While Aetna reported a 6.8 percent enrollment gain in 2009, the rest reported losses, from WellPoint's 3.9 percent loss to UnitedHealth's 6.5 percent loss. Even Aetna reported a membership loss in the fourth quarter, while losses for losses for Wellpoint, UnitedHealth and Cigna slowed down in that quarter.
The companies blamed membership losses primarily on high unemployment, which ripped into employer-sponsored products and is still an ongoing problem in 2010. The nation lost 8.4 million jobs in 2008-2009, and the U.S. Labor Department reports 20,000 more jobs were lost in January.
The following information comes from recent news reports, annual reports and transcripts of earnings conference calls from insurers, which are ranked by size.
1. WellPoint. Enrollment fell 3.9 percent last year to 33.7 million people, with small businesses showing the most significant drop. However, its enrollment fell by only one half of a percent in the final quarter of 2009 and the company ended the year with about 100,000 more enrollees than analysts had expected. And even as it showed a net loss of members, WellPoint gained more than 400,000 new members in 2009.
Learn more about WellPoint.
2. UnitedHealth Group. Commercial enrollment fell 6.5 percent to 24.6 million in 2009, but Medicare and Medicaid enrollment rose 12.5 percent to just under 7.4 million. Job cuts accounted for more than half of the commercial enrollment loss, but the loss slowed from the third to the fourth quarters. "Attrition continues to run at a high level and will be a concern all year in this economy," said CEO Stephen J. Hemsley.
Learn more about UnitedHealth Group.
3. Aetna. While it was the only major insurer to see 2009 enrollment increase — by 6.8 percent to 18.9 million — Aetna reported a fourth quarter decline of 113,000 enrollees. This year, the company expects to lose about 350,000 members due to the recession and price increases. "Entering 2010, a weak economy and high unemployment levels remain challenging," said Chairman and CEO Ronald A. Williams.
Learn more about Aetna.
4. Cigna. Membership fell by 5.5 percent to 11 million in 2009, but enrollment fell less than 1 percent from the third to fourth quarters of last year. Premium revenue fell 3 percent for 2009, with declining enrollment partially offset by rate increases. In 2010, Cigna expects anywhere from a 1 percent loss to a 2 percent gain in enrollment.
Learn more about Cigna.
5. Humana: Commercial membership fell by 6 percent to just over 3.4 million in 2009, while its Medicare Advantage enrollment grew by 28 percent. Membership in individual commercial plans grew by 13 percent in 2009 to 367,000 and more commercial members migrated into high-deductible health plans.
Learn more about Humana.