United States General Accounting Office

GAO Report to the Ranking Minority Member,

Subcommittee on Health, Committee on

Ways and Means, House of

Representatives

August 1995 MEDIGAP

INSURANCE

Insurers’ Compliance

With Federal Minimum

Loss Ratio Standards,

1988-93

GAO/HEHS-95-151

GAO United States

General Accounting Office

Washington, D.C. 20548

Health, Education, and

Human Services Division

B-257438 

August 23, 1995

The Honorable Fortney H. (Pete) Stark

Ranking Minority Member

Subcommittee on Health

Committee on Ways and Means

House of Representatives

Dear Mr. Stark:

The value that Medicare beneficiaries receive from the dollars they spend

on private insurance policies that supplement Medicare (commonly called

Medigap policies) has been an issue of long-standing interest to the

Congress. In 1980, the Congress amended the Social Security Act to

establish a number of consumer protections for Medigap purchasers.

These protections included a requirement that a certain portion of

premiums be returned to policyholders in the form of benefits (called a

loss ratio). The current requirement is that individual Medigap policies

actually achieve a loss ratio of at least 65 percent and that group policies

achieve a loss ratio of at least 75 percent. For policies that fall short of this

standard, the company must refund or credit policyholders in order to

meet the loss ratio requirement; however, for policies that were in effect

when the refunds and credits requirement was enacted, no refunds or

credits will be required until 1997.

In December 1988, you asked us to monitor benefit payments by Medicare

supplemental insurance policies over the 1988 through 1994 period. This is

our fourth report in response to your request.1

Our objectives in developing the current report were to (1) identify trends

in insurers’ aggregate loss ratio performance by comparing and analyzing

1992 and 1993 loss ratio data with that previously reported for 1988

through 1991 and (2) review Medigap insurers’ loss ratio performance by

policy form, which is what consumers purchase, and identify insurers

whose loss ratios were below federal standards during 1992 and 1993.

The information in this report was developed from computer databases

obtained from the National Association of Insurance Commissioners

1

Our previous reports were Medigap Insurance: Better Consumer Protection Should Result From 1990

Changes to Baucus Amendment (GAO/HRD-91-49, Mar. 5, 1991), Medigap Insurance: Insurers Whose

Loss Ratios Did Not Meet Federal Minimum Standards in 1988-89 (GAO/HRD-92-54, Feb. 28, 1992), and

Medigap Insurance: Insurers’ Compliance With Federal Minimum Loss Ratio Standards, 1988-91

(GAO/HEHS-94-47, Feb. 7, 1994).

Page 1 GAO/HEHS-95-151 Medigap Insurance
B-257438 

(NAIC). NAIC created the databases from the annual Medigap experience

exhibits that insurance companies are required to file with state insurance

departments. For each year, we randomly tested the accuracy of the

database by comparing the information on the annual experience exhibit

with the data recorded on the database. Our verification showed that NAIC

accurately created the computerized databases except for minor errors,

none of which affected our analysis. We did not check the accuracy of the

individual exhibits submitted by over 300 companies reporting Medigap

loss ratio information. NAIC also did not verify the accuracy of the exhibits.

This review was conducted from May 1994 to May 1995 in accordance with

generally accepted government auditing standards, except as noted above.

Results in Brief The Medigap market grew steadily over the 1988-93 period, from $7.3

billion to $12.1 billion. Medigap insurers’ aggregate loss ratios were

relatively stable during the first 4 years of that period. Over the next 2

years, however, these ratios decreased about 10 percentage points, to an

aggregate 75 percent for individual policies and 85 percent for group

policies. In 1991, 19 percent of Medigap policies failed to meet loss ratio

standards; this increased to 38 percent by 1993. The premium dollars spent

on such policies increased from $320 million in 1991 to $1.2 billion in 1993.

If insurers had been required to give refunds or credits on substandard

policies, as they will in the future, policyholders would have been due

about $125 million over 1992 and 1993. (See app. II for a list of individual

policies and app. III for a list of group policies that did not meet the

standard.)

Background In 1980 the Congress amended the Social Security Act to establish federal

standards for marketing and selling Medigap insurance. This amendment,2

commonly known as the Baucus amendment, incorporated into federal

law a number of consumer protections. These protections included a

requirement that Medigap policies be expected to have loss ratios of at

least 60 percent for individual policies and at least 75 percent for group

policies. If an insurer’s actuarial estimate was that a policy could be

expected to meet the standard, the insurer was considered to have

complied with the requirement regardless of whether its actual loss ratio

ever met the standard.

The Omnibus Budget Reconciliation Act of 1990 (OBRA 1990, P.L. 101-508,

Nov. 5, 1990) raised the minimum loss ratio standard that individual

2

Contained in section 507(a), Public Law 96-265, June 9, 1980.

Page 2 GAO/HEHS-95-151 Medigap Insurance
B-257438 

policies must meet to 65 percent, effective for policies sold or issued after

November 5, 1991. In addition, OBRA 1990 (1) required companies,

beginning in 1991, to report loss ratio data by policy form rather than in

the aggregate for all policies; (2) required refunds or credits to

policyholders when any policy fails to meet the applicable loss ratio

standard, beginning in 1994; and (3) provided for NAIC to develop standards

for simplifying and standardizing Medigap policies. Provisions of the

Social Security Act Amendments of 1994 (P.L. 103-432, Oct. 31, 1994)

extended the OBRA 1990 requirements for a 65 percent loss ratio and

refunds or credits to policyholders for policies issued before November 6,

1991.

NAIC developed 10 standardized Medigap plans that were included in the

July 1991 revision to its model act and regulation. All states and territories

except American Samoa and Guam adopted the NAIC model. The states did

not have to adopt all 10 standardized plans developed by NAIC, and six

states adopted fewer than 10 plans.3

When interpreting loss ratios, two important factors to consider are policy

maturity and credibility. Policy maturity refers to the length of time a

policy has been in force. Before OBRA 1990, the NAIC loss ratio regulation

applied the minimum standards to policies that had been in force for 3

years or more. OBRA 1990 provided for policies sold or issued after

November 5, 1991, to meet the standards after they had been in force for 2

years. The Social Security Act Amendments of 1994 provided for policies

to meet the standards after they had been in force for 12 months. In

March 1995, NAIC adopted a revised model regulation to incorporate the

Social Security Act Amendments of 1994, and the states have 1 year from

then to adopt this revised model in order to maintain compliance with

federal Medigap standards.

Credibility refers to the number of persons covered by a policy. The

standard we used, based on the opinion of a state actuary who has studied

the issue for NAIC, is that a loss ratio is credible if it is based on a number

of policyholders sufficient to generate at least $150,000 in premiums

within a state.

3

Pennsylvania and Vermont adopted 7; Delaware adopted 6; and Minnesota, Wisconsin, and

Massachusetts had alternative simplification programs in effect when OBRA 1990 was enacted and

have a waiver from the standardized policy requirement.

Page 3 GAO/HEHS-95-151 Medigap Insurance
B-257438 

Insurers’ Aggregate

Loss Ratio

Performance, 1988-93

The Medigap market has grown steadily from $7.3 billion in premiums

earned in 1988 to $12.1 billion in 1993. Most of the Medigap insurance

market is comprised of individual policies (see fig. 1).

Figure 1: The Medigap Market

(1988-93) Dollars in Billions

0

2

4

6

8

10

12

1988 1989 1990 1991 1992 1993

Year

Group Policies

Individual Policies

In 1992, a total of 347 insurance companies reported4 premiums earned on

Medigap policies; in 1993 this number decreased to 325 companies. Almost

70 percent of the premiums for Medigap policies are collected by 25

companies. The Prudential Insurance Company of America is the largest

insurer, accounting for about 23 percent of the premiums earned. (See

app. I for the 25 largest Medigap insurance companies in 1993.)

Medigap insurers’ aggregate loss ratios5

 performance shows signs of

deterioration. From 1988 to 1991, the performance of Medigap insurers

4

Annually, insurers report loss ratio data to state insurance commissioners and NAIC.

5

Aggregate loss ratios are the sum of benefits paid under all outstanding policies divided by the sum of

premiums.

Page 4 GAO/HEHS-95-151 Medigap Insurance
B-257438 

with mature and credible business6 generally improved. While the

aggregate loss ratios were relatively stable over the entire period, more

insurers met the aggregate loss ratio standards in 1991 than 1988.

However, since 1991, companies’ aggregate loss ratios have decreased and

fewer companies with mature and credible business met the minimum loss

ratio standards (see table 1).

Table 1: Aggregate Loss Ratios and

Percent of Medigap Insurers Whose

Loss Ratios Met the Minimum

Standards (1988-93) Aggregate loss ratios

Medigap insurers

Year

Individual

policies

percent

Group

policies

percent Total

Aggregate

loss ratios

met

minimum

standardsa Percent

1988 86 96 190 84 44

1989 82 82 208 117 56

1990 84 91 217 143 66

1991b 86 93 216 154 71

1992b 81 89 217 150 69

1993b 75 85 205 121 59

aInsurer’s aggregate loss ratio by state met minimum standards in every state it did business.

bFrom 1991 through 1993, companies were required to report loss ratio information by policy

form. For this analysis we aggregated the 1991-93 premiums and claims to make the loss ratio

information consistent with data reported in 1988 through 1990.

Loss Ratio Data

Reported by Policy

Form

Beginning with reports covering 1991 business, insurers have reported loss

ratio information by policy form within a state rather than reporting only

statewide aggregate experience. From 1991 through 1993, the number of

Medigap policy forms grew by almost 45 percent, from about 20,000 policy

forms to about 29,000 in 1993. Because new policies are offered each year

and many other policies are low-volume; only about 10 percent of the

forms in each year are mature policies with credible experience. However,

these mature and credible policies account for over 60 percent of the total

premiums earned (see table 2).

6

For purposes of this report, a mature policy is at least 3 years old. Credible premium experience is

when at least $150,000 is collected annually on a policy within a state.

Page 5 GAO/HEHS-95-151 Medigap Insurance
B-257438 

Table 2: Total Medigap Policy Forms

and Forms With Mature and Credible

Experience (1991-93) 

1991 1992 1993

Total policy forms 20,275 25,589 28,906

Number of mature and credible policy forms 2,011 2,513 2,755

Premiums earned on mature and credible policy

forms (in millions) $6,955 $7,684 $7,548

Percentage of total premiums earned on mature

and credible policy forms 63 65 62

The remainder of this report discusses only those policy forms with

mature and credible experience.

Since 1991, average loss ratios have declined for both group and individual

policy forms; that is, the portion of premiums earned devoted to

policyholder benefits has declined between 1991 and 1993. In 1991 the

average loss ratio was 86 percent for individual policy forms and

93 percent for group policy forms, but in 1993 these had decreased to

75 percent for individual and 85 percent for group policy forms (see fig. 2).

Figure 2: Loss Ratios on Mature Policy

Forms With Credible Experience

(1991-93)

Loss Ratio Percent

75.0

80.0

85.0

90.0

95.0

100.0

1991 1992 1993

Year

Individual Policies

Group Policies

Page 6 GAO/HEHS-95-151 Medigap Insurance
B-257438 

A Declining Portion of

Policy Forms Met the

Minimum Loss Ratio

Standard From 1991 to

1993

In 1992 and 1993, most policy forms met the minimum loss ratio standards;

however, compared with 1991, the percentage of forms meeting the

standards decreased, from 81 percent in 1991 to 74 percent in 1992 and

62 percent in 1993. Also, the premiums earned for policy forms whose loss

ratio met the standards declined as a percentage of all premiums earned,

from 95 percent in 1991 to 92 percent in 1992 and 84 percent in 1993 (see

table 3).

Table 3: Medigap Policy Forms’ Compliance With Minimum Loss Ratio Standards (1991-93) 

Medigap policy forms Premiums earned

1991 1992 1993 1991 1992 1993

Met the minimum standards 81% 74% 62% 95% 92% 84%

Did not meet the minimum standards 19% 26% 38% 5% 8% 16%

Number of policy forms 2,011 2,513 2,755

Premiums earned (in millions) $6,955 $7,684 $7,548

Page 7 GAO/HEHS-95-151 Medigap Insurance
B-257438 

Premiums earned on policy forms that failed to meet the standards

increased from $320 million in 1991 to $1.2 billion in 1993 (see fig. 3).

Figure 3: Premiums for Policy Forms

Whose Loss Ratios Were Below

Minimum Standards (1991-93)

Dollars in Millions

0

200

400

600

800

1000

1200

1991 1992 1993

Year

Individual Policies

Group Policies

About one-third of the 1,498 policy forms whose loss ratios were below the

minimum standard sometime during the period 1991 to 1993 did not meet

the standard in multiple years. The loss ratios of 89 policy forms were

below the minimum standard in all 3 years and the companies selling these

policies collected over $260 million in premiums for the 3-year period.

(See app. II for a list of individual policies and app. III for a list of group

policies that did not meet the standard.)

The Social Security Act Amendments of 1994 revised the refunds or credits

requirement of OBRA 1990, effectively extending the requirement to policies

issued before November 6, 1991. Refunds or credits on these policies will

begin in 1997. If these policies had been subject to the refunds or credits

requirement in 1992 and 1993, we estimate that policyholders would have

been entitled to about $125 million in premium refunds or credits.

Page 8 GAO/HEHS-95-151 Medigap Insurance
B-257438 

If you have any questions about this report, please call me at

(202) 512-7119. Other major contributors to this report are listed in

appendix IV.

Sincerely yours,

Sarah F. Jaggar

Director, Health Financing

 and Policy Issues

Page 9 GAO/HEHS-95-151 Medigap Insurance
Contents

Letter 1

Appendix I 

Twenty-Five Largest

Medigap Insurers

(1993)

12

Appendix II 

Medigap Insurers With

Mature and Credible

Loss Ratio Experience

Below the Minimum

Standard for

Individual Policies

(1991-93)

14

Appendix III 

Medigap Insurers With

Mature and Credible

Loss Ratio Experience

Below the Minimum

Standard for Group

Policies (1991-93)

84

Appendix IV 

Major Contributors to

This Report

102

Tables Table 1: Aggregate Loss Ratios and Percent of Medigap Insurers

Whose Loss Ratios Met the Minimum Standards

5

Table 2: Total Medigap Policy Forms and Forms With Mature and

Credible Experience

6

Page 10 GAO/HEHS-95-151 Medigap Insurance
Contents

Table 3: Medigap Policy Forms’ Compliance with Minimum Loss

Ratio Standards

7

Figures Figure 1: The Medigap Market 4

Figure 2: Loss Ratios on Mature Policy Forms with Credible

Experience

6

Figure 3: Premiums for Policy Forms Whose Loss Ratios Were

Below Minimum Standards

8

Abbreviations

NAIC National Association of Insurance Commissioners

OBRA 1990 Omnibus Budget Reconciliation Act of 1990

Page 11 GAO/HEHS-95-151 Medigap Insurance
Appendix I 

Twenty-Five Largest Medigap Insurers

(1993)

Company Premiums earned

Prudential Insurance Company of America $2,786,220,433

Empire Blue Cross & Blue Shield 561,453,880

Bankers Life and Casualty Company 533,544,328

United American Insurance Company 525,901,185

Blue Cross & Blue Shield of Massachusetts 457,428,417

Medical Service Association of Pennsylvania-Pennsylvania

Blue Shield 378,640,285

Blue Cross/Blue Shield of Florida 286,043,303

Health Care Service Corporation 223,636,002

Pioneer Life Insurance Company of Illinois 196,232,655

Blue Cross & Blue Shield of Virginia 193,814,697

Mutual of Omaha Insurance Company 188,402,560

Blue Cross & Blue Shield of New Jersey, Incorporated 183,718,000

Associated Insurance Companies, Incorporated 182,827,024

Blue Cross & Blue Shield of Connecticut, Incorporated 179,047,046

IASD Health Services Corporation 174,318,972

Physicians Mutual Insurance Company 159,656,177

Blue Cross & Blue Shield of Alabama 157,297,455

Standard Life & Accident Insurance Company 155,617,661

Blue Cross & Blue Shield of Michigan 146,491,903

Blue Cross & Blue Shield of Tennessee 137,829,113

State Farm Mutual Automobile Insurance Company 136,980,165

Independence Blue Cross 123,644,635

Blue Cross of Western Pennsylvania 120,472,734

Blue Cross & Blue Shield of Kansas, Incorporated 120,401,000

American Family Life Assurance Company of Columbus,

Georgia 111,201,564

Total $8,420,821,194

Page 12 GAO/HEHS-95-151 Medigap Insurance
Page 13 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1991

Company Policy number Premiums Claims Loss ratio

Alabama

Associated Doctors H & L Ins. Co. 380 $484,065 $273,673 56.5

Atlantic American Life Ins. Co. 2083 • • •

Bankers Life & Casualty Co. GR-75R 700,779 371,626 53.0

First National Life Ins. Co. 9600 • • •

Monumental Life Ins. Co. MS3000PGM • • •

Mutual of Omaha Ins. Co. M2 a 299,502 172,072 57.5

C23M and others x x x

United American Ins. Co. MC3 • • •

Alaska

Blue Cross of WA & AK 701-10538 • • •

Arizona

Amer. Family Life Assurance Co. of Columbus,

GA

A-19000 • • •

Bankers Life & Casualty Co. GR-75R x x x

GR-A002 • • •

Colonial Penn Life Ins. Co. 4-82-595 • • •

Continental General Ins. Co. 323 • • •

Equitable Life & Casualty Ins. Co. 700 x x x

Medico Life Ins. Co. 489 • • •

Mutual of Omaha Ins. Co. 15CMO and others 203,719 120,700 59.2

M115 and others • • •

M4 and others x x x

C23M and others x x x

M2 and others x x x

National Foundation Life Ins. Co. MS-7 • • •

National Home Life Assurance Co. GS 1 • • •

Physicians Mutual Ins. Co. P394/R620 x x x

P197 • • •

Pioneer Life Ins. Co. of Illinois 9279 • • •

9161 • • •

Standard Life & Accident Ins. Co. 1231 • • •

1238 • • •

Union Fidelity Life Ins. Co. of Trevose 1053 261,445 145,028 55.5

United American Ins. Co. MAXC+ x x x

MMS x x x

MAXC x x x

Page 14 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1992 1993

o Premiums Claims Loss ratio Premiums Claims Loss ratio

5 $310,281 $181,855 58.6 x x x

• x x x $235,684 $131,908 56.0

0 x x x 611,058 344,298 56.3

• • • • 1,060,807 16,562 1.6

• • • • 206,263 113,620 55.1

5 x x x x x x

x x x x 178,811 102,048 57.1

• x x x 468,561 257,919 55.0

• • • • 168,850 78,448 46.5

• 258,123 141,171 54.7 428,946 253,327 59.1

x 3,352,105 1,896,541 56.6 3,135,336 1,635,637 52.2

• 327,750 177,352 54.1 662,027 303,705 45.9

• x x x 361,557 178,171 49.3

• 207,583 102,146 49.2 376,100 204,504 54.4

x x x x 306,294 179,639 58.6

• x x x 513,260 277,682 54.1

2 186,071 109,418 58.8 167,375 92,362 55.2

• 248,081 103,058 41.5 x x x

x 380,264 161,641 42.5 301,537 168,332 55.8

x x x x 181,663 102,199 56.3

x x x x 400,713 192,034 47.9

• • • • 545,320 323,531 59.3

• 375,627 209,456 55.8 274,115 122,109 44.5

x x x x 178,592 99,999 56.0

• x x x 895,344 501,230 56.0

• • • • 282,712 145,420 51.4

• x x x 570,295 323,119 56.7

• • • • 250,981 132,768 52.9

• • • • 192,383 113,630 59.1

5 216,380 71,710 33.1 • • •

x 1,538,721 910,658 59.2 x x x

x 2,013,872 1,157,034 57.5 1,607,671 880,177 54.7

x x x x 1,277,783 672,218 52.6

(continued)

