2019 Edition — California Health Insurers

Large insurers remain on top

Katherine Wilson, Wilson Analytics


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California Health Insurers: Large Insurers Remain on Top provides a snapshot of the insurance market in California at the end of 2017.

Data from the state’s two insurance regulators, the Department of Managed Health Care (DMHC) and the California Department of Insurance (CDI), and other sources were used to examine market share, enrollment, financial performance, and consumer satisfaction.

Key findings include:

  • California health insurance was a $183.7 billion business in 2017, up from $162.5 billion in 2015, a 13% increase. Six insurers accounted for more than two-thirds of the revenue.
  • In 2017, some large DMHC-regulated plans experienced flat revenue growth, which coincided with declines in commercial enrollment.
  • Most of the largest insurers, under both DMHC and CDI, were profitable in 2017.
  • Overall enrollment was relatively flat in 2016 and 2017. At year-end 2017, California’s insurers covered 14.1 million commercial enrollees and 13.2 million public managed care enrollees, of which 10.7 million had Medi-Cal. California insurers provided administrative services only to another 5.7 million enrollees in employers’ self-insured plans.
  • The ACA requires insurers to spend a minimum share of premium dollars on medical care or pay a rebate to consumers. In 2017, California insurers owed $97.4 million in premium rebates. Rebates averaged $106 per person and benefited nearly 920,000 Californians.

The full report, a quick reference guide, and all the charts found in the report are available for download below.

These materials are part of CHCF’s California Health Care Almanac, an online clearinghouse for key data and analyses describing the state’s health care landscape. See our entire collection of current and past editions of California Health Insurers and Enrollment.

Resources about the medical loss ratio are also available.