Health Net 2004 Annual Report Download - page 45

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2003 Health Plan Membership Compared to 2002 Health Plan Membership
Total health plan membership decreased 3% to approximately 3.8 million members at December 31, 2003 from approximately
4.0 million members at December 31, 2002.
Enrollment in our commercial health plans, including ASO members, decreased 3% at December 31, 2003 compared to the
same period in 2002. The decrease in commercial membership was primarily due to planned exits from unprofitable large employer
group accounts during 2003, in particular the planned loss of the California Public Employees’ Retirement System (“CalPERS”)
account effective January 1, 2003. The CalPERS account had more than 175,000 members. This loss was partially offset by a
membership increase in our small group and individual market as a result of sales efforts targeted at this portion of the market,
improved relationships with the distribution system, including insurance brokers and general agents, pricing consistently with the
market and health care cost trends and new and improved products.
Membership in our federal Medicare Risk program decreased 4% at December 31, 2003 compared to the same period in 2002,
primarily due to changes in benefit levels offered by us and planned withdrawal of participation and cancellation of the PPO/POS
plan in selected counties.
Membership in our state Medicaid programs decreased 3% at December 31, 2003 compared to the same period in 2002,
primarily due to the State of California’s efforts to disenroll Medi-Cal members no longer eligible for this program, with Los Angeles
County experiencing the majority of the decrease.
The table below summarizes our health plan membership information by program and by state at December 31, 2003 and 2002
and the change in membership by program and by state between 2003 and 2002.
Government Contracts Membership
Commercial
(including ASO members)
Medicare Risk
Medicaid
Health Plan Total
2003
2002
Change
2003
2002
Change
2003
2002
Change
2003
2002
Change
(Membershi
p
in thousands)
Arizona
119
119
—
36
39
(3)
—
—
155
158
(3)
Californi
a
1,673
1,760
(87)
99
102
(3)
702
721
(19)
2,474
2,583
(109)
Connecticut
311
361
(50)
27
29
(2)
98
105
(7)
436
495
(59)
New Jersey
313
302
11
—
—
45
48
(3)
358
350
8
New York
281
260
21
6
6
—
—
—
287
266
21
Oregon
120
79
41
—
—
—
—
120
79
41
Pennsylvania
4
38
(34)
—
—
—
—
—
—
4
38
(34)
Total
2,821
2,919
(98)
168
176
(8)
845
874
(29)
3,834
3,969
(135)
During 2004, we began the transition from our old TRICARE contracts to our new TRICARE contract for the North Region.
Our old TRICARE contracts were comprised of three contracts covering five regions:
•
Region 11, covering Washington, Oregon and part of Idaho
•
Region 6, covering Arkansas, Oklahoma, most of Texas, and most of Louisiana
The TRICARE contract for the North Region covers Connecticut, Delaware, Illinois, Indiana, Kentucky, Maine, Maryland,
Massachusetts, Michigan, New Hampshire, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Rhode Island, Vermont,
Virginia, West Virginia, Wisconsin and the District of Columbia. In addition, the contract covers a small portion of Tennessee,
Missouri and Iowa. Health care delivery began on the new North Region contract on July 1, 2004 for the area that was previously
TRICARE Regions 2 and 5 (now
42
•
Regions 9, 10 and 12, covering California, Hawaii, Alaska and part of Arizona