Page 15 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1991

Company Policy number Premiums Claims Loss ratio

MC3 • • •

Arkansas

Bankers Life & Casualty Co. GR-73S x x x

GR-75R x x x

Monumental Life Ins. Co. MS3000PGM • • •

Mutual of Omaha Ins. Co. M6 and others 187,873 92,795 49.4

Pioneer Life Ins. Co. of Illinois 9279 • • •

9161 • • •

Providential Life Ins. Co. 189 • • •

Pyramid Life Ins. Co. H-94 223,327 105,031 47.0

G-10 239,305 132,488 55.4

H-91 181,081 65,727 36.3

Statesman National Life Ins. Co. P-193, P-222b 324,486 23,376 7.2

MED484 185,038 98,520 53.2

United American Ins. Co. MC1 • • •

MAXC x x x

MVXC x x x

MMS x x x

MAXC+ x x x

California

American Integrity Ins. Co. MS-85 294,930 171,854 58.3

Anthem Life Ins. Co. 40071 684,891 405,202 59.2

Blue Cross of CA 512/518 • • •

442 1,229,000 734,000 59.7

Central States H & L Co. of Omaha 286 • • •

Certified Life Ins. Co. CER-72M x x x

CER-A002 • • •

CER-72M/1051 x x x

Colonial Penn Life Ins. Co. 4-82-595 • • •

3-82-855 x x x

Federal Home Life Ins. Co. NAC 9901 • • •

NAC 9900 x x x

Medico Life Ins. Co. 489 • • •

488 x x x

487 x x x

Mutual of Omaha Ins. Co. 50/51/52VB 1,503,636 806,109 53.6

M1/M65 and others 447,369 148,497 33.2

2CMO and others 1,007,225 415,897 41.3

Page 16 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1992 1993

o Premiums Claims Loss ratio Premiums Claims Loss ratio

• 707,166 360,055 50.9 1,027,496 526,524 51.2

x x x x 203,663 110,900 54.5

x x x x 1,323,973 733,300 55.4

• • • • 183,807 103,878 56.5

4 177,362 77,749 43.8 164,364 78,069 47.5

• • • • 181,627 107,133 59.0

• x x x 412,907 168,798 40.9

• 1,460,068 852,784 58.4 3,272,251 1,875,732 57.3

0 194,757 110,283 56.6 199,018 92,260 46.4

4 208,451 120,726 57.9 228,271 123,355 54.0

3 • • • • • •

2 • • • • • •

2 161,433 95,507 59.2 • • •

• • • • 186,452 105,858 56.8

x 283,684 151,890 53.5 x x x

x x x x 154,704 84,772 54.8

x x x x 714,099 401,634 56.2

x 275,599 163,284 59.2 x x x

3 • • • • • •

2 • • • • • •

• 373,000 178,000 47.7 • • •

7 x x x • • •

• 285,025 158,850 55.7 232,051 110,130 47.5

x 1,088,610 546,345 50.2 x x x

• 1,022,326 496,659 48.6 2,300,198 1,341,826 58.3

x x x x 460,231 257,610 56.0

• x x x 522,851 269,140 51.5

x x x x 1,060,838 556,169 52.4

• 991,677 516,306 52.1 1,411,972 636,574 45.1

x x x x 2,817,511 1,606,988 57.0

• 538,111 231,097 42.9 603,968 215,475 35.7

x 922,839 519,454 56.3 509,658 200,526 39.3

x 690,652 376,399 54.5 431,513 228,013 52.8

6 1,259,337 568,980 45.2 x x x

2 343,479 175,889 51.2 x x x

3 x x x 671,864 351,299 52.3

(continued)

Page 17 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1991

Company Policy number Premiums Claims Loss ratio

MSE x x x

15CMO and others x x x

C17M and others x x x

M3/M67 and others 354,926 177,627 50.0

M115 and others • • •

National Foundation Life Ins. Co. MS3-89-P • • •

MMS-84 • • •

MS-7 • • •

National Home Life Assurance Co. NH 121 • • •

GS 1 and GSH-1 1,301,958 618,135 47.5

Physicians Mutual Ins. Co. P398/R633 • • •

Pioneer Life Ins. Co. of Illinois 9176 • • •

9061 x x x

9161 x x x

9279 • • •

9055 x x x

Standard Life & Accident Ins. Co. 1225 • • •

1230 • • •

1218 • • •

1226 • • •

1233 • • •

1221 • • •

1238 • • •

State Farm Mutual Automobile Ins. Co. 97046 x x x

Statesman National Life Ins. Co. P-305 172,587 93,369 54.1

Union Fidelity Life Ins. Co. of Trevose 8550 817,208 446,295 54.6

1053 x x x

United American Ins. Co. MAXC+ x x x

MMS x x x

MBXC x x x

MC2 • • •

MAXC x x x

Colorado

Aid Association for Lutherans BMS/BMN • • •

American Republic Ins. Co. A-3041 • • •

A-2721 • • •

Amer. Family Life Assurance Co. of Columbus,

GA

A-19000 • • •

Page 18 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1992 1993

o Premiums Claims Loss ratio Premiums Claims Loss ratio

x x x x 381,538 156,167 40.9

x 1,482,779 794,539 53.6 x x x

x x x x 364,299 175,138 48.1

0 286,800 146,929 51.2 227,900 125,668 55.1

• 654,713 384,125 58.7 x x x

• • • • 695,912 328,264 47.2

• • • • 226,667 132,199 58.3

• • • • 271,810 128,189 47.2

• x x x 1,398,240 757,134 54.1

5 1,402,079 789,894 56.3 973,621 476,251 48.9

• • • • 190,821 80,412 42.1

• x x x 388,652 212,135 54.6

x x x x 2,317,435 1,299,829 56.1

x x x x 8,545,780 5,079,712 59.4

• • • • 2,283,881 1,216,920 53.3

x 190,143 104,270 54.8 165,353 98,697 59.7

• • • • 208,289 81,013 38.9

• • • • 417,210 218,386 52.3

• • • • 377,032 124,911 33.1

• • • • 232,908 118,020 50.7

• 1,745,140 1,016,547 58.3 1,317,525 765,651 58.1

• • • • 261,280 84,860 32.5

• • • • 3,418,242 1,921,471 56.2

x x x x 2,769,609 1,637,682 59.1

• • • • • •

6 x x x • • •

x 1,413,719 805,273 57.0 275,309 161,942 58.8

x 12,621,693 7,325,245 58.0 10,669,189 5,867,441 55.0

x 20,781,341 11,708,741 56.3 16,153,974 8,480,748 52.5

x x x x 1,271,635 755,748 59.4

• 465,183 265,409 57.1 x x x

x 15,261,129 8,952,880 58.7 12,683,483 7,206,743 56.8

• • • • 289,920 168,385 58.1

• • • • 164,305 77,212 47.0

• 190,162 101,155 53.2 319,275 188,457 59.0

• x x x 566,745 335,617 59.2

(continued)

Page 19 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1991

Company Policy number Premiums Claims Loss ratio

Bankers Life & Casualty Co. GR-A002 • • •

GR-75R x x x

Central States H & L Co. of Omaha 286 x x x

Continental General Ins. Co. 323 • • •

Equitable Life & Casualty Ins. Co. 880 • • •

Hartford Life Ins. Co. SRP-1261 • • •

Mutual of Omaha Ins. Co. 50/51/52VB 240,633 136,832 56.9

M3 and others x x x

15CMO and others 270,555 124,674 46.1

M2 and others 774,432 457,993 59.1

M1b 159,350 80,264 50.4

C23M/C24Mb 221,355 113,910 51.5

M115 and others • • •

M4 and others x x x

National Foundation Life Ins. Co. MS-7 • • •

New York Life Ins. Co. 8145 x x x

Physicians Mutual Ins. Co. P115 • • •

Pioneer Life Ins. Co. of Illinois 9279 • • •

9061 x x x

Standard Life & Accident Ins. Co. 1231 • • •

1238 • • •

State Farm Mutual Automobile Ins. Co. 97043 x x x

Teton National Ins. Co./Atlantic and Pacific

Insurance Companya

HOM505/505-1 • • •

HOM502/502-1 x x x

HOM500/501 x x x

Union Fidelity Life Ins. Co. of Trevose 1053 174,814 88,559 50.7

United American Ins. Co. MC3 • • •

MAXC 404,411 217,296 53.7

MAXC+ x x x

Western Farm Bureau Life Ins. Co. HIP02 x x x

Connecticut

Mutual of Omaha Ins. Co. M43 and others x x x

Delaware

Blue Cross & Blue Shield of DE, Inc. SECURE-65 PLUS • • •

Mutual of Omaha Ins. Co. M142 and others • • •

District of Columbia

National Home Life Assurance Co. NH1380 150,397 63,650 42.3

Page 20 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1992 1993

o Premiums Claims Loss ratio Premiums Claims Loss ratio

• 160,606 71,328 44.4 532,281 265,095 49.8

x 2,450,476 1,458,301 59.5 2,311,844 1,257,429 54.4

x 203,129 111,797 55.0 175,222 78,123 44.6

• • • • 233,441 90,261 38.7

• x x x 2,935,650 1,705,725 58.1

• 884,315 490,212 55.4 • • •

9 x x x 198,900 101,073 50.8

x 176,152 102,581 58.2 155,460 76,538 49.2

x x x 176,794 97,470 55.1

x x x 661,080 363,616 55.0

4 • • • • • •

5 x x x 186,690 59,873 32.1

• 318,657 141,853 44.5 537,683 282,640 52.6

x x x x 461,606 195,550 42.4

• • • • 254,032 152,074 59.9

x 207,859 120,339 57.9 221,235 124,240 56.2

• 176,121 95,103 54.0 199,440 115,211 57.8

• • • • 212,085 95,369 45.0

x x x x 1,013,687 549,757 54.2

• • • • 540,943 274,905 50.8

• • • • 791,561 465,362 58.8

x x x x 333,306 197,876 59.4

• x x x 212,365 123,150 58.0

x 694,170 414,412 59.7 594,873 334,439 56.2

x x x x 311,064 179,549 57.7

7 • • • • • •

• 308,584 161,005 52.2 x x x

7 x x x x x x

x 596,483 287,719 48.2 x x x

x 239,127 124,752 52.2 x x x

x x x x 157,325 69,090 43.9

• 694,096 394,471 56.8 • • •

• x x x 252,588 128,550 50.9

3 • • • • • •

(continued)

Page 21 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1991

Company Policy number Premiums Claims Loss ratio

Florida

Amer. Family Life Assurance Co. of Columbus,

GA

A-19000 • • •

A-19800 188,028 108,198 57.5

Atlantic American Life Ins. Co. 2083 • • •

Central States H & L Co. of Omaha 533 236,798 129,774 54.8

Colonial Penn Life Ins. Co. 3-82-855 x x x

4-82-595 • • •

Commonwealth Life Ins. Co. 1100 • • •

Continental General Ins. Co. 324 • • •

333 • • •

Golden Rule Ins. Co. GRI-H-11/GRI-H-12 • • •

Hartford Life Ins. Co. SRP-1265 • • •

Life Insurance Co. of GA 6610 724,915 409,341 56.5

Mutual of Omaha Ins. Co. M3a 203,958 109,913 53.9

2CMO and others • • •

M4 and others x x x

M1 and others 330,365 167,792 50.8

M122 and others • • •

50/51/52VB x x x

15CMO and others x x x

National Foundation Life Ins. Co. MS4-89-P • • •

MS3-89-P • • •

National Home Life Assurance Co. GS 5 • • •

NH 122 • • •

Pioneer Life Ins. Co. of Illinois 9055 x x x

State Farm Mutual Automobile Ins. Co. 97049 • • •

Union Bankers Ins. Co. 76M x x x

MS-2 • • •

United American Ins. Co. MMS x x x

MAXC+ x x x

MC2 • • •

MVXC x x x

United General Life Ins. Co. 261 x x x

Georgia

American General Life & Accident Ins. Co. 6001 M-1 • • •

Amer. Family Life Assurance Co. of Columbus,

GA

A-19700 x x x

Page 22 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1992 1993

o Premiums Claims Loss ratio Premiums Claims Loss ratio

• 369,864 213,962 57.8 x x x

5 x x x x x x

• 768,362 384,517 50.0 570,164 239,713 42.0

8 317,625 181,043 57.0 x x x

x x x x 2,741,514 1,629,075 59.4

• x x x 4,837,602 2,899,152 59.9

• • • • 379,597 209,395 55.2

• • • • 387,744 208,470 53.8

• • • • 162,209 86,808 53.5

• • • • 159,403 93,816 58.9

• • • • 182,718 55,656 30.5

5 1,080,893 555,987 51.4 1,102,800 655,781 59.5

9 x x x • • •

• 750,276 362,870 48.4 641,831 313,861 48.9

x 721,548 367,975 51.0 x x x

8 303,343 149,564 49.3 x x x

• 589,075 220,670 37.5 x x x

x 1,085,678 635,096 58.5 x x x

x 454,354 225,352 49.6 x x x

• • • • 266,513 158,548 59.5

• • • • 353,975 173,114 48.9

• x x x 218,883 93,353 42.6

• x x x 815,604 471,164 57.8

x x x x 325,235 178,634 54.9

• • • • 258,492 151,608 58.7

x 164,741 78,447 47.6 • • •

• • • • 324,800 165,538 51.0

x x x x 11,424,273 6,659,580 58.3

x 7,594,286 4,466,875 58.8 x x x

• 356,215 196,405 55.1 503,900 247,109 49.0

x x x x 429,983 241,026 56.1

x x x x 666,391 398,813 59.8

• x x x 957,676 561,384 58.6

x 170,154 93,497 54.9 • • •

(continued)

Page 23 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1991

Company Policy number Premiums Claims Loss ratio

A-19000 • • •

Atlantic American Life Ins. Co. 5083 • • •

4083 • • •

2083 x x x

Bankers Life and Casualty Co. GR-A002 • • •

Capital Security Life 466MS • • •

Colonial Penn Life Ins. Co. 4-82-595 • • •

Gulf Life Ins. Co. 737 L&C x x x

Life Insurance Co. of Georgia 6613 • • •

6612 x x x

Mutual of Omaha Ins. Co. 50/51/52VB x x x

15CMO and others x x x

M4 and others x x x

M143 and others • • •

M2 and others 585,291 333,798 57.0

M1/M7 and others 234,613 116,144 49.5

Mutual Protective Ins. Co. 489 • • •

National Financial Ins. Co. GL65 309,340 140,546 45.4

National Foundation Life Ins. Co. MS100 x x x

MS-7 • • •

New York Life Ins. Co. 8145 267,787 130,462 48.7

Professional Ins. Corp. MS81 • • •

Union Bankers Ins. Co. 86M • • •

MS-2 • • •

United American Ins. Co. MC1 • • •

MCCAT • • •

MC3 • • •

MMS x x x

MAXC+ x x x

MAXC x x x

MVXC 187,831 107,017 57.0

Hawaii

Bankers Life & Casualty Co. GR-75R 327,531 136,929 41.8

Hartford Life Ins. Co. SRP-1261 • • •

SRP-7218 • • •

Idaho

Bankers Life & Casualty Co. GR-A002 • • •

GR-75R x x x

Page 24 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1992 1993

o Premiums Claims Loss ratio Premiums Claims Loss ratio

• 1,538,519 828,871 53.9 x x x

• • • • 345,756 202,783 58.6

• 256,377 129,880 50.7 282,077 165,391 58.6

x 856,703 505,109 59.0 671,583 349,566 52.1

• • • • 947,903 531,667 56.1

• x x x 326,410 168,571 51.6

• x x x 1,724,649 907,189 52.6

x 161,363 90,990 56.4 x x x

• • • • 195,586 86,410 44.2

x x x x 605,344 350,761 57.9

x x x x 505,395 288,721 57.1

x 217,025 91,710 42.3 x x x

x 307,265 163,428 53.2 x x x

• 156,881 92,168 58.8 x x x

0 x x x 543,496 287,690 52.9

5 x x x 167,382 65,397 39.1

• • • • 379,764 218,238 57.5

4 188,941 80,443 42.6 • • •

x 319,790 164,932 51.6 277,425 142,440 51.3

• • • • 580,157 212,951 36.7

7 • • • 271,993 151,767 55.8

• • • • 158,347 64,379 40.7

• 170,445 102,103 59.9 x x x

• • • • 152,598 86,916 57.0

• 171,705 87,806 51.1 380,576 217,710 57.2

• x x x 1,409,279 792,779 56.3

• x x x 2,109,715 1,200,771 56.9

x 6,427,164 3,769,567 58.7 6,024,535 3,072,626 51.0

x x x x 1,761,987 887,491 50.4

x x x x 2,313,665 1,234,479 53.4

0 x x x x x x

8 289,575 117,348 40.5 246,777 87,534 35.5

• 160,380 69,102 43.1 • • •

• 170,836 72,556 42.5 • • •

• 336,070 160,914 47.9 817,042 370,136 45.3

x 3,978,160 2,287,682 57.5 3,549,263 1,724,269 48.6

(continued)

