans/LOBs: Health Net Medicare Advantage, Health Net Commercial, Health Net Medicaid. Lives Managed: 3.1 million. Health Net of Oregon. Headquarters: 1300 SW 5th Ave, Portland, OR 97201. Revenue: $890 million (2020). Plans/LOBs: Health Net of Oregon, Health Net Life Insurance Company. Lives Managed: 225,000. Website: https://www.healthnet.com/

• Healthfirst - Headquarters: 100 Church Street, New York, NY 10007. Revenue: $10.2 billion (2020). Plans/LOBs: Healthfirst NY, Healthfirst NJ, Healthfirst Leaf. Lives Managed: 1.6 million. Website: https://healthfirst.org/ . Healthfirst is a non-profit health plan that provides medical insurance products and related services to individuals, employer groups, and Medicare and Medicaid beneficiaries in the New York City area. Focus plans/LOBs include commercial health plans, Medicare Advantage plans, and Medicaid managed care plans.

• HealthNow New York Inc - Headquarters: 257 West Genesee Street, Buffalo, NY. Revenue: $3.5 billion (2020). Plans/LOBs: BlueShield of Northeastern New York, BlueCross BlueShield of Western New York, BlueCross BlueShield of Vermont. Lives Managed: 1.2 million. Website: https://www.healthnowny.com/

• HealthPartners - URL: www.healthpartners.com  - Revenue: N/A - HQ: Bloomington, MN

• Highmark Inc - Headquarters: Fifth Avenue Place, 120 Fifth Avenue, Pittsburgh, PA 15222. Revenue: $20.5 billion (2020). Plans/LOBs: Highmark Blue Cross Blue Shield, Highmark Medicare, Visionworks Lives Managed: 38.5 million. Website: https://www.highmark.com/

• Humana - Headquarters: 500 W. Main St, Louisville, KY 40202. Revenue: $77.1 billion (2020). Plans/LOBs: Humana Medicare Advantage, Humana Commercial, Humana Medicaid. Lives Managed: 20 million. Website: https://www.humana.com/

• Independence Blue Cross - Headquarters: 1901 Market Street, Philadelphia, PA 19103. Revenue: $18.2 billion (2020). Plans/LOBs: Independence Blue Cross, Keystone Health Plan East, AmeriHealth Caritas. Lives Managed: 8.3 million. Website: https://www.ibx.com/

• Kaiser Foundation Health Plan of the Northwest - Headquarters: 500 NE Multnomah St, Portland, OR 97232. Revenue: $11.7 billion (2020). Plans/LOBs: Kaiser Permanente NW, Kaiser Foundation Health Plan of Washington. Lives Managed: 640,000. Website: https://healthy.kaiserpermanente.org/northwest/ . Kaiser Permanente. Headquarters: 1 Kaiser Plaza, Oakland, CA 94612. Revenue: $84.5 billion (2020). Plans/LOBs: Kaiser Permanente Medicare, Kaiser Permanente Commercial, Kaiser Permanente Medicaid. Lives Managed: 12.5 million. Website: https://www.kp.org/ . KPS Health Plans. Headquarters: 400 Warren Ave, Bremerton, WA 98337. Revenue: $282 million (2020). Plans/LOBs: KPS Health Plans. Lives Managed: 80,000. Website: https://www.kpshealthplans.com/

• Memorial Hermann Health Plan - Headquarters: 929 Gessner Rd, Suite 1500, Houston, TX 77024. Revenue: $2 billion (2020). Plans/LOBs: Memorial Hermann Health Plan. Lives Managed: 400,000. Website: https://www.memorialhermann.org/

• Moda Health - Headquarters: 601 SW 2nd Ave, Portland, OR 97204. Revenue: $1.1 billion (2020). Plans/LOBs: Moda Health Plan, Delta Dental of Oregon, Ardon Health. Lives Managed: 520,000. Website: https://www.modahealth.com/ . Samaritan Health Plans. Headquarters: 2300 NW Walnut Blvd, Corvallis, OR 97330. Revenue: $906 million (2020). Plans/LOBs: Samaritan Health Plans. Lives Managed: 120,000. Website: https://www.samhealthplans.org/

• Molina Healthcare, Inc - Headquarters: 200 Oceangate, Suite 100, Long Beach, CA 90802. Revenue: $22.9 billion (2020). Plans/LOBs: Molina Medicaid, Molina Medicare, Molina Marketplace, Molina Dual Options. Lives Managed: 4.9 million. Website: https://www.molinahealthcare.com/

• MVP Health Care - Headquarters: 625 State Street, Schenectady, NY 12305. Revenue: $3.7 billion (2020). Plans/LOBs: MVP Health Plan, MVP Preferred Care, MVP Health Insurance Company. Lives Managed: 700,000. MVP Health Care is a non-profit health plan that provides medical insurance products and related services to individuals, employer groups, and Medicare and Medicaid beneficiaries in New York and Vermont. Plans/LOBs include commercial health plans, Medicare Advantage plans, and Medicaid managed care plans. Website: https://www.mvphealthcare.com/ .

