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HEALTH Market - Market Share


Key to Health Plan Terms and Acronyms


Largest Private Health Plans:
The total market consists of the total number of lives covered by insurance whether from private or public sources. In 2007, HMSA and Kaiser Permanente continued in their market positions as the largest private health plans in Hawai'i, with 68 percent and 20 percent of the private market, respectively.

Employment-Based Coverage: According to U.S. Census figures, of the people covered by private health plans in Hawai'i, 93 percent were covered through employment-based plans in 2004. This is up from 82 percent in 1990.1

Overlapping Coverage: One in eleven Hawai'i residents was covered by more than one health plan in 2007.

Government Programs: Overall, the number of covered lives in government sponsored plans has increased 29 percent since 1995, while the percent of individuals covered by private plans increased 2 percent. In total, government programs represented 36 percent of the covered lives in 2007.

Medicare, the federal government's coverage for the elderly, accounted for 35 percent of the government program covered lives in 2007; QUEST and Medicaid, state and federally-funded programs, represented 29 percent and 8 percent of government funded health plans respectively. TRICARE, the federal government's coverage for military-dependent and military retiree health care, accounted for 28 percent.

QUEST Plans: Current QUEST enrollment rates represent 10.6 percent of all covered lives. HMSA has the largest QUEST plan with 50 percent of all QUEST covered lives. AlohaCare is the second largest with 36 percent of all QUEST covered lives.

The decline in enrollment around the mid to late 1990s was primarily due to changes in eligibility requirements in 1996, including caps on the number of lives covered. HMSA's QUEST plan experienced a low enrollment of 26 percent of total QUEST covered lives in 2000, but has since regained its membership due to changes in the state's enrollment cap policies and the reduced number of participating plans.


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Source: Hawaii Management Alliance Association.; Hawaii Medical Service Association.; Kaiser Permanente.; MDX Hawaii.; University Health Alliance.
Note: Covered lives are the individuals "covered" by a health plan. "Other Plans" includes HMAA and UHA. "HMSA" includes HMSA and Health Plan Hawai'i. "Commercials" includes mainland carriers and Queens: Aetna, Cigna, Deseret Mutual, Longs, United, and Queens.
Source: AlohaCare.; Hawaii Medical Service Association.; Kaiser Permanente.; TriWest.; Hawai`i State Department of Human Services, MedQUEST Division.; Centers for Medicare and Medicaid Services.
Note: Covered lives are the individuals "covered" by a health plan. 2003 Medicare and Medicare (FFS) covered lives are assumed for 2004. Government coverage includes any plan funded by the government.
Source: AlohaCare.; Hawaii Medical Service Association.; Kaiser Permanente.; Hawai`i State Department of Human Services, MedQUEST Division.
Note: Covered lives are the individuals "covered" by a health plan. Prior to 2002, "Other" includes QUEST-eligible individuals covered by Queen's Hawai`I Care, Kapi`olani Health Hawai`I, and StraubCare Quanatum. These plans went out of existence in 2002, thus the decrease in "Other" and the increase in the other plans that absorbed QUEST-eligible individuals. From 2002 on, "Other" includes QUEST-eligible individuals who are not covered by any of the three existing insurers. Summerlin is a new Quest plan beginning in August 2007.
Source: AlohaCare.; Hawaii Management Alliance Association.; Hawaii Medical Service Association.; Kaiser Permanente.; MDX Hawaii.; University Health Alliance.; Hawai`i State Department of Human Services, MedQUEST Division.; Health Trends in Hawai`i, eds. 1-6.; Centers for Medicare and Medicaid Services.; U.S. Census Bureau.
Note: For government and private, the denominator represents the number of individuals "covered" by a health plan and includes the "overlap" population. For the uninsured, the denominator is the census population. Government coverage includes any plan funded by the government.