Page 25 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1991

Company Policy number Premiums Claims Loss ratio

GR-73S x x x

Central States H & L Co. of Omaha 286 x x x

Federal Home Life Ins. Co. NAC 9930 x x x

NAC 9942 • • •

Guarantee Trust Life Ins. Co. 85420 x x x

Hartford Life Ins. Co. SRP-1261 • • •

Pioneer Life Ins. Co. of Illinois 9279 • • •

State Farm Mutual Automobile Ins. Co. 97046 • • •

97033 x x x

Union Bankers Ins. Co. 86M 273,864 161,659 59.0

United American Ins. Co. MAXC 156,882 84,412 53.8

MMS x x x

MAXC+ 239,942 136,887 57.1

Illinois

Aid Association for Lutherans 4952 THRU 4956 • • •

American Republic Ins. Co. A-2777 x x x

A-2721 x x x

A-3041 • • •

Amer. Family Life Assurance Co. of Columbus,

GA

A-19800 x x x

A-19000 • • •

Bankers Life & Casualty Co. GR-A002 • • •

GR-75R x x x

P1-67720 • • •

GR-73S x x x

CR-93T 464,689 272,503 58.6

P1-56566 • • •

Central States H & L Co. of Omaha 286 233,923 119,567 51.1

Colonial Penn Life Ins. Co. 4-82-595 • • •

3-82-855 x x x

Continental Casualty Co. P1-56566 256,037 142,183 55.5

Continental General Ins. Co. 323 • • •

Golden Rule Ins. Co. GRI-H-2 x x x

CL-H-2/GR-H-2 x x x

Guarantee Trust Life Ins. Co. 85420 x x x

89420 • • •

Health Care Service Corp. CB 41.2 x x x

CB 41.4 x x x

Page 26 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1992 1993

o Premiums Claims Loss ratio Premiums Claims Loss ratio

x x x x 313,067 165,607 52.9

x x x x 154,837 83,433 53.9

x x x x 324,852 162,668 50.1

• 223,539 128,950 57.7 • • •

x 154,849 73,308 47.3 • • •

• 150,464 85,160 56.6 • • •

• • • • 279,986 164,898 58.9

• • • • 177,194 101,573 57.3

x 260,291 141,971 54.5 250,269 130,749 52.2

0 x x x x x x

8 • • • • • •

x x x x 210,174 108,486 51.6

x x x 192,215 75,331 39.2

• • • • 152,744 79,384 52.0

x 247,602 137,455 55.5 x x x

x x x x 2,471,491 1,479,064 59.8

• • • • 333,536 195,994 58.8

x 429,311 239,457 55.8 363,760 208,483 57.3

• x x x 1,469,960 846,969 57.6

• 1,871,435 996,910 53.3 3,829,772 2,169,664 56.7

x x x x 10,393,371 5,674,055 54.6

• x x x 1,786,086 979,664 54.8

x 2,178,171 1,279,951 58.8 x x x

6 x x x 432,843 250,685 57.9

• 771,872 448,214 58.1 847,140 437,088 51.6

x x x 155,336 62,551 40.3

• x x x 2,521,082 1,300,576 51.6

x x x x 262,919 110,255 41.9

5 • • • • • •

• 423,939 235,028 55.4 561,611 269,360 48.0

x 460,601 275,356 59.8 461,006 263,505 57.2

x x x x 516,141 248,909 48.2

x x x x 396,310 205,875 51.9

• x x x 263,008 138,325 52.6

x 8,883,407 4,577,505 51.5 x x x

x 9,309,070 4,816,515 51.7 x x x

(continued)

Page 27 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1991

Company Policy number Premiums Claims Loss ratio

CB 41.3 x x x

Mutual of Omaha Ins. Co. 2CMO and others • • •

M2 and others x x x

M115 and others • • •

M3 and others x x x

50/51/52VB 850,177 487,335 57.3

15CMO and others x x x

M1 and others 657,342 389,005 59.2

M154 and others • • •

MD18 and others x x x

2/3/30/31CMOb 746,819 397,150 53.2

MSE x x x

MD50 and others x x x

National Casualty Co. 4029 x x x

4006 188,271 95,769 50.9

5000 x x x

National Foundation Life Ins. Co. MS-7 • • •

National Home Life Assurance Co. GS 1 and GSH-1 535,567 308,727 57.6

National States Ins. Co. CMS • • •

New York Life Ins. Co. 8145 491,238 284,456 57.9

Physicians Mutual Ins. Co. P115 • • •

P197 x x x

Pioneer Life Ins. Co. of Illinois 9055 x x x

8940 x x x

8901 x x x

8916 x x x

9161 x x x

9279 • • •

Standard Life & Accident Ins. Co. 1235 • • •

1219 • • •

Union Bankers Ins. Co. MS-2 • • •

86M x x x

Union Fidelity Life Ins. Co. of Trevose 8350 568,095 318,548 56.1

1053 520,740 307,821 59.1

8550 315,964 184,660 58.4

United American Ins. Co. MVXC 205,239 114,884 56.0

MAXC 4,120,392 2,456,830 59.6

MMS x x x

Page 28 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1992 1993

o Premiums Claims Loss ratio Premiums Claims Loss ratio

x 4,742,276 2,692,450 56.8 x x x

• x x x 611,800 355,917 58.2

x 1,867,201 1,076,132 57.6 x x x

• 1,085,666 573,432 52.8 x x x

x 506,526 280,382 55.4 x x x

3 768,986 434,445 56.5 655,905 372,427 56.8

x 788,056 324,641 41.2 664,746 345,512 52.0

2 575,050 274,186 47.7 x x x

• • • • 264,927 114,194 43.1

x • • • 150,835 57,472 38.1

2 • • • • • •

x 210,483 97,626 46.4 191,287 66,471 34.7

x 160,004 94,524 59.1 • • •

x 184,259 106,920 58.0 • • •

9 164,341 66,331 40.4 • • •

x 158,311 68,574 43.3 • • •

• • • • 1,543,416 569,551 36.9

6 514,698 305,252 59.3 359,782 159,527 44.3

• • • • 236,004 131,550 55.7

9 512,304 282,416 55.1 x x x

• x x x 190,041 109,616 57.7

x x x x 1,073,146 641,724 59.8

x x x x 352,145 182,501 51.8

x x x x 892,900 524,522 58.7

x 171,913 73,576 42.8 164,633 97,211 59.0

x x x x 640,426 351,745 54.9

x x x x 4,913,630 2,917,760 59.4

• • • • 1,021,970 556,039 54.4

• • • • 1,646,649 937,077 56.9

• • • • 473,033 266,081 56.2

• • • • 347,492 167,887 48.3

x x x x 608,347 351,424 57.8

504,602 285,302 56.5 • • •

476,162 271,479 57.0 • • •

4 279,459 165,187 59.1 • • •

0 x x x x x x

6 x x x x x x

x 4,424,387 2,645,939 59.8 3,851,078 2,160,475 56.1

(continued)

Page 29 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1991

Company Policy number Premiums Claims Loss ratio

DMXC-U 569,189 313,209 55.0

World Ins. Co. A2480 x x x

A2485 x x x

Indiana

American Republic Ins. Co. A-2930 • • •

A-2721 x x x

Amer. Family Life Assurance Co. of Columbus,

GA

A-19800 x x x

A-19000 • • •

Associated Doctors H & L Ins. Co. 350 301,911 176,751 58.5

380 208,411 113,596 54.5

Associated Ins. Co., Inc. 65-013 • • •

Atlantic American Life Ins. Co. 2083 x x x

Bankers Life & Casualty Co. GR-75R x x x

Colonial Penn Life Ins. Co. 4-82-595 • • •

Combined Ins. Co. of America 8081 200,762 118,442 59.0

7902 • • •

Commonwealth Life Ins. Co. 500 and 801 • • •

Continental General Ins. Co. 323 • • •

First National Life Ins. Co. 9000 • • •

Globe Life & Accident Ins. Co. MCP-3 217,243 127,375 58.6

Great Fidelity Life Ins. Co. 7340 & 6135b 373,993 201,788 54.0

Harvest Life Ins. Co. MSP-7/83 • • •

MSP-1/89 • • •

Integrity National Life Ins. Co. H-722-0389 • • •

Mutual of Omaha Ins. Co. M115 and others • • •

M1 and others 213,356 119,738 56.1

M3 and others x x x

50/51/52VB x x x

2CMO and others x x x

National Home Life Assurance Co. NH1380 997,486 569,524 57.1

NH 121 • • •

New York Life Ins. Co. 8145 x x x

Physicians Mutual Ins. Co. P197 • • •

P397/R633 • • •

Standard Life & Accident Ins. Co. 1222 • • •

1208 • • •

Union Bankers Ins. Co. 86M 864,002 489,758 56.7

Page 30 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1992 1993

o Premiums Claims Loss ratio Premiums Claims Loss ratio

0 x x x x x x

x 269,952 123,945 45.9 x x x

x 185,652 88,542 47.7 x x x

• • • • 174,737 91,237 52.2

x 208,718 122,170 58.5 219,448 130,073 59.3

x 444,158 264,061 59.5 383,013 203,985 53.3

• 646,933 379,946 58.7 1,100,837 631,050 57.3

5 x x x x x x

5 • • • • • •

• • • • 3,339,159 1,722,780 51.6

x x x x 888,982 433,044 48.7

x x x x 11,193,595 6,468,672 57.8

• • • • 325,724 181,948 55.9

0 362,291 186,559 51.5 487,017 283,264 58.2

• 165,979 84,394 50.8 x x x

• x x x 983,355 483,246 49.1

• 211,957 115,636 54.6 176,396 78,375 44.4

• 903,010 412,045 45.6 • • •

6 x x x x x x

0 • • • • • •

• 160,785 91,214 56.7 • • •

• x x x 794,569 402,081 50.6

• • • • 523,754 286,064 54.6

• 672,051 332,772 49.5 1,035,489 428,220 41.4

184,691 106,861 57.9 x x x

x x x x 282,459 152,102 53.8

x 302,787 163,368 54.0 x x x

x 159,324 86,270 54.1 • • •

• • • • • •

• • • • 220,362 96,949 44.0

x 227,669 110,869 48.7 198,696 76,935 38.7

• x x x 620,230 351,058 56.6

• • • • 178,220 94,352 52.9

• • • • 435,682 193,416 44.4

• 305,960 170,378 55.7 x x x

7 x x x 1,142,364 669,938 58.6

(continued)

Page 31 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1991

Company Policy number Premiums Claims Loss ratio

MS-2 • • •

Union Fidelity Life Ins. Co. of Trevose 8550 373,827 222,781 59.6

1053 437,819 175,049 40.0

1042 251,478 125,867 50.1

8541 309,408 153,858 49.7

United American Ins. Co. MC2 • • •

United Farm Bureau Family Life Ins. Co. 1 338,892 201,666 59.5

Iowa

American Family Mutual Ins. Co. H-65 • • •

American Republic Ins. Co. A-2777 x x x

A-2721 x x x

A-3041 • • •

American Travellers Life Ins. Co. ATL-CAT-89 • • •

Amer. Family Life Assurance Co. of Columbus,

GA

A-19000 • • •

A-19800 248,890 125,048 50.2

Bankers Life & Casualty Co. GR-75R 13,039,374 7,728,393 59.3

GR-A020 • • •

GR-A002 • • •

Colonial Penn Franklin Ins. Co. 10-82-530 • • •

Colonial Penn Life Ins. Co. 4-82-595 • • •

Continental General Ins. Co. 323 • • •

Federal Home Life Ins. Co. NAC 9987 • • •

NAC 9980 x x x

Hartford Life Ins. Co. SRP-1261 • • •

Medico Life Ins. Co. 489 POLICY AND R • • •

Monumental Life Ins. Co. MS3000PGM • • •

Mutual of Omaha Ins. Co. 15CMO and others 290,704 171,741 59.1

M1 and others 325,129 159,137 48.9

M52 and others x x x

C23M and others x x x

50/51/52VB 237,947 103,566 43.5

2CMO and others 189,888 87,909 46.3

M3/M51 and others 423,879 224,596 53.0

M115 and others • • •

Mutual Protective Ins. Co. 489 POLICY AND R • • •

National Foundation Life Ins. Co. MS100 150,828 75,146 49.8

New York Life Ins. Co. 8145 413,318 178,471 43.2

Page 32 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1992 1993

o Premiums Claims Loss ratio Premiums Claims Loss ratio

• x x x 1,453,590 859,158 59.1

6 320,664 162,689 50.7 • • •

0 x x x • • •

204,792 113,118 55.2 • • •

7 x x x • • •

• • • • 172,115 94,635 55.0

5 x x x • • •

• 228,803 119,042 52.0 x x x

x 174,354 94,072 54.0 179,300 86,373 48.2

x 1,662,393 947,776 57.0 2,110,394 1,197,230 56.7

• • • • 360,451 183,076 50.8

• • • • 196,742 101,874 51.8

• 320,870 180,818 56.4 460,701 247,199 53.7

2 x x x 201,631 105,902 52.5

3 13,173,117 7,649,736 58.1 11,513,980 6,412,902 55.7

• • • • 550,564 316,715 57.5

• 2,689,379 1,476,768 54.9 5,236,626 2,764,652 52.8

• • • • 288,373 2,582 0.9

• • • • 323,501 151,873 46.9

• 489,166 255,033 52.1 451,211 161,381 35.8

• • • • 249,298 101,740 40.8

x 545,675 319,161 58.5 x x x

• 188,180 112,634 59.9 • • •

• 248,677 139,497 56.1 x x x

• • • • 227,830 119,001 52.2

246,768 102,004 41.3 204,984 74,217 36.2

9 283,942 141,559 49.9 249,965 131,753 52.7

x x x x 996,170 552,538 55.5

x 154,317 91,124 59.0 • • •

5 212,185 86,409 40.7 192,382 90,243 46.9

3 170,286 71,625 42.1 160,977 75,766 47.1

0 x x x 294,563 136,647 46.4

• 405,344 157,463 38.8 513,099 250,603 48.8

• 308,347 174,364 56.5 • • •

8 • • • • • •

2 403,612 205,392 50.9 376,197 177,899 47.3

(continued)

Page 33 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1991

Company Policy number Premiums Claims Loss ratio

Physicians Mutual Ins. Co. P197 473,987 283,080 59.7

P397/R633 • • •

Pioneer Life Ins. Co. of Illinois 9161 • • •

9279 • • •

Standard Life & Accident Ins. Co. 1208 • • •

Union Bankers Ins. Co. MS-2 • • •

Union Fidelity Life Ins. Co. of Trevose 1053 164,953 62,276 37.8

8550 154,599 89,087 57.6

United American Ins. Co. MC3 • • •

MMS 973,512 527,862 54.2

MAXC 583,270 291,106 49.9

MAXC+ x x x

World Ins. Co. A2485 165,413 98,120 59.3

Kansas

American Republic Ins. Co. A-2721 x x x

Amer. Family Life Assurance Co. of Columbus,

GA

A-19000 • • •

Continental General Ins. Co. 323 • • •

Federal Home Life Ins. Co. NAC 9987 • • •

NAC 9981 x x x

Mutual of Omaha Ins. Co. M115 and others • • •

M4/M86 and others 410,629 191,741 46.7

M2/M84 and others x x x

50/51/52VB 202,138 107,117 53.0

Mutual Protective Ins. Co. 489 • • •

Pioneer Life Ins. Co. of Illinois 9061 x x x

9161 • • •

United American Ins. Co. MAXC 645,517 318,045 49.3

MMS 1,324,645 736,074 55.6

MAXC+ 653,791 338,934 51.8

MC3 • • •

Kentucky

American Republic Ins. Co. A-2721 150,285 89,319 59.4

American Travellers Life Ins. Co. ATL-CAT-89 • • •

Associated Doctors H & L Ins. Co. 380 441,154 235,313 53.3

Atlantic American Life Ins. Co. 2083 x x x

Bankers Life & Casualty Co. GR-75R x x x

GR-A002 • • •

Page 34 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1992 1993

o Premiums Claims Loss ratio Premiums Claims Loss ratio

7 1,055,194 623,745 59.1 1,414,921 845,826 59.8

• • • • 261,631 144,534 55.2

• x x x 952,638 528,118 55.4

• • • • 382,498 203,651 53.2

• • • • 191,381 105,812 55.3

• • • • 522,262 279,523 53.5

8 • • • • • •

6 • • • • • •

• x x x 253,465 143,571 56.6

2 806,868 438,941 54.4 666,948 317,124 47.5

9 x x x 412,678 198,889 48.2

x 805,777 451,200 56.0 x x x

3 • • • • • •

x x x x 508,172 292,990 57.7

• • • • 239,587 134,484 56.1

• 263,245 130,782 49.7 292,807 124,724 42.6

• 236,021 97,952 41.5 523,181 196,223 37.5

x 1,897,143 924,751 48.7 1,705,870 809,890 47.5

• 173,210 80,312 46.4 245,567 117,913 48.0

7 383,020 215,349 56.2 341,915 158,109 46.2

x 433,785 248,847 57.4 x x x

0 189,336 107,236 56.6 158,804 89,878 56.6

• 156,311 80,613 51.6 259,149 123,553 47.7

x x x x 400,104 228,172 57.0

• x x x 547,353 307,535 56.2

3 592,299 348,231 58.8 544,905 314,325 57.7

6 x x x 1,125,813 567,846 50.4

8 586,064 338,849 57.8 490,287 249,505 50.9

• 393,602 221,472 56.3 x x x

4 185,919 104,204 56.0 210,299 115,224 54.8

• • • • 455,665 265,513 58.3

3 283,592 159,900 56.4 x x x

x 353,866 187,251 52.9 289,094 163,311 56.5

x 1,918,680 1,090,326 56.8 1,835,699 1,001,122 54.5

• 171,830 100,518 58.5 388,324 218,949 56.4

(continued)

