Alignment, Bright Health Group and other insurers with a strong presence in California all suffered from competitor SCAN Health Plan’s aggressive benefit design during the annual enrollment period, said Ari Gottlieb, principal at A2 Strategy Group. The for-profit player grew its Medicare Advantage enrollment 16.8% month-over-month to 258,028 enrollees and expanded outside of California to Arizona and Nevada this year. “SCAN has been a consistent player that has been a consistent presence in the market,” Gottlieb said. “They have new leadership that clearly has broad aspirations and ambitions, and has shown a willingness to be aggressive in executing them.”

Clover Health, likewise, grew its membership by 18% during the period to 80,238 members. According to the Bank of America report, more than 90% of new Clover members come from registrants who left UnitedHealth Group, Humana, and CVS. The Medicare Advantage-focused insurer’s enrollment growth “somewhat validates its benefit design (although it has yet to do so in a cost-effective manner),” the report said. The majority of the company’s enrollees are now concentrated in Georgia and New Jersey, two states with high COVID-19 rates that have resulted in higher-than-expected medical costs, Chairman Andrew said. Toys.

“For us, it just comes down to ‘how much capital do we need to ride out the potential waves of COVID? ‘ Toy said. “Until it becomes endemic, then the government will adjust the program, or hopefully knock on wood, that the vaccines put us in a good position after this wave.”

The company has focused on a wide-area network strategy and says its AI-powered technology platform ensures quality patient care at every provider it visits. The company pays doctors an average of $200 per visit to use its technology, and clinicians don’t need to be under contract with the insurtech to use its software. More than 60,000 suppliers are part of its network.

He said one reason insurers may have struggled to attract new members this year is because the price of listing on online brokerage sites like eHealth has gone up.

“The lead price and growth in this industry has increased a lot,” Toy said. “For any plan that relied heavily on those channels, I think that resulted in this tough year this year.”

But the company’s growth is likely due to aggressive benefit designs, Gottlieb said. He noted that smaller insurers such as Clever Care were also able to achieve exceptional growth during the annual membership period, but questioned the sustainability of their business. In the first three quarters of 2021, Clever Care, a Medicare Advantage plan specifically for Asian Americans, lost $12 million on fewer than 2,000 members, according to filings by the California Department of Managed Health Care. Gottlieb wondered if Clever Care and other plans would suffer the fate of Bright Health Group earlier this year – when Cigna stepped in to bail out the cash-poor startup with $550 million. At the time, analysts said Cigna’s investment in Bright signaled that the legacy insurer did not view the startup as a competitor.

“Health insurance is a big consumer of capital, and you have to be able to afford it,” Gottlieb said. “If the capital markets are effectively closed to you, what do you do and how do you reduce your thinking about the future? More rational behavior can, in some ways, benefit big players, who have the capital and the time to wait.”