Centene’s health insurance marketplace business
In its 2019 Financial Guidance and Investor meeting presentation, Centene (CNC) highlighted its position as the national leader in the health insurance marketplace business with a presence in 16 states in the US. The company enrolled 1.5 million members in its health insurance marketplace plans at the end of fiscal 2018, a YoY rise of 52% or 500,000 members.
According to the investor presentation, the company has managed to penetrate its health insurance marketplace offerings in 70% of its markets. The company expects to attain a member retention rate close to 80% and an effectuation rate nearing 90% for plans in its health insurance marketplace business in fiscal 2019. According to the company’s fourth-quarter earnings conference call, Centene managed to enter three new exchange states as well as expand its offerings in six existing states in its Ambetter business in fiscal 2018.
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According to the company’s fourth-quarter earnings conference call, Centene managed to enroll 2 million members in its health insurance marketplace offerings in January 2019. This enrollment was spread across 20 states in the US and included a YoY rise of 250,000 Ambetter members and 80,000 Fidelis members. Ambetter accounts for almost 20% of the market share in the health insurance marketplace business.
According to the company’s fourth-quarter earnings conference call, despite the 3% fall in the market for the national health insurance marketplace business, Centene had managed to grow its market share for its Ambetter business by 15% as of the end of fiscal 2018.
According to its 2019 financial guidance and investor meeting presentation, Centene is focusing on low-income and subsidized members who are 250% below the federal poverty line to drive the growth of its Ambetter business. According to the company’s fourth-quarter earnings conference call, excluding members enrolled in Fidelis Care plans, almost 90% of Centene’s health insurance marketplace members are eligible for subsidies.
Centene has designed its health insurance marketplace products and healthcare benefits based on the needs of its target audience. The company has also developed a robust primary care network comprising of community providers and FQHCs (Federally Qualified Health Centers).