Page 35 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1991

Company Policy number Premiums Claims Loss ratio

Central States H & L Co. of Omaha 286 x x x

Community Mutual Ins. Co. PD010 • • •

Monumental Life Ins. Co. MS3000PGM • • •

Mutual of Omaha Ins. Co. M2 and others 554,743 240,487 43.4

M115 and others • • •

M4,HM17b 256,237 152,727 59.6

C23M and others x x x

National Financial Ins. Co. GL65-4 188,433 94,747 50.3

National States Ins. Co. CMS • • •

Physicians Mutual Ins. Co. P192 316,421 167,014 52.8

Pioneer Life Ins. Co. of Illinois 9161 x x x

9061 x x x

9279 • • •

Pyramid Life Ins. Co. H-94 260,886 134,256 51.5

Standard Life & Accident Ins. Co. 1231 • • •

1222 • • •

Union Bankers Ins. Co. MS-2 • • •

United American Ins. Co. MAXC x x x

MVXC x x x

MC1 • • •

MAXC+ x x x

MMS x x x

MC3 • • •

MCCAT • • •

Louisiana

Amer. Family Life Assurance Co. of Columbus,

GA

A-19000 • • •

Atlantic American Life Ins. Co. MS2083 227,774 136,545 59.9

Bankers Life & Casualty Co. GR-A002 • • •

CR-93T 214,249 126,980 59.3

GR-75R x x x

Central States H & L Co. of Omaha 286 289,288 163,336 56.5

Combined Ins. Co. of America 7902 • • •

Continental General Ins. Co. 323 • • •

Equitable Life & Casualty Ins. Co. 990 • • •

Mutual of Omaha Ins. Co. 50/51/52VB 309,074 126,615 41.0

2/3CMO,20/22b 261,095 141,119 54.0

2CMO and others • • •

Page 36 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1992 1993

o Premiums Claims Loss ratio Premiums Claims Loss ratio

x x x x 158,544 82,810 52.2

• • • • 194,553 113,036 58.1

• x x x 398,645 221,024 55.4

4 x x x 449,433 208,239 46.3

• • • • 199,901 92,641 46.3

6 x x x 223,895 113,114 50.5

x 503,112 253,392 50.4 x x x

3 x x x • • •

• • • • 168,585 97,038 57.6

8 331,024 157,679 47.6 298,270 159,883 53.6

x x x x 3,484,449 2,059,321 59.1

x x x x 1,351,502 708,364 52.4

• • • • 682,278 330,789 48.5

5 232,003 109,536 47.2 185,790 108,445 58.4

• • • • 226,476 133,166 58.8

• • • • 342,820 175,371 51.2

• • • • 193,096 104,793 54.3

x x x x 827,749 435,287 52.6

x 170,518 100,911 59.2 • • •

• • • • 239,078 134,556 56.3

x x x x 803,767 429,445 53.4

x 685,189 360,279 52.6 x x x

• x x x 642,624 319,093 49.7

• • • • 160,997 92,974 57.7

• 409,362 198,880 48.6 x x x

9 • • • • • •

• 541,589 296,823 54.8 994,289 505,831 50.9

3 x x x x x x

x 3,403,339 1,960,910 57.6 3,143,106 1,653,146 52.6

5 290,272 136,376 47.0 262,691 139,934 53.3

• 152,705 90,488 59.3 • • •

• x x x 309,823 161,115 52.0

• • • • 216,659 115,938 53.5

0 269,673 138,300 51.3 244,080 135,395 55.5

0 • • • • • •

• x x x 209,301 85,394 40.8

(continued)

Page 37 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1991

Company Policy number Premiums Claims Loss ratio

M115 and others • • •

National Home Life Assurance Co. GS 1 x x x

NH 121 • • •

New York Life Ins. Co. 8145 778,662 379,298 48.7

Providential Life Ins. Co. 189 • • •

182 x x x

Statesman National Life Ins. Co. P305,P378,P373b 165,953 89,779 54.1

MED-484 x x x

P-376,P-376Rb 201,218 120,387 59.8

United American Ins. Co. MC3 • • •

MCCAT • • •

MC7 217,779 129,386 59.4

MMS x x x

MAXC x x x

Maine

American Travellers Life Ins. Co. WLH-54 305,611 174,285 57.0

Hartford Life Ins. Co. SRP-1261 • • •

United American Ins. Co. MAXC x x x

Maryland

American Integrity Ins. Co. MMS-84 158,789 57,662 36.3

Amer. Family Life Assurance Co. of Columbus,

GA

A-19000 • • •

Bankers Life & Casualty Co. GR-73S 186,281 86,209 46.3

Combined Ins. Co. of America 000014954 • • •

Hartford Life Ins. Co. SRP-1261 • • •

Monumental Life Ins. Co. MS3000PGM • • •

Mutual of Omaha Ins. Co. M2/M58 and others x x x

M130 and others • • •

2CMO and others • • •

M4/M60 and others x x x

C23M and others x x x

50/51/52VB 186,317 102,756 55.2

2/3/34/35CMOb 193,342 110,214 57.0

National Foundation Life Ins. Co. MS-7 • • •

Massachusetts

Blue Cross & Blue Shield of MA MXLO 555,085 302,426 54.5

Hartford Life Ins. Co. SRP-1261 • • •

Mutual of Omaha Ins. Co. M18 and others x x x

Page 38 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1992 1993

o Premiums Claims Loss ratio Premiums Claims Loss ratio

• x x x 677,673 341,185 50.3

x 151,401 86,229 57.0 • • •

• x x x 422,697 218,524 51.7

7 x x x x x x

• 716,019 402,946 56.3 1,868,555 995,079 53.3

x x x x 1,660,734 865,118 52.1

• • • • • •

x x x x 188,716 92,308 48.9

8 • • • • • •

• 543,582 283,646 52.2 746,361 425,814 57.1

• • • • 250,028 124,542 49.8

4 x x x x x x

x 1,513,972 838,965 55.4 1,359,649 775,243 57.0

x 600,389 351,277 58.5 577,893 284,806 49.3

0 x x x x x x

• 165,445 79,171 47.9 • • •

x 162,080 67,568 41.7 • • •

3 • • • • • •

• • • • 236,479 99,669 42.1

3 x x x • • •

• • • • 363,161 212,508 58.5

• 754,219 362,251 48.0 • • •

• x x x 817,691 466,760 57.1

x 258,350 152,504 59.0 x x x

• • • • 167,692 79,503 47.4

• 177,462 102,920 58.0 176,251 68,313 38.8

x x x x 261,446 81,044 31.0

x 154,263 87,164 56.5 • • •

2 x x x 167,332 85,731 51.2

0 • • • • • •

• • • • 282,167 73,709 26.1

5 • • • • • •

• 451,870 270,612 59.9 • • •

x 331,631 159,293 48.0 x x x

(continued)

Page 39 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1991

Company Policy number Premiums Claims Loss ratio

2/3/4/23/24CMOb 178,768 103,092 57.7

M17 and others 168,848 98,815 58.5

50/51/52VB x x x

C23M/C24Mb 155,585 92,912 59.7

2CMO and others • • •

National Home Life Assurance Co. NH 910 361,621 180,849 50.0

Michigan

Amer. Family Life Assurance Co. of Columbus,

GA

A-19000 • • •

Colonial Penn Life Ins. Co. 3-82-855 x x x

Continental General Ins. Co. 324 • • •

Golden Rule Ins. Co. GRI-H-2D x x x

Harvest Life Ins. Co. MSP-B-1/89 • • •

Mutual Protective Ins. Co. 489 • • •

National Home Life Assurance Co. NH 910 154,089 86,215 56.0

Pioneer Life Ins. Co. of Illinios 9161 • • •

9155 • • •

Statesman National Life Ins. Co. P-181R • • •

Union Fidelity Life Ins. Co. 1053 x x x

United American Ins. Co. MBXC x x x

Minnesota

Aid Association For Lutherans 4952 THRU 4956 • • •

American Republic Ins. Co. A-2721 x x x

A-2994 • • •

A-2941 • • •

Amer. Family Life Assurance Co. of Columbus,

GA

A-19700 x x x

A-19800 679,140 298,317 43.9

Bankers Life & Casualty Co. GR-75M x x x

GR-75R x x x

GR-A002 • • •

Central States H & L Co. of Omaha 567 • • •

289 x x x

288 x x x

Colonial Penn Life Ins. Co. 4-82-595 • • •

3-82-855 x x x

Continental General Ins. Co. 312 x x x

326 • • •

Page 40 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1992 1993

o Premiums Claims Loss ratio Premiums Claims Loss ratio

7 • • • • • •

5 174,997 87,819 50.2 160,583 87,782 54.7

x x x x 228,070 89,762 39.4

7 • • • • • •

• 174,473 71,727 41.1 x x x

0 • • • • • •

• x x x 326,746 191,391 58.6

x x x x 227,453 130,568 57.4

• x x x 290,818 146,491 50.4

x 419,719 236,415 56.3 438,136 238,655 54.5

• 1,417,563 796,491 56.2 1,090,861 609,674 55.9

• 313,212 160,716 51.3 438,157 243,020 55.5

0 • • • • • •

• • • • 352,017 149,041 42.3

• • • • 248,756 134,954 54.3

• 205,746 101,460 49.3 x x x

x 191,319 98,801 51.6 • • •

x 176,749 97,114 54.9 168,706 95,982 56.9

• • • • 163,712 73,873 45.1

x 393,320 220,595 56.1 393,876 192,078 48.8

• • • • 360,684 165,605 45.9

• 222,181 125,697 56.6 x x x

x 244,465 134,958 55.2 201,985 114,972 56.9

9 769,771 453,312 58.9 690,291 379,766 55.0

x x x x 1,135,591 627,297 55.2

x x x x 9,118,740 5,292,608 58.0

• • • • 2,145,432 1,154,092 53.8

• • • • 158,351 88,590 55.9

x x x x 2,248,583 1,281,672 57.0

x x x x 2,904,619 1,654,145 56.9

• x x x 269,681 150,737 55.9

x x x x 267,181 139,898 52.4

x 223,305 130,828 58.6 201,205 119,336 59.3

• 1,515,214 855,017 56.4 1,129,146 414,161 36.7

(continued)

Page 41 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1991

Company Policy number Premiums Claims Loss ratio

331 • • •

316 370,754 209,286 56.4

Guarantee Trust Life Ins. Co. 85420 x x x

Mennonite Mutual Aid Association 82530 • • •

Midamerica Mutual Life Ins. Co. 1101 • • •

Mutual of Omaha Ins. Co. M2/M22 and others 1,162,975 649,610 55.9

15CMO and others x x x

M4 and others x x x

50/51/52VB 234,674 126,001 53.7

M138 and others • • •

M1/M21b 159,256 69,694 43.8

National States Ins. Co. MMS-4 x x x

Physicians Mutual Ins. Co. P197 • • •

Pyramid Life Ins. Co. 294 and H-94 x x x

United American Ins. Co. MN1 • • •

MBXC x x x

MMS x x x

MC3 • • •

Mississippi

American General Life & Accident Ins. Co. 6001 M-1 x x x

American Travellers Life Ins. Co. ATL-CAT-89 • • •

Amer. Family Life Assurance Co. of Columbus,

GA

A-19000 • • •

Associated Doctors H & L Ins. Co. 380 860,692 503,410 58.5

Atlantic American Life Ins. Co. MS2083 x x x

Bankers Life & Casualty Co. GR-75R x x x

GR-A020 • • •

GR-A002 • • •

CR-93T 164,874 90,245 54.7

Colonial Penn Life Ins. Co. 4-82-595 • • •

Equitable Life & Casualty Ins. Co. 880 • • •

Gulf Life Ins. Co. MED-1 232,356 101,675 43.8

Humana Insurance Co. GMSIC-2 • • •

Life Insurance Co. of Georgia 6612 • • •

New York Life Ins. Co. 8145 235,015 120,971 51.5

Physicians Mutual Ins. Co. P115 • • •

P192 x x x

Pioneer Life Ins. Co. of Illinois 9161 x x x

Page 42 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1992 1993

o Premiums Claims Loss ratio Premiums Claims Loss ratio

• • • • 678,408 381,691 56.3

4 x x x x x x

x 586,007 350,639 59.8 523,081 255,942 48.9

• • • • 209,565 118,208 56.4

• • • • 336,643 172,442 51.2

9 1,165,022 684,081 58.7 1,030,921 500,338 48.5

x 192,342 83,805 43.6 155,776 39,351 25.3

x 834,258 467,307 56.0 712,622 294,835 41.4

7 x x x 190,494 75,212 39.5

• 185,092 71,031 38.4 x x x

8 • • • • • •

x x x x 162,238 82,157 50.6

• x x x 393,812 222,476 56.5

x 203,462 115,378 56.7 175,906 89,936 51.1

• • • • 261,053 117,703 45.1

x x x x 245,647 113,635 46.3

x 1,825,266 996,016 54.6 x x x

• x x x 728,698 409,251 56.2

x 428,986 206,527 48.1 410,561 211,230 51.4

• • • • 247,626 147,405 59.5

• 571,602 313,902 54.9 986,360 479,331 48.6

5 x x x x x x

x 152,114 76,444 50.3 • • •

x 2,098,375 1,134,803 54.1 1,842,560 979,167 53.1

• • • • 224,261 123,869 55.2

• 312,783 129,814 41.5 608,955 302,872 49.7

7 154,186 92,222 59.8 • • •

• • • • 735,000 400,792 54.5

• x x x 988,949 588,309 59.5

8 x x x x x x

• 183,885 65,970 35.9 428,644 203,874 47.6

• 163,849 70,949 43.3 • • •

5 235,150 106,731 45.4 217,573 110,055 50.6

• x x x 444,157 255,615 57.6

x x x x 766,988 430,718 56.2

x x x x 1,486,327 852,755 57.4

(continued)

Page 43 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1991

Company Policy number Premiums Claims Loss ratio

9279 • • •

9061 x x x

Union Fidelity Life Ins. Co. of Trevose 1053 x x x

8550 262,476 148,395 56.5

1042 233,528 130,314 55.8

United American Ins. Co. DMC • • •

MMS x x x

MAXC x x x

DMXC-U x x x

MAXC+ 803,358 397,730 49.5

MC1 • • •

MC3 • • •

Missouri

American National Ins. Co. GMS-6 189,953 80,211 42.2

American Republic Ins. Co. A-2721 673,045 400,260 59.5

Amer. Family Life Assurance Co. of Columbus,

GA

A-19000 • • •

Associated Doctors H & L Ins. Co. 380 179,535 104,181 58.0

Bankers Fidelity Life Ins. Co. 2083 • • •

MS 3083 • • •

Bankers Life & Casualty Co. GR-75R x x x

GR-A002 • • •

Blue Cross & Blue Shield of KC BCBSKC-MSL-2-90 x x x

Blue Cross & Blue Shield of MO MC-1 643,589 355,265 55.2

UC-24 21,736,241 10,850,866 49.9

Central States H & L Co. of Omaha 286 425,840 237,052 55.7

Colonial Penn Life Ins. Co. 4-82-595 • • •

Combined Ins. Co. of America 000014954 • • •

Continental General Ins. Co. 323 • • •

Equitable Life & Casualty Ins. Co. 700 x x x

Guarantee Trust Life Ins. Co. 89420 • • •

Medico Life Ins. Co. 489 POLICY AND R • • •

Mutual of Omaha Ins. Co. M4/M78b 618,669 332,387 53.7

15CMO and others 453,036 232,162 51.2

M2/M76b 783,999 404,314 51.6

50VB/51VB/52VBb 596,759 303,650 50.9

M101 and others x x x

2/3/4CMO,20/22b 646,144 317,240 49.1

Page 44 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1992 1993

o Premiums Claims Loss ratio Premiums Claims Loss ratio

• • • • 650,122 351,507 54.1

x x x x 639,564 342,237 53.5

x 347,414 170,914 49.2 • • •

5 214,527 92,574 43.2 • • •

8 205,929 70,479 34.2 • • •

• • • • 162,271 82,363 50.8

x 1,019,545 565,756 55.5 905,465 522,631 57.7

x 759,015 444,780 58.6 710,156 338,536 47.7

x 277,134 163,400 59.0 242,656 98,877 40.7

5 x x x 624,420 287,298 46.0

• • • • 235,609 122,826 52.1

• x x x 650,986 310,074 47.6

2 • • • • • •

5 997,762 577,325 57.9 1,287,008 770,297 59.9

• 179,325 92,063 51.3 x x x

0 • • • • • •

• 1,980,910 986,461 49.8 1,509,808 895,814 59.3

• 160,805 25,937 16.1 • • •

x 8,103,741 4,826,018 59.6 7,384,624 4,196,727 56.8

• x x x 2,837,383 1,695,791 59.8

x 192,768 108,724 56.4 • • •

2 1,116,245 648,320 58.1 1,373,918 678,162 49.4

9 20,089,952 8,557,356 42.6 17,772,412 8,135,933 45.8

7 x x x x x x

• x x x 2,032,876 1,114,027 54.8

• • • • 161,193 95,421 59.2

• 190,922 98,473 51.6 232,059 106,122 45.7

x 580,422 21,228 3.7 490,129 289,829 59.1

• x x x 349,933 207,424 59.3

• 194,617 115,581 59.4 x x x

7 x x x x x x

2 x x x 343,655 111,068 32.3

6 x x x x x x

9 x x x x x x

x 245,991 121,342 49.3 x x x

• • • • • •

(continued)

Page 45 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1991

Company Policy number Premiums Claims Loss ratio

M1/M75 and others 267,634 101,493 37.9

C23M and others x x x

M3/M77 and others x x x

M115 and others • • •

Mutual Protective Ins. Co. 489 • • •

National Home Life Assurance Co. NH 121 • • •

New York Life Ins. Co. 8145 x x x

Physicians Mutual Ins. Co. P197 171,050 88,780 51.9

Pioneer Life Ins. Co. of Illinois 9279 • • •

9061 x x x

8916 x x x

Pyramid Life Ins. Co. G-10 271,020 144,635 53.4

Shelter Life Ins. Co. H-746.0 • • •

H-746.4 x x x

Standard Life & Accident Ins. Co. 1231 • • •

State Farm Mutual Automobile Ins. Co. 97049 • • •

Union Bankers Ins. Co. MS-2 • • •

Union Fidelity Life Ins. Co. of Trevose 1042 349,839 187,443 53.6

1053 1,070,597 534,834 50.0

8550 258,051 142,249 55.1

United American Ins. Co. MMS x x x

DMC • • •

MC1 • • •

MAXC x x x

MC3 • • •

MBXC 205,026 115,044 56.1

World Ins. Co. A2485 158,557 52,092 32.9

A2480 852,521 420,644 49.3

Montana

American Republic Ins. Co. A-2721 • • •

Bankers Life & Casualty Co. GR-A002 • • •

GR-75R x x x

Continental General Ins. Co. 323 • • •

Equitable Life & Casualty Ins. Co. 700 317,911 177,714 55.9

Federal Home Life Ins. Co. NAC 9942 • • •

Medico Life Ins. Co. 489 • • •

Mutual of Omaha Ins. Co. M4 and others 269,905 128,622 47.7

M2b 157,611 92,446 58.7

Page 46 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1992 1993

o Premiums Claims Loss ratio Premiums Claims Loss ratio

9 228,327 134,706 59.0 192,674 90,869 47.2

x x x x 736,638 421,061 57.2

x 195,812 90,802 46.4 166,014 39,521 23.8

• 569,954 328,113 57.6 x x x

• 253,122 141,026 55.7 216,352 79,127 36.6

• • • • 350,861 175,173 49.9

x 570,226 335,068 58.8 545,610 298,392 54.7

9 x x x x x x

• • • • 787,162 371,363 47.2

x x x x 1,284,077 732,275 57.0

x x x x 263,393 142,981 54.3

4 x x x x x x

• 432,353 213,200 49.3 400,120 199,312 49.8

x 175,286 77,382 44.1 x x x

• • • • 459,650 270,764 58.9

• • • • 165,835 98,715 59.5

• x x x 700,709 359,539 51.3

6 x x x • • •

0 x x x x x x

x x x • • •

x x x x 2,329,888 1,277,389 54.8

• • • • 218,038 87,083 39.9

• 186,546 109,956 58.9 378,248 226,093 59.8

x x x x 1,598,976 918,311 57.4

• x x x 1,624,902 960,185 59.1

x x x • • •

9 x x x x x x

3 800,468 378,657 47.3 x x x

• • • • 175,077 84,641 48.3

• 497,816 259,647 52.2 861,991 434,177 50.4

x 3,059,964 1,691,357 55.3 2,838,092 1,418,799 50.0

• 177,880 92,864 52.2 247,439 116,839 47.2

9 x x x 218,937 119,230 54.5

• x x x 367,489 171,418 46.6

• • • • 259,570 124,488 48.0

7 x x x 187,022 82,839 44.3

7 • • • • • •

(continued)

