| Managed Care On-Line: Information Exchange |
MCOL has identified three significant premium competition tends, by comparing plan rates from several purchasing pools. MCOL maintains a database of a number of Purchasing Pool premium rates in Managed Care On-LineÔ . MCOL examined this data for California HMOs from three major purchasing pools: the Federal Employees, Cal-Pers, and the Health Insurance Plan of California (using the HIPC age 40-49 rates for their preferred plan in the CA Bay Area).
The following trends are of note:
- The least expensive plan in each pool widened the gap between its rate, and the pool average in 1997
- There is some consistency from 1996 to 1997 in which plans are least expensive in more than one pool
- The least expensive plan decreased in premium much more than the average for each pool from 96 to 97
Summary and then detail tables from the MCOL study follow.
| Least Expensive Plan % of Average Premium | 1996 | 1997 |
| FEHBP CA Single Premium | 86.3% | 82.7% |
| FEHBP CA Family Premium | 87.8% | 78.4% |
| Cal Pers Single Premium | 89.2% | 87.8% |
| Cal Pers Family Premium | 90.2% | 88.4% |
| HIPC Single Premium | 87.7% | 79.4% |
| HIPC Family Premium | 89.1% | 86.2% |
| Plans in Top 5 in at least Two Pools: 1996 | Plans in Top 5 in at least Two Pools: 1997 |
| Kaiser North (All Three) | Kaiser North (Pers, HIPC) |
| HealthNet (Pers, HIPC) | HealthNet (Pers, HIPC) |
| Maxicare (FEHBP, Pers) | Maxicare (FEHBP, Pers) |
| National HMO (FEHBP, Pers) | MetraHealth (FEHBP, HIPC) |
| Blue Shield (FEHBP, HIPC) |
| Single Premium Rates | 1996 |
1997 |
% Change |
| Least Expensive Plan Rates | |||
| FEHBP CA | $134.51 |
$126.27 |
-6.1% |
| Cal Pers | $146.00 |
$144.95 |
-0.7% |
| HIPC Area 3 Preferred Age 40-49 | $116.75 |
$115.36 |
-1.2% |
| Average Rates | |||
| FEHBP CA | $155.91 |
$152.60 |
-2.1% |
| Cal Pers | $163.67 |
$165.13 |
0.9% |
| HIPC Area 3 Preferred Age 40-49 | $133.06 |
$145.27 |
9.2% |
FEHBP 1996 |
Premium |
% Average |
FEHBP 1997 |
Premium |
% Average |
Five Least Expensive Single Plans |
|||||
California Care |
$134.51 |
86.3% |
MetraHealth (United Healthcare) |
$126.27 |
82.7% |
MetLife HMO |
$137.63 |
88.3% |
Care America HMO |
$132.80 |
87.0% |
Care America HMO |
$143.11 |
91.8% |
United Health Plan HMO |
$135.87 |
89.0% |
National Health Plan HMO |
$146.36 |
93.9% |
PacifiCare HMO |
$138.80 |
91.0% |
PacifiCare HMO |
$148.55 |
95.3% |
Maxicare |
$140.14 |
91.8% |
CA FEHBP Average |
$155.91 |
100.0% |
CA FEHBP Average |
$152.60 |
100.0% |
Five Least Expensive Family Plans |
|||||
California Care |
$343.14 |
87.8% |
United Health Plan HMO |
$294.17 |
78.4% |
National Health Plan HMO |
$363.33 |
92.9% |
MetraHealth (United Healthcare) |
$351.67 |
93.8% |
United Health Plan HMO |
$368.62 |
94.3% |
Maxicare |
$354.68 |
94.6% |
Maxicare |
$376.11 |
96.2% |
PacifiCare HMO |
$359.28 |
95.8% |
Kaiser Permanente HMO North |
$377.43 |
96.5% |
Blue Shield HMO |
$359.52 |
95.9% |
CA FEHBP Average |
$391.03 |
100.0% |
CA FEHBP Average |
$375.05 |
100.0% |
Cal Pers 1996 |
Premium |
% Average |
Cal Pers 1997 |
Premium |
% Average |
Five Least Expensive Single Plans |
|||||
National Health Plan HMO |
$146.00 |
89.2% |
Kaiser Permanente HMO North |
$144.95 |
87.8% |
Kaiser Permanente HMO North |
$147.67 |
90.2% |
National Health Plan HMO |
$146.00 |
88.4% |
HealthNet HMO |
$148.00 |
90.4% |
Kaiser Permanente South |
$147.73 |
89.5% |
Maxicare |
$150.00 |
91.6% |
HealthNet HMO |
$148.00 |
89.6% |
CA Correctional Peace Officers |
$151.00 |
92.3% |
Maxicare |
$150.00 |
90.8% |
Cal Pers Average |
$163.67 |
100.0% |
Cal Pers Average |
$165.13 |
100.0% |
Five Least Expensive Family Plans |
|||||
CA Correctional Peace Officers |
$379.00 |
90.2% |
Kaiser Permanente HMO North |
$376.87 |
88.4% |
National Health Plan HMO |
$379.60 |
90.3% |
National Health Plan HMO |
$379.60 |
89.0% |
Kaiser Permanente HMO North |
$383.94 |
91.4% |
Kaiser Permanente South |
$384.10 |
90.0% |
HealthNet HMO |
$384.80 |
91.6% |
HealthNet HMO |
$384.80 |
90.2% |
Maxicare |
$390.00 |
92.8% |
Maxicare |
$390.00 |
91.4% |
Cal Pers Average |
$420.18 |
100.0% |
Cal Pers Average |
$426.55 |
100.0% |
HIPC Area 3 Preferred Age 40-49 1996 |
Premium |
% Average |
HIPC Area 3 Preferred Age 40-49 1997 |
Premium |
% Average |
Five Least Expensive Single Plans |
|||||
Chinese Community Health Plan |
$116.75 |
87.7% |
Kaiser Permanente HMO North |
$115.36 |
79.4% |
Kaiser Permanente HMO North |
$117.01 |
87.9% |
Chinese Community Health Plan |
$122.50 |
84.3% |
Contra Costa Health Plan HMO |
$127.00 |
95.4% |
Contra Costa Health Plan HMO |
$127.00 |
87.4% |
Blue Shield HMO |
$130.46 |
98.0% |
MetraHealth (United Healthcare) |
$132.80 |
91.4% |
Aetna HMO |
$131.36 |
98.7% |
Blue Shield HMO |
$135.68 |
93.4% |
HIPC Area 3 Preferred Age 40-49 Avg |
$133.06 |
100.0% |
HIPC Area 3 Preferred Age 40-49 Avg |
$145.27 |
100.0% |
Five Least Expensive Family Plans |
|||||
Chinese Community Health Plan |
$372.93 |
89.1% |
Chinese Community Health Plan |
$381.50 |
86.2% |
Kaiser Permanente HMO North |
$381.88 |
91.3% |
Kaiser Permanente HMO North |
$344.25 |
77.8% |
HealthNet HMO |
$389.27 |
93.0% |
HealthNet HMO |
$421.00 |
95.1% |
Blue Shield HMO |
$405.37 |
96.9% |
MetraHealth (United Healthcare) |
$412.91 |
93.3% |
Lifeguard HMO |
$406.00 |
97.0% |
Lifeguard HMO |
$421.58 |
95.3% |
HIPC Area 3 Preferred Age 40-49 Avg |
$418.35 |
100.0% |
HIPC Area 3 Preferred Age 40-49 Avg |
$442.55 |
100.0% |
This file has been provided for
MCOL subscribers only.