Four insurers snag 96% of sign-ups on Calif. exchange

Four insurance companies received 96% of enrollments through California's exchange during the first three months of operations.

Anthem Blue Cross of California captured the largest share of business, with 30.7% of enrollments, trailed closely by Blue Shield of California, which captured 29.2% of customers. Kaiser Permanente (19.3%) and Health Net (16.5%) were third and fourth.

Only Chinese Community Health Plan and L.A. Care Health Plan, among the other seven firms selling products through Covered California, captured at least 1% of enrollments.

Gerald Kominski, a health policy expert at the University of California Los Angeles, is not surprised by the initial breakdown of market share. The four companies with most of the enrollments were already major players in the individual marketplace, he said, and some of the smaller insures are selling only products in small segments of the state.

Enrollments in private plans through the California exchange topped 500,000 by the close of 2013. Among those signing up for coverage, 85% were eligible for subsidies. Roughly 125,000 more individuals signed up for coverage by Jan. 15, suggesting continued strong growth ahead of the close of the open enrollment period March 31. In addition, nearly 600,000 individuals enrolled in California's Medicaid program by the end of December.

Enrollments by Hispanics continued to lag well behind expectations. Less than 20% of individuals who signed up for coverage by the end of 2013 indicated that they are of Hispanic origin. That's despite estimates that such individuals comprise nearly half of California's uninsured population that's eligible for acquiring coverage through the exchange.

Peter Lee, executive director of Covered California, indicated that efforts to sign up more Hispanics will be a primary emphasis moving forward. “We have much work to do over the next three months to build on our outreach to this important population and help those who have applied complete the process,” Lee said in a statement.

Only 25% of individuals signing up for coverage in California were under age 35. That's roughly equivalent to the trend nationwide. Most experts believe that at least a third of signups will need to be under 35 to establish a balanced risk pool.

Kominski believes that concerns over the age breakdown have been overstated. “There's been an instant consensus that anything short of roughly 36 percent means that there aren't enough young people and therefore the premiums are going to skyrocket,” he said. “I don't share that perspective.”

Follow Paul Demko on Twitter: @MHpdemko