Page 47 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1991

Company Policy number Premiums Claims Loss ratio

Mutual Protective Ins. Co. 489 • • •

New York Life Ins. Co. 8145 x x x

Physicians Mutual Ins. Co. P393/R620 x x x

Pioneer Life Ins. Co. of Illinois 9279 • • •

9161 • • •

Standard Life & Accident Ins. Co. 1222 • • •

United American Ins. Co. MAXC x x x

MMS x x x

MAXC+ x x x

Nebraska

American Republic Ins. Co. A-2721 x x x

A-2930 • • •

Bankers Fidelity Life Ins. Co. 2083 • • •

Bankers Life & Casualty Co. GR-A002 • • •

GR-A020 • • •

GR-75R 3,177,743 1,742,603 54.8

GR-73S x x x

Blue Cross & Blue Shield of Nebraska 9760(I) x x x

9600-005 • • •

Central States H & L Co. of Omaha 286 583,661 243,575 41.7

Colonial Penn Life Ins. Co. 4-82-595 • • •

3-82-855 x x x

Continental General Ins. Co. 309 x x x

323 • • •

314 229,683 119,269 51.9

332 • • •

Harvest Life Ins. Co. MSP-1/89 • • •

Medico Life Ins. Co. 489 • • •

Mutual of Omaha Ins. Co. 50/51/52VB 302,380 145,814 48.2

M1b 160,609 60,781 37.8

2CMO and others • • •

M2 and others 728,779 371,154 50.9

M3 and others 230,094 93,159 40.5

C23M and others 204,743 104,680 51.1

15/16CMOb 210,022 86,714 41.3

MSE x x x

M115 and others • • •

M4 and others 969,234 558,900 57.7

Page 48 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1992 1993

o Premiums Claims Loss ratio Premiums Claims Loss ratio

• • • • 237,394 130,999 55.2

x x x x 214,596 103,059 48.0

x x x x 152,751 90,523 59.3

• • • • 304,235 145,840 47.9

• x x x 391,915 230,394 58.8

• • • • 160,151 72,476 45.3

x 200,305 112,106 56.0 x x x

x 573,776 290,411 50.6 474,510 271,416 57.2

x x x x 406,300 211,306 52.0

x 498,691 265,887 53.3 469,961 212,791 45.3

• x x x 314,095 163,546 52.1

• 600,993 330,433 55.0 485,980 264,922 54.5

• x x x 2,242,385 1,228,843 54.8

• • • • 625,595 349,667 55.9

8 3,481,168 1,881,951 54.1 3,284,819 1,616,930 49.2

x x x x 504,529 234,270 46.4

x 830,790 480,291 57.8 x x x

• 1,552,564 405,596 26.1 • • •

7 554,064 275,533 49.7 471,368 198,939 42.2

• x x x 439,105 208,457 47.5

x x x x 195,410 79,285 40.6

x 382,451 218,231 57.1 401,987 233,189 58.0

• 1,385,776 756,501 54.6 1,649,249 704,484 42.7

9 x x x 222,634 91,187 41.0

• • • • 181,726 67,181 37.0

• 378,161 173,890 46.0 319,601 141,353 44.2

• 307,368 176,700 57.5 381,818 194,190 50.9

2 290,277 164,233 56.6 269,805 134,014 49.7

8 • • • • • •

• 204,202 64,911 31.8 182,591 68,912 37.7

9 697,846 405,111 58.1 x x x

5 203,143 118,919 58.5 x x x

212,777 117,923 55.4 205,424 113,649 55.3

3 x x x • • •

x 168,532 99,736 59.2 • • •

• 396,851 229,335 57.8 522,409 216,866 41.5

7 x x x 655,339 283,632 43.3

(continued)

Page 49 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1991

Company Policy number Premiums Claims Loss ratio

2/3/4/30/31CMOb 235,259 100,217 42.6

Mutual Protective Ins. Co. 489 • • •

487 185,747 83,883 45.2

National Foundation Life Ins. Co. MS100 179,331 98,729 55.1

National Home Life Assurance Co. GS 1 190,608 113,179 59.4

National States Ins. Co. RMS • • •

New York Life Ins. Co. 8145 208,047 79,514 38.2

Physicians Mutual Ins. Co. P197 x x x

P115 • • •

P397/R633 • • •

Pioneer Life Ins. Co. of Illinois 9161 • • •

9061 x x x

9279 • • •

State Farm Mutual Automobile Ins. Co. 97046 x x x

Union Bankers Ins. Co. MS-2 • • •

Union Fidelity Life Ins. Co. of Trevose 1053 212,770 84,116 39.5

United American Ins. Co. MAXC 308,825 178,082 57.7

MMS 1,092,647 616,598 56.4

MAXC+ 831,226 383,715 46.2

MC3 • • •

World Insurance Co. A2485 235,068 127,820 54.4

Nevada

Bankers Life & Casualty Co. GR-73S x x x

GR-75R x x x

GR-A002 • • •

Blue Cross/Blue Shield Plan of Nevada 82171 • • •

82172 • • •

Continental General Ins. Co. 323 • • •

Equitable Life & Casualty Ins. Co. 880 • • •

Mutual of Omaha Ins. Co. M2 and others x x x

M4 and others x x x

New York Life Ins. Co. 8145 186,428 95,815 51.4

Standard Life & Accident Ins. Co. 1238 • • •

1231 • • •

United American Ins. Co. MAXC+ x x x

MAXC x x x

MC3 • • •

MMS x x x

Page 50 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1992 1993

o Premiums Claims Loss ratio Premiums Claims Loss ratio

6 • • • • • •

• x x x 531,250 239,379 45.1

2 x x x • • •

152,524 89,613 58.8 • • •

4 179,297 73,788 41.2 • • •

• 171,226 101,743 59.4 • • •

2 219,581 104,803 47.7 x x x

x x x x 1,568,432 895,374 57.1

• x x x 520,169 267,529 51.4

• • • • 280,038 148,290 53.0

• x x x 1,158,814 624,526 53.9

x x x x 360,928 192,144 53.2

• • • • 662,161 292,835 44.2

x 462,608 245,049 53.0 713,933 422,547 59.2

• • • • 676,004 345,190 51.1

5 185,478 85,122 45.9 • • •

7 277,199 119,476 43.1 225,490 116,995 51.9

4 x x x 822,797 396,448 48.2

2 x x x x x x

• x x x 394,274 180,402 45.8

4 183,150 97,206 53.1 • • •

x 159,346 90,595 56.9 152,218 68,479 45.0

x 477,195 241,940 50.7 443,720 229,516 51.7

• • • • 256,896 152,906 59.5

• 408,173 242,332 59.4 579,639 329,565 56.9

• 318,605 189,155 59.4 366,813 208,559 56.9

• • • • 164,747 98,224 59.6

• • • • 446,681 252,448 56.5

x 266,332 120,386 45.2 x x x

x x x x 169,937 83,707 49.3

4 210,969 92,883 44.0 206,925 111,144 53.7

• • • • 266,361 141,162 53.0

• 337,898 179,948 53.3 326,819 167,046 51.1

x 288,736 152,012 52.6 x x x

x 343,956 203,713 59.2 x x x

• 325,663 183,060 56.2 x x x

x 893,014 460,998 51.6 769,530 452,669 58.8

(continued)

Page 51 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1991

Company Policy number Premiums Claims Loss ratio

New Hampshire

Bankers Life & Casualty Co. GR-A002 • • •

GR-75R x x x

Blue Cross & Blue Shield of New Hampshire 061.066 (MEDICOMP) x x x

New Jersey

Colonial Penn Franklin Ins. Co. 10-82-460 337,046 196,982 58.4

Combined Ins. Co. of America 7902 • • •

Mutual of Omaha Ins. Co. C23M and others x x x

National Foundation Life Ins. Co. MS-85-P • • •

National Home Life Assurance Co. NH 910 466,818 262,120 56.2

NH1380 1,137,591 634,745 55.8

Union Fidelity Life Ins. Co. of Trevose 1042 211,778 91,959 43.4

8550 496,424 241,919 48.7

1053 443,386 208,943 47.1

New Mexico

Bankers Fidelity Life Ins. Co. MS1083 199,646 116,113 58.2

Bankers Life & Casualty Co. GR-A002 • • •

GR-75R x x x

Equitable Life & Casualty Ins. Co. 700 x x x

Mutual of Omaha Ins. Co. M2 and others x x x

National Home Life Assurance Co. NH1380 252,680 117,411 46.5

New Mexico Blue Cross & Blue Shield, Inc. M296 x x x

New York Life Ins. Co. 8145 x x x

Pioneer Life Ins. Co. of Illinois 9061 x x x

State Farm Mutual Automobile Ins. Co. 97046 • • •

97033 x x x

Union Fidelity Life Ins. Co. of Trevose 1053 153,956 73,759 47.9

United American Ins. Co. MAXC+ 348,977 191,363 54.8

MC3 • • •

New York

Aetna Life Insurance & Annuity Co. 24310 175,602 77,166 43.9

Colonial Penn Franklin Ins. Co. 10-82-316 274,422 141,628 51.6

First United American Life Ins. Co. NY-MAXC 271,111 136,584 50.4

Mutual of Omaha Ins. Co. 50/51/52VB x x x

M23 and others x x x

M25 and others x x x

New York Life Ins. Co. 8147 x x x

North Carolina

Page 52 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1992 1993

o Premiums Claims Loss ratio Premiums Claims Loss ratio

• 504,960 260,540 51.6 1,847,153 910,115 49.3

x x x x 2,214,103 1,294,293 58.5

x 3,507,135 1,910,188 54.5 x x x

4 • • • • • •

• 209,462 120,189 57.4 x x x

x x x x 260,943 116,091 44.5

• • • • 306,269 182,895 59.7

2 • • • • • •

8 • • • • • •

4 188,388 77,666 41.2 • • •

7 413,173 232,654 56.3 • • •

396,519 160,450 40.5 • • •

2 • • • • • •

• • • • 266,452 139,112 52.2

x 557,687 291,888 52.3 500,980 246,779 49.3

x x x x 213,947 102,665 48.0

x 180,304 66,347 36.8 178,141 69,600 39.1

5 • • • • • •

x x x x 445,502 250,729 56.3

x x x x 181,107 98,049 54.1

x x x x 211,402 122,093 57.8

• x x x 256,503 143,096 55.8

x x x x 249,896 139,243 55.7

9 • • • • • •

8 x x x 264,051 134,418 50.9

• 348,063 155,527 44.7 x x x

9 • • • • • •

6 • • • • • •

4 x x x x x x

x 1,799,040 1,040,510 57.8 x x x

x x x x 269,208 158,383 58.8

x 481,923 251,215 52.1 347,326 192,416 55.4

x 508,265 292,628 57.6 x x x

(continued)

Page 53 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1991

Company Policy number Premiums Claims Loss ratio

Amer. Family Life Assurance Co. of Columbus,

GA

A-19800 x x x

A-19000 • • •

Bankers Fidelity Life Ins. Co. 2083 • • •

MS1083 808,485 460,529 57.0

Bankers Life & Casualty Co. GR-73S 683,621 381,046 55.7

GR-75R x x x

GR-A002 • • •

Blue Cross & Blue Shield of NC M148 13,086,411 7,106,684 54.3

M145 299,012 135,033 45.2

M3 226,687 118,026 52.1

Central States H & L Co. of Omaha 286 x x x

Colonial Penn Life Ins. Co. 4-82-595 • • •

Combined Ins. Co. of America 8081 • • •

8061 • • •

Continental General Ins. Co. 323 • • •

390 • • •

Globe Life & Accident Ins. Co. MCP-3 392,324 214,256 54.6

Gulf Life Ins. Co. 737 L&C x x x

Hartford Life Ins. Co. SRP-1261 • • •

Integrity National Life Ins. Co. H-740-0490 • • •

Liberty Life Ins. Co. 894 x x x

868 • • •

873 x x x

Life Insurance Co. of Georgia 6610 x x x

Mutual of Omaha Ins. Co. M27 and others 238,213 132,862 55.8

50/51/52VB 634,923 359,385 56.6

M28 and others 598,331 324,154 54.2

11CMO and others 217,218 92,484 42.6

M152 and others • • •

M30 and others 184,405 79,173 42.9

M115 and others • • •

National Financial Ins. Co. G764 x x x

MG-82 188,345 100,133 53.2

MS86R 392,111 229,432 58.5

GL65 303,333 168,685 55.6

National Home Life Assurance Co. NH1380 2,384,109 1,426,468 59.8

NH 910 259,767 147,828 56.9

Page 54 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1992 1993

o Premiums Claims Loss ratio Premiums Claims Loss ratio

x 292,657 144,254 49.3 258,397 109,874 42.5

• 832,899 414,667 49.8 1,262,862 614,783 48.7

• 569,271 239,143 42.0 437,119 200,095 45.8

0 • • • • • •

7 597,180 330,733 55.4 557,730 331,497 59.4

x 3,135,325 1,873,005 59.7 2,804,236 1,523,298 54.3

• 992,472 508,338 51.2 1,911,883 964,272 50.4

3 x x x • • •

2 x x x • • •

x x x • • •

x 288,668 154,690 53.6 232,947 130,981 56.2

• x x x 1,247,269 639,755 51.3

• 215,570 105,224 48.8 183,014 100,728 55.0

• 179,793 92,449 51.4 x x x

• 289,045 156,041 54.0 279,394 128,097 45.8

• 178,428 97,480 54.6 172,927 81,910 47.4

6 x x x x x x

x 394,911 234,392 59.4 x x x

• 845,316 486,898 57.6 • • •

• • • • 195,302 113,265 58.0

x x x x 797,774 408,075 51.2

• • • • 201,974 62,777 31.1

x x x x 1,528,305 808,327 52.9

x 372,977 214,212 57.4 x x x

8 200,702 82,051 40.9 172,866 71,921 41.6

6 566,458 301,831 53.3 x x x

2 536,025 278,876 52.0 x x x

6 181,282 68,986 38.1 • • •

• • • • 352,184 197,478 56.1

9 x x x 152,099 86,081 56.6

• • • • 221,975 131,084 59.1

x 325,001 189,890 58.4 x x x

2 173,003 95,121 55.0 x x x

5 x x x 340,026 190,191 55.9

6 240,772 94,672 39.3 x x x

8 • • • • • •

9 • • • • • •

(continued)

Page 55 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1991

Company Policy number Premiums Claims Loss ratio

NH 121 • • •

New York Life Ins. Co. 8145 310,895 179,601 57.8

Physicians Mutual Ins. Co. MOVE-INS • • •

P393/R622 x x x

P192 x x x

Pioneer Life Ins. Co. of Illinois 9161 • • •

Savers Life Ins. Co. MS2-9001 x x x

MS1-9001 • • •

Standard Life & Accident Ins. Co. 1239 • • •

1231 • • •

1208 • • •

State Farm Mutual Automobile Ins. Co. 97046 x x x

Union Bankers Ins. Co. MS-2 • • •

Union Fidelity Life Ins. Co. of Trevose 1053 1,062,495 543,004 51.1

8550 • • •

1042 x x x

United American Ins. Co. MAXC+ x x x

MBXC 181,451 101,867 56.1

MC3 • • •

DMC • • •

MMS 1,819,947 915,451 50.3

MC1 • • •

MAXC x x x

United Family Life Ins. Co. AA31 355,494 182,379 51.3

World Insurance Co. A2485 x x x

A2480 424,436 251,876 59.3

North Dakota

American Republic Ins. Co. A-2721 • • •

Amer. Family Life Assurance Co. of Columbus,

GA

A-19000 • • •

Bankers Life & Casualty Co. GR-75R x x x

Colonial Penn Life Ins. Co. 3-82-855 x x x

4-82-595 • • •

Equitable Life & Casualty Ins. Co. 880 • • •

Harvest Life Ins. Co. MSP-1/89 • • •

Mutual of Omaha Ins. Co. M2 and others 248,285 117,778 47.4

Mutual Protective Ins. Co. 489 • • •

State Farm Mutual Automobile Ins. Co. 97033 x x x

Page 56 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1992 1993

o Premiums Claims Loss ratio Premiums Claims Loss ratio

• 222,459 107,489 48.3 201,949 106,341 52.7

8 287,456 168,945 58.8 x x x

• 280,938 149,820 53.3 • • •

x x x x 305,322 174,129 57.0

x • • • 256,575 108,708 42.4

• x x x 4,322,814 2,551,541 59.0

x 656,306 354,215 54.0 x x x

• 157,017 77,008 49.0 x x x

• • • • 2,127,906 1,188,496 55.9

• 611,235 362,377 59.3 486,858 204,229 41.9

• • • • 616,804 311,383 50.5

x 399,512 231,289 57.9 x x x

• • • • 749,801 444,988 59.3

842,847 409,873 48.6 162,581 79,133 48.7

• 615,280 360,023 58.5 • • •

x 479,799 275,692 57.5 • • •

x x x x 1,306,223 626,187 47.9

162,194 95,199 58.7 • • •

• 842,921 467,430 55.5 1,918,093 948,962 49.5

• 182,122 81,604 44.8 376,889 210,652 55.9

3 1,503,040 692,314 46.1 1,290,454 683,979 53.0

• x x x 653,688 345,643 52.9

x x x x 1,953,210 1,125,022 57.6

3 x x x x x x

x 271,629 101,903 37.5 x x x

3 337,429 150,492 44.6 x x x

• x x x 386,983 189,496 49.0

• • • • 199,172 81,904 41.1

x 1,001,563 535,992 53.5 1,061,647 556,529 52.4

x x x x 154,944 60,526 39.1

• x x x 467,225 246,568 52.8

• • • • 651,376 379,232 58.2

• • • • 160,644 62,649 39.0

4 x x x 220,433 105,812 48.0

• • • • 194,913 108,425 55.6

x x x x 472,565 266,199 56.3

(continued)

