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Highmark Inc.'s health plan membership tops 5.2 million members

Highmark Inc.

PITTSBURGH (March 15, 2016) — Highmark Inc. today announced that its health plan membership tops 5.2 million members across all lines of business. Highmark remains the fourth-largest Blue Plan in the country, as well as the largest health plan in Pennsylvania, West Virginia and Delaware.

"Our health plan remains strong and stable despite the many challenges of the past year," said Deborah Rice-Johnson, president of Highmark Health Plan. "When employees are offered a choice among insurers, 8 out of 10 choose Highmark plans. In addition, our overall member retention rate of 95 percent across all markets is one of the highest retention rates in the industry."

Total membership
  • Western Pennsylvania: 3 million
  • Central Pennsylvania: 1.2 million
  • Northeastern Pennsylvania: 320,000
  • West Virginia: 290,000
  • Delaware: 440,000

"As these numbers demonstrate, our brand preference is tremendous," Rice-Johnson noted. "Members know that when they travel for family or work, they can access a national network of Blue providers at in-network benefit levels. Their Blue Card is accepted and they are protected no matter where in the country they find themselves, which is not a level of security every competitor in our market can offer."

Individual membership

Highmark has found that the ACA population is older, more chronically ill and using more health care services compared to commercial health plan members. In 2014 and 2015, the company paid more in claims than it collected in premiums. These challenges resulted in Highmark experiencing unsustainable losses of approximately $773 million in the first two years of the ACA.

"Highmark continues to take steps to bring sustainability to this market, but we cannot do it alone," Rice-Johnson added. "We have now achieved an appropriate level of ACA membership, and instituted an enhanced, comprehensive care management program to help our ACA members holistically manage their care. Still, we must all do our share to serve this population so that they can continue to get the care they need to address their health."

Highmark's current enrollment for individuals* who have purchased plans on the federal exchange and directly through Highmark totals approximately 195,000 members, with a region-by-region breakdown as follows:

  • Western Pennsylvania: 53,000 members
  • Central Pennsylvania: 35,000 members
  • Northeastern Pennsylvania: 35,000 members
  • West Virginia: 42,000 members
  • Delaware: 30,000 members

*These enrollment numbers represent members that have enrolled and paid for their first month of coverage. They are current as of February 25, 2016, but they may change. There is considerable turnover of ACA membership that we are closely monitoring.

About Highmark Inc.

Highmark Inc. is among the ten largest health insurers in the United States and is the fourth-largest Blue Cross and Blue Shield-affiliated company. Highmark and its diversified businesses and affiliates operate health insurance plans in Pennsylvania, Delaware and West Virginia that serve 5.2 million members. Its diversified health businesses serve group customer and individual health needs across the United States through dental insurance, vision care and other related health businesses. Highmark is an independent licensee of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield companies. For more information, visit

For more information, contact:
Wendy Morphew
Highmark Inc.