• PacificSource Health Plans - Headquarters: 13010 SW 68th Pkwy, Suite 200, Tigard, OR 97223. Revenue: $881 million (2020). Plans/LOBs: PacificSource Health Plans, PacificSource Community Solutions. Lives Managed: 355,000. Website: https://www.pacificsource.com/

• Partners Health - AllWays Health Partners - Headquarters: 399 Revolution Drive, Suite 750, Somerville, MA 02145. Revenue: $635 million (2020). Plans/LOBs: AllWays Health Partners, AllWays Health Partners (NH). Lives Managed: 200,000. Website: https://www.allwayshealthpartners.org/

• Premera Blue Cross - Headquarters: 7001 220th St SW, Mountlake Terrace, WA 98043. Revenue: $7.1 billion (2020). Plans/LOBs: Premera Blue Cross, LifeWise Health Plan of Washington, Premera Blue Cross Blue Shield of Alaska. Lives Managed: 2 million. Website: https://www.premera.com/

• Presbyterian Healthcare Services - Headquarters: 9521 San Mateo Blvd NE, Albuquerque, NM 87113. Revenue: $4.8 billion (2020). Plans/LOBs: Presbyterian Health Plan, Presbyterian Medicare Advantage. Lives Managed: 580,000. Website: https://www.phs.org/

• Providence Health Plan - Headquarters: 4400 NE Halsey St, Portland, OR 97213. Revenue: $4.1 billion (2020). Plans/LOBs: Providence Health Plan, PacificSource Health Plans. Lives Managed: 1 million. Website: Providence Medicare Advantage Plans. Headquarters: 4400 NE Halsey St, Portland, OR 97213. Revenue: $751 million (2020). Plans/LOBs: Providence Medicare Advantage Plans. Lives Managed: 70,000. Website: https://www.providencemedicareadvantage.com/

• Regence BlueCross BlueShield of Oregon - Headquarters: 100 SW Market St, Portland, OR 97201. Revenue: $7.5 billion (2020). Plans/LOBs: Regence BlueCross BlueShield of Oregon, Regence BlueShield (Washington), BridgeSpan Health Company. Lives Managed: 3.2 million. Website: https://www.regence.com/

• Scott and White Health Plan - Headquarters: 2401 South 31st St, Temple, TX 76508. Revenue: $2.5 billion (2020). Plans/LOBs: Scott and White Health Plan, Scott and White Care Plans. Lives Managed: 350,000. Website: https://www.sw.org/

• Superior HealthPlan - Headquarters: 5900 E Ben White Blvd, Suite 300, Austin, TX 78741. Revenue: $5.5 billion (2020). Plans/LOBs: Superior HealthPlan Medicaid, Superior HealthPlan STAR Kids, Superior HealthPlan Ambetter. Lives Managed: 1.4 million. Website: https://www.superiorhealthplan.com/

• Tufts Health Plan - Headquarters: 705 Mount Auburn Street, Watertown, MA 02472. Revenue: $6.6 billion (2020). Plans/LOBs: Tufts Health Plan, Tufts Health Public Plans, Network Health. Lives Managed: 1.2 million. Revenue: $6.6 billion (2020). Lives Managed: 1.2 million. Website: https://www.tuftshealthplan.com/

• UnitedHealth Group Inc - Headquarters: 9900 Bren Road East, Minnetonka, MN 55343. Revenue: $257.1 billion (2020). Plans/LOBs: UnitedHealthcare Medicare & Retirement, UnitedHealthcare Employer & Individual, UnitedHealthcare Community & State, UnitedHealthcare Global. Lives Managed: 50.5 million. Website: https://www.uhc.com/ . UnitedHealth Group. Headquarters: 9900 Bren Road East, Minnetonka, MN 55343. Revenue: $257.1 billion (2020). Plans/LOBs: UnitedHealthcare Employer & Individual, UnitedHealthcare Medicare & Retirement, UnitedHealthcare Community & State, OptumHealth. Lives Managed: 142 million. Website: https://www.unitedhealthgroup.com/ . OptumHealth - Parent Company: UnitedHealth Group - URL: www.optum.com  - Revenue: N/A - HQ: Eden Prairie, MN. AARP - Parent Company: UnitedHealth Group - URL: www.aarphealthcare.com  - Revenue: N/A - HQ: Washington, D.C

• WellCare Health Plans of Arizona - Headquarters: 2355 E. Camelback Road, Suite 300, Phoenix, AZ 85016. Revenue: $23.4 billion (2020). Plans/LOBs: WellCare Medicare Advantage, WellCare Medicaid, WellCare Marketplace. Lives Managed: 6.4 million. Website: https://www.wellcare.com/

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GHIT Digital ( https://ghit.digital/) is a domain focused, future ready, boutique IT Services & Digital Transformation firm. We are Minority and Women Owned (MWOB) small business from New Jersey, USA. Diversity, Inclusion, and Growth is our Mantra. Team GHIT works on strategic IT Projects for Government (G); HealthCare (H); Insurance (I); and Technology (T) clients, thus the brand GHIT. We are nimble, scalable and sell & deliver with Platform Partners & Delivery Partners. Our niche capabilities include Agile Project Management, Infrastructure Services, Data Services, Cloud native Data and Apps Implementation, Integration, Migration, Security & Optimization.

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