Page 57 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1991

Company Policy number Premiums Claims Loss ratio

United American Ins. Co. MAXC+ 657,200 378,092 57.5

MAXC 639,383 291,065 45.5

MMS x x x

MC3 • • •

Ohio

Acceleration Life Ins. Co. AMSP-511 444,742 252,559 56.8

AMSP-1100 1/89 • • •

American Travellers Life Ins. Co. ATL-CAT-89 • • •

Amer. Family Life Assurance Co. of Columbus,

GA

A-19000 • • •

A-19800 190,621 112,801 59.2

Auto-Owners Life Ins. Co. 50431 • • •

Bankers Life & Casualty Co. P1-67720 • • •

P1-56566 • • •

GR-73S x x x

GR-A020 • • •

GR-A002 • • •

Blue Cross & Blue Shield Mutual of Ohio NG8902-E • • •

NG8903-E,NG8806b • • •

Central States H & L Co. of Omaha 286 473,733 242,515 51.2

Colonial Penn Life Ins. Co. 4-82-595 • • •

Combined Ins. Co. of America 7902 • • •

Community Mutual Ins. Co. PD010 • • •

Continental General Ins. Co. 323 • • •

Golden Rule Ins. Co. GRI-H-12.2P • • •

Guarantee Trust Life Ins. Co. 85420 x x x

89420 • • •

Hartford Life Ins. Co. SRP-1261 • • •

Harvest Life Ins. Co. MSP-3/90 • • •

MSP-1/89 • • •

Mutual of Omaha Ins. Co. 50/51/52VB x x x

MSE x x x

M1 and others x x x

M115 and others • • •

C23M and others x x x

15CMO and others 396,511 224,174 56.5

M154 and others • • •

M3 and others x x x

Page 58 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1992 1993

o Premiums Claims Loss ratio Premiums Claims Loss ratio

5 575,205 313,921 54.6 468,480 233,503 49.8

5 564,109 301,832 53.5 477,676 191,163 40.0

x 652,705 387,640 59.4 586,361 248,479 42.4

• • • • 201,635 120,257 59.6

8 311,323 156,288 50.2 • • •

• 285,365 163,929 57.4 x x x

• 157,604 79,826 50.6 227,926 130,731 57.4

• x x x 1,447,093 853,992 59.0

2 165,295 97,996 59.3 152,621 81,274 53.3

• 171,226 95,441 55.7 x x x

• x x x 455,187 242,490 53.3

• 216,718 114,412 52.8 267,853 132,010 49.3

x x x x 1,028,107 588,620 57.3

• • • • 937,578 494,214 52.7

• 1,239,053 715,036 57.7 2,344,770 1,283,561 54.7

• • • • 198,000 109,000 55.1

• x x x 3,727,000 2,162,000 58.0

2 x x x 354,831 139,789 39.4

• x x x 888,457 480,100 54.0

• x x x 300,895 173,592 57.7

• 4,374,118 2,337,859 53.4 3,743,594 2,166,115 57.9

• 217,996 126,593 58.1 287,307 135,479 47.2

• • • • 189,733 113,388 59.8

x 376,948 220,562 58.5 290,760 150,080 51.6

• x x x 159,088 74,689 46.9

• 517,764 300,936 58.1 • • •

• • • • 168,295 93,438 55.5

• 727,975 411,235 56.5 688,418 318,512 46.3

x 356,220 211,203 59.3 301,145 172,692 57.3

x x x x 268,326 95,138 35.5

x 397,442 215,251 54.2 360,920 174,915 48.5

• 388,698 195,388 50.3 605,376 299,262 49.4

x x x x 583,417 331,666 56.8

5 368,198 160,875 43.7 x x x

• • • • 189,158 101,575 53.7

x x x x 320,430 177,113 55.3

(continued)

Page 59 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1991

Company Policy number Premiums Claims Loss ratio

Mutual Protective Ins. Co. 990 • • •

489 • • •

488 x x x

National Foundation Life Ins. Co. MS-7 • • •

National Home Life Assurance Co. NH 910 442,133 237,079 53.6

Physicians Mutual Ins. Co. P115 • • •

P197 x x x

P192 x x x

Pioneer Life Ins. Co. of Illinois 9279 • • •

9161 x x x

Standard Life & Accident Ins. Co. 1222 • • •

1208 • • •

1238 • • •

Union Bankers Ins. Co. MS-2 • • •

Union Fidelity Life Ins. Co. of Trevose 1042 x x x

8550 526,472 305,807 58.1

1053 1,087,598 556,180 51.1

United American Ins. Co. MC3 • • •

MAXC+ x x x

DMXC-U x x x

MMS x x x

MAXC x x x

MC2 • • •

DMC • • •

MCCAT • • •

MBXC x x x

Oklahoma

Amer. Family Life Assurance Co. of Columbus,

GA

A-19000 • • •

Bankers Life & Casualty Co. GR-75R x x x

GR-A020 • • •

GR-A002 • • •

GR-73S x x x

Continental General Ins. Co. 323 • • •

Equitable Life & Casualty Ins. Co. 990 • • •

Globe Life & Accident Ins. Co. MCP-3 267,287 153,721 57.5

Group Health Service of Oklahoma, Inc. 4.021-1 • • •

Guarantee Trust Life Ins. Co. 85420 x x x

Page 60 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1992 1993

o Premiums Claims Loss ratio Premiums Claims Loss ratio

• • • • 173,377 94,506 54.5

• 526,318 284,291 54.0 825,420 493,999 59.8

x 152,204 77,252 50.8 • • •

• • • • 573,958 312,221 54.4

6 • • • • • •

• 322,012 183,192 56.9 x x x

x x x x 1,308,632 723,296 55.3

x x x x 723,378 417,862 57.8

• • • • 661,468 342,361 51.8

x x x x 1,477,035 767,265 51.9

• • • • 945,357 542,795 57.4

• • • • 386,899 228,422 59.0

• • • • 2,009,630 1,065,964 53.0

• • • • 350,039 199,919 57.1

x 377,779 196,030 51.9 • • •

x x x • • •

1,029,846 468,459 45.5 193,287 77,941 40.3

• x x x 3,273,583 1,879,456 57.4

x x x x 2,206,171 1,193,653 54.1

x x x x 335,001 185,787 55.5

x 3,657,936 2,138,645 58.5 3,118,072 1,663,825 53.4

x x x x 2,224,131 1,325,180 59.6

• • • • 224,040 104,474 46.6

• • • • 315,975 148,106 46.9

• • • • 800,084 332,777 41.6

x 307,364 176,433 57.4 x x x

• x x x 226,237 98,533 43.6

x 3,384,401 1,921,491 56.8 3,358,565 1,732,479 51.6

• • • • 192,110 114,378 59.5

• 406,453 222,982 54.9 691,899 378,707 54.7

x 456,132 264,447 58.0 441,101 251,283 57.0

• 225,485 128,124 56.8 242,788 108,404 44.6

• • • • 308,442 178,358 57.8

5 x x x x x x

• 159,491 80,262 50.3 x x x

x x x x 254,407 103,031 40.5

(continued)

Page 61 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1991

Company Policy number Premiums Claims Loss ratio

89420 • • •

Monumental Life Ins. Co. MS3000PGM • • •

Mutual of Omaha Ins. Co. M115 and others • • •

50/51/52VB 192,331 89,885 46.7

M2 and others 1,473,297 749,847 50.9

M4 and others 693,682 353,904 51.0

New York Life Ins. Co. 8145 175,818 63,716 36.2

Old Surety Life Ins. Co. MS 1,321,278 758,574 57.4

Pioneer Life Ins. Co. of Illinois 9061 x x x

9161 x x x

9279 • • •

Reserve National Ins. Co. MCS-86 • • •

Standard Life & Accident Ins. Co. 1222 • • •

1238 • • •

Union Bankers Ins. Co. MS-2 • • •

86M x x x

Union Fidelity Life Ins. Co. of Trevose 1042 202,263 111,002 54.9

1053 x x x

United American Ins. Co. MAXC x x x

DMXC-U 169,916 80,910 47.6

MAXC+ 790,530 443,828 56.1

MC3 • • •

MCCAT • • •

MMS 1,337,470 726,649 54.3

Western Farm Bureau Life Ins. Co. HIP02 x x x

Oregon

Amer. Family Life Assurance Co. of Columbus,

GA

A-19000 • • •

Bankers Life & Casualty Co. GR-A002 • • •

GR-A020 • • •

GR-75R x x x

GR-73S x x x

Colonial Penn Life Ins. Co. 3-82-855 x x x

Combined Ins. Co. of America 8061 • • •

Federal Home Life Ins. Co. NAC 9930 x x x

First National Life Ins. Co. 9000 • • •

Mutual of Omaha Ins. Co. M94 and others 502,470 290,676 57.8

15CMO and others x x x

Page 62 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1992 1993

o Premiums Claims Loss ratio Premiums Claims Loss ratio

• 155,184 75,387 48.6 245,131 128,797 52.5

• • • • 193,399 114,553 59.2

• 498,833 275,523 55.2 678,962 331,384 48.8

7 165,976 47,252 28.5 153,064 33,294 21.8

9 1,309,965 722,283 55.1 1,228,942 548,676 44.6

0 x x x 549,431 225,549 41.1

2 171,982 93,825 54.6 157,250 86,242 54.8

4 x x x 1,911,890 1,047,921 54.8

x x x x 630,065 309,204 49.1

x x x x 1,192,699 645,844 54.1

• • • • 281,891 124,970 44.3

• • • • 398,135 207,433 52.1

• 372,618 195,252 52.4 339,562 169,842 50.0

• • • • 1,448,822 867,308 59.9

• • • • 186,920 111,135 59.5

x x x x 891,168 509,717 57.2

9 171,906 85,850 49.9 • • •

x 383,554 229,766 59.9 • • •

x 384,988 213,488 55.5 328,417 190,164 57.9

6 • • • • • •

738,130 373,187 50.6 659,430 345,879 52.5

• 340,624 127,308 37.4 469,887 263,109 56.0

• • • • 176,688 100,182 56.7

3 1,121,139 522,618 46.6 920,089 502,140 54.6

x x x x 305,002 154,978 50.8

• • • • 174,441 94,939 54.4

• 601,636 283,813 47.2 1,813,366 946,665 52.2

• • • • 206,845 108,534 52.5

x 5,386,686 2,902,342 53.9 4,915,764 2,273,109 46.2

x x x x 482,023 270,697 56.2

x x x x 184,021 78,740 42.8

• 165,878 97,414 58.7 • • •

x x x x 481,410 281,951 58.6

• 778,681 417,407 53.6 • • •

8 490,223 275,364 56.2 420,053 226,502 53.9

x x x x 190,284 88,765 46.6

(continued)

Page 63 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1991

Company Policy number Premiums Claims Loss ratio

50/51/52VB 177,141 74,785 42.2

M96 and others 279,313 152,179 54.5

Mutual Protective Ins. Co. 489 • • •

National Foundation Life Ins. Co. MS100 x x x

New York Life Ins. Co. 8145 x x x

Pyramid Life Ins. Co. G-10 177,631 101,089 56.9

H-94 x x x

Standard Life & Accident Ins. Co. 1231 • • •

1222 • • •

1238 • • •

State Farm Mutual Automobile Ins. Co. 97046 x x x

Union Bankers Ins. Co. 86M x x x

United American Ins. Co. MAXC 1,046,848 590,270 56.4

MC3 • • •

MMS 1,695,293 958,054 56.5

MAXC+ 1,577,046 834,541 52.9

MCCAT • • •

Pennsylvania

American Income Life Ins. Co. H41000 • • •

Combined Insurance Co. of America 7902 • • •

Conestoga Life Assurance Co. MS82 • • •

Federal Home Life Ins. Co. NAC 9750 x x x

Harvest Life Ins. Co. HMGC4012RU • • •

Mutual of Omaha Ins. Co. 15CMO and others x x x

National Home Life Assurance Co. NH1190 240,038 130,786 54.5

NH 910 388,639 231,738 59.6

Penn Treaty Life Ins. Co. MEDSUP x x x

Union Bankers Ins. Co. 86M • • •

Union Fidelity Life Ins. Co. of Trevose 1063 • • •

1042 x x x

United Security Assurance Co. of Pennsylvania MS-1-GRS • • •

USAA Life Insurance Co. AG4001 • • •

Rhode Island

Bankers Life & Casualty Co. GR-A002 • • •

South Carolina

American Republic Ins. Co. A-2930 • • •

Amer. Family Life Assurance Co. of Columbus,

GA

A-19800 x x x

Page 64 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1992 1993

o Premiums Claims Loss ratio Premiums Claims Loss ratio

2 156,221 71,747 45.9 • • •

5 x x x 208,762 107,847 51.7

• x x x 181,270 89,198 49.2

x 761,353 449,634 59.1 x x x

x x x x 189,918 88,329 46.5

9 166,133 97,621 58.8 • • •

x x x x 167,226 98,224 58.7

• 732,151 394,244 53.8 x x x

• 210,619 118,384 56.2 177,798 75,939 42.7

• • • • 584,383 314,580 53.8

x x x x 1,070,842 568,138 53.1

x 979,562 580,350 59.2 887,689 501,410 56.5

4 949,166 539,254 56.8 x x x

• 216,909 103,350 47.6 406,169 234,741 57.8

5 1,490,359 748,662 50.2 1,221,200 604,088 49.5

9 1,447,435 808,472 55.9 1,200,494 573,887 47.8

• • • • 153,538 87,698 57.1

• • • • 155,605 87,121 56.0

• 289,046 170,643 59.0 x x x

• 382,261 227,916 59.6 x x x

x 925,504 502,659 54.3 x x x

• 259,677 150,882 58.1 239,355 143,312 59.9

x x x x 371,389 180,254 48.5

5 • • • • • •

6 • • • • • •

x 1,416,313 829,162 58.5 x x x

• • • • 182,690 101,640 55.6

• 799,755 475,485 59.5 • • •

x 356,509 205,164 57.5 • • •

• • • • 214,008 126,056 58.9

• 499,781 279,048 55.8 x x x

• • • • 262,023 144,946 55.3

• • • • 152,210 78,756 51.7

x x x x 208,919 109,263 52.3

(continued)

Page 65 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1991

Company Policy number Premiums Claims Loss ratio

Bankers Life & Casualty Co. CR-93T x x x

GR-73S x x x

Blue Cross & Blue Shield of SC, Inc. 11310 • • •

Independent Life & Accident Ins. Co. MCS 101 171,313 87,515 51.1

Liberty Life Ins. Co. 868 • • •

894 x x x

892 163,573 95,789 58.6

Life Insurance Co. of Georgia 6612 251,463 121,100 48.2

6610 • • •

Mutual of Omaha Ins. Co. M2 and others x x x

M115 and others • • •

National Home Life Assurance Co. NH 121 • • •

New York Life Ins. Co. 8145 160,196 88,156 55.0

Pioneer Life Ins. Co. of Illinois 9061 x x x

9161 • • •

Savers Life Ins. Co. MS2-9001 • • •

Southland Life Ins. Co. 12590 x x x

Union Bankers Ins. Co. 86M x x x

United American Ins. Co. MCCAT • • •

South Dakota

American Travellers Life Ins. Co. ATL-CAT-89 • • •

Bankers Life & Casualty Co. GR-75R 1,046,789 614,603 58.7

Central States H & L Co. of Omaha 286 x x x

Continental General Ins. Co. 323 • • •

Mutual of Omaha Ins. Co. M154 and others • • •

Pioneer Life Ins. Co. of Illinois 9279 • • •

State Farm Mutual Automobile Ins. Co. 97046 • • •

97033 x x x

Union Bankers Ins. Co. MS-2 • • •

United American Ins. Co. MAXC 365,240 216,330 59.2

MMS x x x

MC3 • • •

Tennessee

American Republic Ins. Co. A-2721 • • •

Amer. Family Life Assurance Co. of Columbus,

GA

A-19000 • • •

A-19800 324,046 181,437 56.0

Atlantic American Life Ins. Co. 2083 x x x

Page 66 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1992 1993

o Premiums Claims Loss ratio Premiums Claims Loss ratio

x x x x 247,745 126,545 51.1

x x x x 161,504 79,921 49.5

• • • • 325,302 105,931 32.6

• • • • • •

• • • • 378,974 193,060 50.9

x x x x 1,622,052 948,588 58.5

6 x x x x x x

2 x x x 208,912 88,499 42.4

• 958,242 516,379 53.9 x x x

x x x x 638,427 332,643 52.1

• 266,867 112,519 42.2 392,184 198,094 50.5

• • • • 238,521 134,074 56.2

0 x x x 165,600 89,794 54.2

x x x x 695,072 377,019 54.2

• • • • 239,792 140,636 58.6

• 182,792 58,559 32.0 • • •

x 164,764 71,967 43.7 • • •

x x x x 229,010 132,589 57.9

• • • • 236,005 122,820 52.0

• • • • 287,290 154,273 53.7

7 1,170,743 604,445 51.6 1,155,379 643,003 55.7

x x x x 863,232 389,595 45.1

• x x x 301,811 158,377 52.5

• • • • 197,139 84,307 42.8

• • • • 318,296 180,180 56.6

• 228,342 135,790 59.5 310,894 165,483 53.2

x x x x 357,326 211,299 59.1

• • • • 184,877 104,844 56.7

2 x x x x x x

x x x x 966,341 562,963 58.3

• 186,860 101,871 54.5 x x x

• 186,684 84,589 45.3 222,605 114,410 51.4

• 744,035 380,297 51.1 1,026,567 534,052 52.0

0 282,896 167,532 59.2 252,044 135,387 53.7

x 981,345 480,234 48.9 787,256 404,512 51.4

(continued)

Page 67 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1991

Company Policy number Premiums Claims Loss ratio

Bankers Life & Casualty Co. GR-75R x x x

P1-67720 • • •

CR-93T x x x

GR-A002 • • •

Colonial Penn Life Ins. Co. 4-82-595 • • •

Continental Life Ins. Co. of Brentwood SSC85 952,953 567,951 59.6

SCIII • • •

SCII • • •

Georgia H & L Ins. Co. 803 221,520 128,423 58.0

Gulf Life Ins. Co. 737 L&C x x x

Life Insurance Co. of Georgia 6612 194,099 80,961 41.7

6610 x x x

Mutual of Omaha Ins. Co. M115 and others • • •

50/51/52VB 191,319 64,527 33.7

M1 and others x x x

2CMO and others 242,801 139,001 57.2

M4 and others 248,508 132,507 53.3

M2a 544,564 278,759 51.2

National Home Life Assurance Co. GSH-1 197,774 103,550 52.4

NH 121 • • •

Physicians Mutual Ins. Co. P197 • • •

Pioneer Life Ins. Co. of Illinois 9279 • • •

9161 • • •

9061 x x x

Pyramid Life Ins. Co. H-94 530,828 239,604 45.1

G-10 356,582 178,481 50.1

Standard Life & Accident Ins. Co. 1231 • • •

1238 • • •

1228 • • •

Union Fidelity Life Ins. Co. of Trevose 1053 588,226 346,047 58.8

1042 257,410 147,531 57.3

United American Ins. Co. MAXC+ x x x

MBXC x x x

MAXC x x x

MCCAT • • •

MC3 • • •

DMC • • •

MC1 • • •

Page 68 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1992 1993

o Premiums Claims Loss ratio Premiums Claims Loss ratio

x x x x 3,900,734 2,247,857 57.6

• x x x 164,804 95,648 58.0

x x x x 229,746 113,994 49.6

• 311,827 135,958 43.6 871,193 440,775 50.6

• x x x 1,088,117 584,284 53.7

6 • • • • • •

• • • • 227,950 101,497 44.5

• 1,254,357 596,007 47.5 1,487,789 816,065 54.9

0 • • • • • •

x 162,422 84,463 52.0 x x x

7 256,295 100,086 39.1 189,108 58,310 30.8

x 800,938 372,422 46.5 809,645 395,228 48.8

• • • • 174,692 65,583 37.5

7 x x x 163,496 81,697 50.0

x 201,939 117,065 58.0 178,777 103,140 57.7

2 222,683 133,042 59.7 x x x

3 x x x 230,298 121,611 52.8

2 x x x x x x

4 x x x • • •

• x x x 519,658 264,006 50.8

• 492,818 280,337 56.9 1,039,193 614,914 59.2

• • • • 1,183,823 667,497 56.4

• x x x 2,326,337 1,190,056 51.2

x x x x 1,717,653 951,277 55.4

454,265 208,983 46.0 x x x

323,653 172,343 53.2 x x x

• 1,351,807 775,257 57.3 982,142 527,767 53.7

• • • • 2,275,548 1,294,063 56.9

• • • • 208,534 109,315 52.4

8 525,861 278,156 52.9 • • •

3 223,417 86,826 38.9 • • •

x x x x 1,240,673 602,427 48.6

x 365,858 217,817 59.5 x x x

x x x x 1,107,890 630,975 57.0

• • • • 641,778 375,370 58.5

• 574,552 300,689 52.3 1,107,203 631,807 57.1

• • • • 197,519 107,624 54.5

• 163,814 83,565 51.0 480,533 234,066 48.7

(continued)

Page 69 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1991

Company Policy number Premiums Claims Loss ratio

MMS x x x

Texas

American Exchange Life Ins. Co. 127 x x x

191 x x x

American General Life & Accident Ins. Co. AGLA 76789 • • •

American Insurance Co. of Texas AMS382 • • •

AMS78 575,644 332,397 57.7

American Integrity Ins. Co. MS-85 210,784 106,932 50.7

MS-7/8b 166,860 84,886 50.9

American Life & Accident Ins. Co. MMS x x x

S30 164,486 91,795 55.8

IF-DM x x x

S35 1,053,020 617,973 58.7

AL-100 3,372,259 1,984,101 58.8

A-MAXC+ 685,432 379,390 55.4

AL-02 258,631 151,506 58.6

AL-06 x x x

American National Ins. Co. GMS-2 • • •

American Republic Ins. Co. A-2930 • • •

American Travellers Life Ins. Co. ATL-CAT-89 • • •

Amer. Family Life Assurance Co. of Columbus,

GA

A-19000 • • •

Atlantic American Life Ins. Co. 2083 x x x

Bankers Fidelity Life Ins. Co. 2083 • • •

Bankers Life & Casualty Co. GR-75R x x x

GR-73S x x x

GR-A002 • • •

Central Security Life Ins. Co. Form H08601 x x x

Form H08902 • • •

Central States H & L Co. of Omaha 286 601,746 309,291 51.4

Colonial Penn Life Ins. Co. 4-82-595 • • •

3-82-855 x x x

Combined Insurance Co. of America 8061 • • •

14952 • • •

Continental General Ins. Co. 323 • • •

Equitable Life & Casualty Ins. Co. 990 • • •

First National Life Ins. Co. 9000 • • •

Medico Life Ins. Co. 489 • • •

Page 70 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1992 1993

o Premiums Claims Loss ratio Premiums Claims Loss ratio

x 1,689,752 987,786 58.5 1,492,061 889,801 59.6

x 434,920 214,679 49.4 376,902 180,930 48.0

x x x x 292,566 161,718 55.3

• 344,360 204,284 59.3 x x x

• 153,057 79,165 51.7 • • •

7 • • • • • •

7 • • • • • •

9 • • • • • •

x 1,263,160 753,948 59.7 1,118,354 619,936 55.4

8 • • • • • •

x x x x 283,258 155,130 54.8

7 x x x x x x

8 x x x 2,920,582 1,607,629 55.0

4 558,315 299,667 53.7 476,485 246,079 51.6

6 x x x 186,211 103,872 55.8

x 152,343 90,370 59.3 • • •

• x x x 233,713 119,753 51.2

• • • • 156,427 82,715 52.9

• • • • 519,728 292,054 56.2

• x x x 2,256,387 1,299,196 57.6

x 1,095,651 520,283 47.5 804,461 330,148 41.0

• • • • 404,791 232,182 57.4

x 11,781,017 6,807,652 57.8 10,908,121 5,649,050 51.8

x x x x 1,581,666 893,405 56.5

• 753,422 424,930 56.4 3,637,057 2,006,824 55.2

x x x x 282,397 112,318 39.8

• • • • 278,229 151,595 54.5

4 604,768 254,891 42.1 x x x

• x x x 2,270,861 1,206,182 53.1

x x x x 282,037 125,201 44.4

• 186,058 102,109 54.9 x x x

• 158,555 72,085 45.5 235,074 108,639 46.2

• • • • 243,782 142,451 58.4

• • • • 152,758 64,922 42.5

• 1,043,099 575,949 55.2 • • •

• x x x 1,936,576 1,058,314 54.6

(continued)

Page 71 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1991

Company Policy number Premiums Claims Loss ratio

990 • • •

Mutual of Omaha Ins. Co. 15CMO and others 895,000 492,821 55.1

M4 and others x x x

50/51/52VB 1,035,199 489,158 47.3

M2 and others x x x

2CMO and others 920,878 548,091 59.5

M115 and others • • •

Mutual Protective Ins. Co. 990 • • •

National Financial Ins. Co. TSTA2-8 • • •

MS86R x x x

GL65-4 x x x

PMS86 180,616 87,372 48.4

National Foundation Life Ins. Co. MS4-89-P • • •

MS-7 • • •

National Home Life Assurance Co. NH 143 • • •

NH 77 x x x

GS 1 • • •

NH 66 x x x

National Security Life & Accident Ins. Co. SC 394,632 176,316 44.7

New Era Life Ins. Co. K-1-88 • • •

GLA 82 $200 • • •

GLA 585 100% • • •

H-0018F • • •

H-0020C • • •

MS-2-82 • • •

New York Life Ins. Co. 8145 x x x

Old Surety Life Ins. Co. of Texas MS x x x

Physicians Mutual Ins. Co. P397/R633 • • •

P318 • • •

Pioneer Life Ins. Co. of Illinois 9279 • • •

9176 • • •

Providential Life Ins. Co. 182 x x x

189 • • •

Pyramid Life Ins. Co. H-91 x x x

Southwest Service Life Ins. Co. MS93 x x x

Standard Life & Accident Ins. Co. 1222 • • •

Statesman National Life Ins. Co. P-305 854,361 462,204 54.1

P-376RA • • •

Page 72 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1992 1993

o Premiums Claims Loss ratio Premiums Claims Loss ratio

• • • • 290,169 147,583 50.9

754,147 411,142 54.5 616,204 240,899 39.1

x 2,805,650 1,678,852 59.8 2,520,532 1,399,719 55.5

3 913,442 427,580 46.8 808,825 324,402 40.1

x 6,496,617 3,840,536 59.1 6,131,833 3,371,972 55.0

5 806,313 304,519 37.8 761,961 316,140 41.5

• x x x 3,240,264 1,809,411 55.8

• • • • 244,869 129,095 52.7

• 1,466,863 683,842 46.6 1,570,250 800,637 51.0

x x x x 330,943 134,949 40.8

x 307,700 169,008 54.9 x x x

4 x x x 227,196 132,999 58.5

• • • • 183,861 81,354 44.2

• • • • 1,711,062 697,477 40.8

• • • • 458,035 218,540 47.7

x 3,517,537 1,871,126 53.2 3,052,324 1,760,559 57.7

• 1,732,376 944,694 54.5 1,265,126 644,765 51.0

x 384,689 207,722 54.0 366,742 214,179 58.4

7 x x x 266,987 140,364 52.6

• x x x 619,782 268,237 43.3

• x x x 266,148 75,649 28.4

• x x x 728,135 361,009 49.6

• • • • 1,512,146 342,952 22.7

• • • • 176,952 44,163 25.0

• x x x 415,523 186,715 44.9

x x x x 617,485 367,070 59.4

x x x x 1,453,301 834,538 57.4

• • • • 354,653 200,254 56.5

• • • • 306,941 150,739 49.1

• • • • 1,935,911 1,089,844 56.3

• x x x 218,041 118,335 54.3

x x x x 213,433 93,726 43.9

• • • • 601,027 324,165 53.9

x 212,803 96,305 45.3 178,602 100,949 56.5

x 156,878 88,351 56.3 • • •

• • • • 968,651 547,635 56.5

822,749 389,076 47.3 x x x

• 592,761 333,764 56.3 • • •

(continued)

Page 73 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1991

Company Policy number Premiums Claims Loss ratio

P-181 1,041,417 548,365 52.7

Union Bankers Ins. Co. 76M 398,084 227,499 57.1

MS-2 • • •

86M x x x

Union Fidelity Life Ins. Co. of Trevose 8350 584,907 343,511 58.7

United American Ins. Co. MC3 • • •

MC1 • • •

MAXC+ x x x

MBXC x x x

MCCAT • • •

MAXC x x x

MMS x x x

MVXC x x x

United Teacher Associates Ins. Co. MS-860101-UTA x x x

MS-890101-UTA-TX • • •

Utah

Bankers Life & Casualty Co. GR-A002 • • •

GR-75R x x x

Blue Cross & Blue Shield of Utah 888365-001/3-012 347,052 151,277 43.6

888365-001/3-007 360,507 200,606 55.6

888365-001/3-010 x x x

Equitable Life & Casualty Ins. Co. 700 x x x

880 • • •

990 • • •

Mutual of Omaha Ins. Co. M4,HM17b 150,620 85,591 56.8

M2 and others x x x

Pioneer Life Ins. Co. of Illinois 9061 x x x

Standard Life & Accident Ins. Co. 1238 • • •

State Farm Mutual Automobile Ins. Co. 97046 • • •

97033 x x x

United American Ins. Co. MAXC+ 228,679 103,778 45.4

Vermont

Bankers Life & Casualty Co. GR-A002 • • •

Virginia

Amer. Family Life Assurance Co. of Columbus,

GA

A-19800 336,920 154,074 45.7

A-19000 • • •

Bankers Life & Casualty Co. GR-75R x x x

Page 74 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1992 1993

o Premiums Claims Loss ratio Premiums Claims Loss ratio

7 156,671 59,696 38.1 • • •

x x x 200,502 99,636 49.7

• 234,099 129,899 55.5 552,445 288,214 52.2

x 823,881 487,347 59.2 745,262 414,432 55.6

7 x x x • • •

• 1,764,297 969,761 55.0 2,605,118 1,231,413 47.3

• • • • 223,785 134,088 59.9

x 4,779,468 2,699,060 56.5 4,519,058 2,266,090 50.1

x 203,223 97,627 48.0 202,044 104,369 51.7

• 169,899 89,912 52.9 1,366,876 709,101 51.9

x 3,271,833 1,843,269 56.3 3,070,896 1,617,061 52.7

x 6,695,595 3,773,442 56.4 6,140,729 2,918,715 47.5

x 222,083 116,629 52.5 x x x

x 749,152 422,920 56.5 x x x

• 1,941,757 1,113,351 57.3 x x x

• • • • 250,100 107,981 43.2

x 691,540 411,427 59.5 607,464 344,898 56.8

6 329,176 137,168 41.7 296,332 136,958 46.2

6 447,992 228,337 51.0 550,210 262,531 47.7

x 4,762,257 2,854,741 59.9 x x x

x x x x 844,770 469,542 55.6

• x x x 3,365,598 1,935,007 57.5

• • • • 414,488 227,351 54.9

8 • • • • • •

x 153,873 39,004 25.3 • • •

x x x x 358,249 174,060 48.6

• • • • 198,022 95,371 48.2

• 187,854 110,889 59.0 x x x

x 406,701 243,027 59.8 381,770 183,607 48.1

4 x x x • • •

• • • • 297,628 137,913 46.3

7 262,114 101,575 38.8 230,041 100,634 43.7

• 742,919 374,619 50.4 1,432,686 742,065 51.8

x x x x 1,883,030 1,091,364 58.0

(continued)

Page 75 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1991

Company Policy number Premiums Claims Loss ratio

GR-73S x x x

CR-93T • • •

Capital Security Life 8140A • • •

Colonial Penn Life Ins. Co. 4-82-595 • • •

Combined Insurance Co. of America 000014952 • • •

Globe Life & Accident Ins. Co. MCP-3 342,517 200,979 58.7

MCP-4 168,579 75,367 44.7

Gulf Life Ins. Co. MED-1 650,606 389,509 59.9

Humana Insurance Co. GMSIC2 x x x

Integrity National Life Ins. Co. H-722-0389 • • •

Life Insurance Co. of Georgia 6610 • • •

Mutual of Omaha Ins. Co. M115 and others • • •

50/51/52VB x x x

M4/M72 and others 406,911 226,962 55.8

M3/M71,H64b 154,246 78,896 51.1

M35 and others 288,761 130,657 45.2

C23M and others x x x

National Financial Ins. Co. GL65-4 184,452 65,316 35.4

G764 x x x

New York Life Ins. Co. 8145 237,932 111,002 46.7

Pioneer Life Ins. Co. of Illinois 9061 x x x

9279 • • •

Pyramid Life Ins. Co. G-10 158,414 69,690 44.0

H-94 158,368 69,398 43.8

State Farm Mutual Automobile Ins. Co. 97046 x x x

Union Fidelity Life Ins. Co. of Trevose 1042 229,526 105,168 45.8

1053 640,848 340,428 53.1

8550 467,719 277,229 59.3

United American Ins. Co. MMS x x x

MAXC+ 1,048,058 574,581 54.8

MBXC x x x

USAA Life Insurance Co. AG4001 • • •

Washington

Amer. Family Life Assurance Co. of Columbus,

GA

A-19000 • • •

Bankers Fidelity Life Ins. Co. MS1083 467,429 261,658 56.0

2083 • • •

Bankers Life & Casualty Co. GR-73S x x x

Page 76 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1992 1993

o Premiums Claims Loss ratio Premiums Claims Loss ratio

x 447,868 240,027 53.6 423,544 228,272 53.9

• 172,605 90,579 52.5 • • •

• x x x 181,755 80,957 44.5

• x x x 323,125 153,742 47.6

• • • • 158,619 76,092 48.0

7 x x x x x x

7 • • • • • •

9 x x x x x x

x x x x 1,489,074 838,251 56.3

• • • • 156,763 88,716 56.6

• 191,329 26,686 13.9 199,078 70,574 35.5

• 197,774 78,315 39.6 370,431 198,662 53.6

x 198,786 116,135 58.4 x x x

8 x x x 314,252 179,024 57.0

• • • • • •

2 236,188 141,442 59.9 212,627 116,885 55.0

x x x x 350,374 181,389 51.8

4 x x x • • •

x 168,531 76,045 45.1 • • •

7 235,372 95,998 40.8 225,938 117,486 52.0

x x x x 249,738 142,056 56.9

• • • • 154,842 77,593 50.1

0 • • • • • •

8 150,168 83,918 55.9 • • •

x x x x 753,419 440,806 58.5

8 212,446 126,149 59.4 • • •

539,713 307,753 57.0 • • •

3 404,455 237,681 58.8 • • •

x x x x 898,878 510,396 56.8

8 x x x x x x

x 221,958 114,238 51.5 x x x

• 688,742 403,000 58.5 x x x

• x x x 365,271 201,089 55.1

0 • • • • • •

• 316,685 128,562 40.6 222,591 86,973 39.1

x 1,147,036 633,020 55.2 1,096,680 637,482 58.1

(continued)

Page 77 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1991

Company Policy number Premiums Claims Loss ratio

GR-75R 3,629,420 2,042,718 56.3

GR-A002 • • •

Blue Cross of Washington & Alaska 701-10535 • • •

Blue Cross & Blue Shield of Oregon SP001 • • •

Central States H & L Co. of Omaha 286 164,348 96,112 58.5

Commonwealth Life Insurance Co. 500 and 801 • • •

Continental General Ins. Co. 324 • • •

Equitable Life & Casualty Ins. Co. 700 x x x

Federal Home Life Ins. Co. NAC 9930 x x x

NAC 9942 • • •

Hartford Life Insurance Co. SRP-1261 • • •

Healthcare, Inc. MS-86060 • • •

MS-182 • • •

MS-86100 • • •

King County Medical Blue Shield 34400 x x x

34200 x x x

Mutual of Omaha Ins. Co. E90MD and others • • •

Mutual Protective Ins. Co. 489 • • •

990 • • •

National Home Life Assurance Co. GS 3 • • •

NH1380 437,657 251,641 57.5

National States Ins. Co. RMS • • •

New York Life Ins. Co. 8145 291,217 159,895 54.9

Physicians Mutual Ins. Co. P393/R622 x x x

P115 • • •

Pioneer Life Ins. Co. of Illinois 9161 • • •

Standard Life & Accident Ins. Co. 1239 • • •

1228 • • •

State Farm Mutual Automobile Ins. Co. 97033 x x x

Union Fidelity Life Ins. Co. of Trevose 1053 166,903 78,597 47.1

United American Ins. Co. MAXC+ x x x

West Virginia

Amer. Family Life Assurance Co. of Columbus,

GA

A-19000 • • •

Bankers Life & Casualty Co. CR-93T x x x

GR-75R x x x

Gulf Life Insurance Co. 73787 E x x x

Monumental Life Ins. Co. MS3000PGM • • •

Page 78 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1992 1993

o Premiums Claims Loss ratio Premiums Claims Loss ratio

3 3,761,337 1,984,566 52.8 3,693,131 1,888,802 51.1

• • • • 526,202 247,168 47.0

• • • • 6,663,041 3,344,071 50.2

• • • • 727,793 418,951 57.6

5 • • • • • •

• x x x 190,365 90,041 47.3

• x x x 485,705 266,781 54.9

x 250,797 47,819 19.1 x x x

x 1,035,052 554,712 53.6 569,875 267,327 46.9

• x x x 179,181 79,690 44.5

• 1,456,305 834,317 57.3 • • •

• 207,335 113,270 54.6 x x x

• 401,041 239,358 59.7 x x x

• 219,091 123,483 56.4 170,000 101,514 59.7

x x x x 2,714,454 1,589,286 58.5

x 2,367,509 1,402,537 59.2 3,459,728 1,822,103 52.7

• • • • 208,914 124,445 59.6

• x x x 1,512,473 890,978 58.9

• • • • 234,613 135,598 57.8

• 154,618 90,726 58.7 • • •

5 • • • • • •

• • • • 166,619 90,091 54.1

9 295,536 162,075 54.8 296,839 163,893 55.2

x x x x 183,145 105,103 57.4

• • • • 294,410 165,203 56.1

• x x x 974,844 582,119 59.7

• • • • 1,013,344 510,076 50.3

• • • • 262,886 134,261 51.1

x x x x 575,234 338,182 58.8

• • • • • •

x x x x 1,241,471 644,782 51.9

• 400,596 226,450 56.5 618,423 290,696 47.0

x x x x 254,909 138,871 54.5

x x x x 3,023,824 1,669,393 55.2

x x x x 264,520 155,284 58.7

• • • • 205,314 106,045 51.7

(continued)

Page 79 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1991

Company Policy number Premiums Claims Loss ratio

Mutual of Omaha Ins. Co. M4/M82 and others x x x

M2/M80 and others x x x

C23M and others x x x

M115 and others • • •

50/51/52VB 188,463 109,779 58.2

2CMO and others x x x

M1/M79b 165,663 89,440 54.0

Union Fidelity Life Ins. Co. of Trevose 8550 x x x

1053 320,375 166,225 51.9

United American Ins. Co. MAXC x x x

MC3 • • •

MMS x x x

MBXC x x x

Wisconsin

Aid Association for Lutherans 4952 THRU 4956 • • •

American Republic Ins. Co. A-2930 • • •

Amer. Family Life Assurance Co. of Columbus,

GA

A-19700 186,809 86,653 46.4

A-19800 639,370 338,905 53.0

Bankers Life & Casualty Co. GR-75R x x x

GR-A002 • • •

Central States H & L Co. of Omaha 286 1,899,728 1,105,465 58.2

Colonial Penn Life Ins. Co. 4-82-595 • • •

3-82-855 x x x

Continental General Ins. Co. 327 • • •

Federal Life Ins. Co. (Mutual) A-7400 • • •

Guarantee Trust Life Ins. Co. 85420 x x x

Medico Life Ins. Co. 489 • • •

Mutual of Omaha Ins. Co. M40,HM26b 1,951,117 1,159,895 59.4

M39 and others x x x

50/51/52VB x x x

50CMO and others 246,761 133,321 54.0

M38 and others x x x

M123 and others • • •

Mutual Protective Ins. Co. 489 • • •

New York Life Ins. Co. 8145 x x x

North American Ins. Co. 400 170,616 63,099 37.0

Pioneer Life Ins. Co. of Illinois 9161 • • •

Page 80 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1992 1993

o Premiums Claims Loss ratio Premiums Claims Loss ratio

x 231,918 132,145 57.0 203,531 109,007 53.6

x 485,604 255,690 52.7 x x x

x 216,218 113,408 52.5 196,651 102,909 52.3

• 218,149 107,434 49.2 315,965 171,884 54.4

2 168,601 84,123 49.9 157,823 65,688 41.6

x 152,766 70,336 46.0 • • •

0 • • • • • •

x 349,613 175,268 50.1 • • •

9 270,758 138,095 51.0 • • •

x 1,059,867 598,490 56.5 1,104,592 621,460 56.3

• • • • 674,128 355,900 52.8

x 935,732 506,170 54.1 951,305 465,228 48.9

x 215,275 128,078 59.5 x x x

• • • • 359,112 169,930 47.3

• x x x 1,405,515 783,542 55.7

4 • • • • • •

0 555,369 232,851 41.9 464,801 239,478 51.5

x x x x 5,507,587 3,179,252 57.7

• • • • 4,449,071 2,581,794 58.0

2 x x x 1,154,938 664,364 57.5

• x x x 3,761,927 1,945,317 51.7

x x x x 1,214,079 617,192 50.8

• x x x 722,116 325,159 45.0

• 302,915 172,931 57.1 • • •

x 297,624 126,997 42.7 189,083 77,757 41.1

• 171,524 102,742 59.9 605,687 322,710 53.3

4 • • • x x x

x 234,214 105,166 44.9 173,655 48,069 27.7

x 441,359 245,527 55.6 393,569 174,596 44.4

0 x x x 173,070 81,703 47.2

x 417,417 248,478 59.5 367,461 203,001 55.2

• 920,755 399,924 43.4 1,414,006 605,785 42.8

• x x x 3,355,924 1,924,145 57.3

x 172,652 45,878 26.6 160,313 78,888 49.2

0 • • • • • •

• 536,099 320,375 59.8 x x x

(continued)

Page 81 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1991

Company Policy number Premiums Claims Loss ratio

9061 x x x

Rural Security Life Ins. Co. HP-191 x x x

State Farm Mutual Automobile Ins. Co. 97033 x x x

United American Ins. Co. MMS x x x

DMXC-U 234,474 132,191 56.4

W1 • • •

Wisconsin Physicians Service Ins. Corp. 17406-051-9012 • • •

Wyoming

Bankers Life & Casualty Co. GR-A002 • • •

GR-75R 464,925 219,913 47.3

Blue Cross & Blue Shield of Wyoming MSI92 • • •

Combined Insurance Co. of America 000014954 • • •

Pioneer Life Ins. Co. of Illinois 9161 • • •

9061 x x x

State Farm Mutual Automobile Ins. Co. 97033 x x x

Union Bankers Ins. Co. 86M • • •

United American Ins. Co. MAXC+ 310,343 157,476 50.7

MMS x x x

Total $195,984,156 $105,185,275 53.7

Page 82 GAO/HEHS-95-151 Medigap Insurance
Appendix II 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Individual Policies (1991-93)

1992 1993

o Premiums Claims Loss ratio Premiums Claims Loss ratio

x 836,065 499,636 59.8 x x x

x x x x 1,446,037 840,910 58.2

x x x x 1,824,409 1,053,455 57.7

x • • • 1,841,719 1,099,564 59.7

4 x x x x x x

• 837,431 456,379 54.5 1,326,885 758,766 57.2

• 164,550 85,950 52.2 220,748 98,530 44.6

• • • • 152,348 53,023 34.8

3 433,000 212,268 49.0 402,302 204,814 50.9

• 328,984 175,928 53.5 348,564 133,840 38.4

• • • • 153,202 91,408 59.7

• x x x 305,620 178,688 58.5

x x x x 350,109 180,422 51.5

x 202,689 116,207 57.3 200,102 112,189 56.1

• x x x 153,533 85,037 55.4

7 299,959 164,612 54.9 x x x

x x x x 179,655 81,509 45.4

7 $476,577,836 $258,526,298 54.2 $780,531,667 $416,467,921 53.4

Legend:

X = Policy loss ratio met the applicable minimum federal standard.

• = Insurer reported no loss ratio experience or experience reported was either not mature or not

credible.

aName changed in 1992.

bCompanies included data for similar policies on a single experience exhibit.

Page 83 GAO/HEHS-95-151 Medigap Insurance
Appendix III 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Group Policies (1991-93)

1991

Company Policy number Premiums Claims Loss ratio

Alabama

Allianz Life Ins. Co. of North Americaa GSC1054 • • •

GSC-1300 $209,187 $110,924 53.0

National Home Life Assurance Co. NH1380 • • •

Alaska

Prudential Insurance Co. of America 1 x x x

Arizona

National Home Life Assurance Co. NH1380 • • •

Principal Mutual Life Ins. Co. GC500(D-MSP)W/GC 241,560 134,783 55.8

USAA Life Ins. Co. ag7001 • • •

Arkansas

National Home Life Assurance Co. NH1380 • • •

California

Allianz Life Ins. Co. of North Americaa D603 • • •

GSC1667 • • •

Calfarm Life Ins. Co. GPH11252 • • •

GPH 11248 • • •

GPH11247 • • •

Colonial Penn Franklin Ins. Co. 10-82-316 • • •

Commonwealth Life Ins. Co. A1000,A1000(1/89) • • •

Hartford Life Ins. Co. SRP-1265 • • •

Idealife Ins. Co. IGH-9905-P • • •

Monumental Life Ins. Co. MS3000PGM • • •

National Home Life Assurance Co. NH1380 • • •

NH1190 • • •

NH 810 • • •

NH 910 • • •

Principal Mutual Life Ins. Co. GC500(D) W/GC552 243,781 126,361 51.8

Provident Life & Accident Ins. Co. F-65872 x x x

Union Labor Life Ins. Co. 610400 x x x

USAA Life Ins. Co. ag7001 • • •

Colorado

Hartford Life Ins. Co. SRP-1261 • • •

SRP-7318 x x x

Life Investors Ins. Co. of America GMS 1,2,3b 218,558 102,049 46.7

Monumental Life Ins. Co. MS3000PGM • • •

National Home Life Assurance Co. NH1380 • • •

Page 84 GAO/HEHS-95-151 Medigap Insurance
Appendix III 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Group Policies (1991-93)

1992 1993

o Premiums Claims Loss ratio Premiums Claims Loss ratio

• x x x 210,259 127,205 60.5

0 • • • • • •

• $688,876 $395,740 57.4 583,326 313,443 53.7

x x x x 1,587,306 1,119,815 70.5

• 222,334 133,167 59.9 184,917 92,636 50.1

8 249,251 167,856 67.3 305,363 190,711 62.5

• • • • 362,015 221,369 61.1

• 338,800 227,876 67.3 299,067 129,237 43.2

• 226,376 154,380 68.2 173,073 115,449 66.7

• x x x 587,229 332,645 56.6

• • • • 243,806 79,918 32.8

• 4,502,855 3,312,539 73.6 • • •

• • • • 556,108 218,057 39.2

• x x x 173,545 60,826 35.0

• • • • 261,830 184,600 70.5

• • • • 151,962 84,346 55.5

• • • • 680,325 370,450 54.5

• x x x 5,491,001 3,746,397 68.2

• 3,661,564 2,088,576 57.0 2,813,026 1,777,189 63.2

• 410,991 234,137 57.0 330,365 235,753 71.4

• 338,695 190,262 56.2 269,620 157,098 58.3

• 904,083 529,444 58.6 729,742 389,978 53.4

8 378,520 242,860 64.2 514,973 377,880 73.4

x 4,148,261 2,952,301 71.2 x x x

x 596,611 420,152 70.4 x x x

• • • • 1,291,814 825,298 63.9

• • • • 836,829 478,120 57.1

x • • • 1,267,139 886,934 70.0

7 • • • • • •

• • • • 298,576 170,512 57.1

• 207,301 92,094 44.4 188,252 76,028 40.4

(continued)

Page 85 GAO/HEHS-95-151 Medigap Insurance
Appendix III 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Group Policies (1991-93)

1991

Company Policy number Premiums Claims Loss ratio

Principal Mutual Life Ins. Co. GC500(D) WITH GC 331,665 212,413 64.0

Provident Life & Accident Ins. Co. F-65872 • • •

Connecticut

Blue Cross & Blue Shield of Connecticut, Inc. BC65 PLAN 81 x x x

BC65 HIGH OPTION • • •

BC65 PLAN 82 x x x

Hartford Life Ins. Co. SRP-1261 • • •

Provident Life & Accident Ins. Co. F-65872 • • •

Delaware

Blue Cross & Blue Shield of Delaware, Inc. Standard • • •

SECURE-65 • • •

Provident Life & Accident Ins. Co. F-63150 326,812 203,801 62.4

Prudential Insurance Co. of America 1 x x x

District of Columbia

Allianz Life Ins. Co. of North Americaa GSC1667 • • •

GSC-1395 414,519 280,887 67.8

GSC-1310 2,671,438 1,656,045 62.0

GSC-1544 586,112 346,662 59.1

GSC-1012 246,543 128,165 52.0

GSC-1090 150,342 79,182 52.7

GSC-1385 7,246,522 4,823,240 66.6

Hartford Life Ins. Co. SRP-7318 • • •

Preferred Life Ins Co of New York GSC-1310-PL 315,590 184,135 58.3

Florida

Allianz Life Ins. Co. of North Americaa GSC1544 • • •

Colonial Penn Franklin Ins. Co. 10-82-316 • • •

Commonwealth Life Ins. Co. 1000 • • •

Guarantee Trust Life Ins. Co. 9242G • • •

National Home Life Assurance Co. NH 810 • • •

NH 910 • • •

Union Labor Life Ins. Co. 610400 • • •

Georgia

Allianz Life Ins. Co. of North Americaa GSC1054 • • •

National Home Life Assurance Co. NH1380 • • •

Nationwide Life Ins. Co. GR-2001-3 x x x

Provident Life & Accident Ins. Co. F-65872 278,031 179,095 64.4

USAA Life Ins. Co. ag7001 • • •

Hawaii

Page 86 GAO/HEHS-95-151 Medigap Insurance
Appendix III 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Group Policies (1991-93)

1992 1993

o Premiums Claims Loss ratio Premiums Claims Loss ratio

0 x x x 401,331 293,377 73.1

• 195,520 130,545 66.8 x x x

x x x x 5,997,692 4,250,034 70.9

• • • • 25,427,070 16,301,501 64.1

x 4,132,018 2,659,752 64.4 3,932,330 2,675,095 68.0

• • • • 275,407 197,156 71.6

• 235,565 157,625 66.9 x x x

• 855,805 428,759 50.1 • • •

• 188,242 109,343 58.1 • • •

4 x x x x x x

x x x x 5,792,408 4,164,634 71.9

• 415,427 (325,026) –78.2 328,746 (24,450) –7.4

8 • • • • • •

0 • • • • • •

• • • • • •

0 • • • • • •

7 • • • • • •

6 • • • • • •

• • • • 157,718 68,986 43.7

3 • • • • • •

• 172,038 115,530 67.2 173,528 93,603 53.9

• x x x 227,286 107,987 47.5

• x x x 334,265 172,590 51.6

• • • • 20,747,633 12,932,350 62.3

• x x x 225,944 95,282 42.2

• x x x 942,461 642,948 68.2

• x x x 243,148 175,583 72.2

• 215,495 160,315 74.4 x x x

• 1,488,531 903,762 60.7 1,280,847 628,181 49.0

x x x x 202,321 132,645 65.6

4 451,971 245,209 54.3 461,159 327,234 71.0

• • • • 211,757 129,488 61.1

(continued)

Page 87 GAO/HEHS-95-151 Medigap Insurance
Appendix III 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Group Policies (1991-93)

1991

Company Policy number Premiums Claims Loss ratio

Hartford Life Ins. Co. SRP-7318 • • •

Prudential Insurance Co. of America 01 985,962 682,673 69.2

Idaho

Hartford Life Ins. Co. SRP-7318 x x x

Illinois

Bankers Life and Casualty Co. CR-97K x x x

Continental Casualty Co. 44017 1,043,320 652,958 62.6

Health Care Svc. Corp. CB 44.6 • • •

GB 10-A2.2 x x x

CB 44.8 • • •

CB 44.7 • • •

Life Investors Ins. Co. of America GMS 1,2,3b 218,768 77,455 35.4

National Home Life Assurance Co. NH1380 • • •

NH 910 • • •

Principal Mutual Life Ins. Co. GC500(D) WITH GC 1,028,204 756,447 73.6

Indiana

Hartford Life Ins. Co. SRP-1261 • • •

Life Investors Ins. Co. of America GMS 1,2,3b 244,275 108,787 44.5

Monumental Life Ins. Co. MS3000PGM • • •

National Home Life Assurance Co. NH1380 • • •

Principal Mutual Life Ins. Co. GC500(D-MSP)W/GC 605,504 404,019 66.7

Provident Life & Accident Ins. Co. F-65872 • • •

Iowa

Life Investors Ins. Co. of America GMS 1,2,3b 336,538 121,228 36.0

National Home Life Assurance Co. NH1380 • • •

Principal Mutual Life Ins. Co. GC500(D) WITH GC 14,020,163 8,852,946 63.1

Provident Life & Accident Ins. Co. F-65872 • • •

Kansas

Hartford Life Ins. Co. SRP-7318 x x x

SRP-1261 • • •

Kentucky

Hartford Life Ins. Co. SRP-1261 • • •

National Home Life Assurance Co. NH 910 • • •

NH1380 • • •

Provident Life & Accident Ins. Co. F-65872 • • •

Louisiana

National Home Life Assurance Co. NH 910 • • •

NH1380 • • •

Page 88 GAO/HEHS-95-151 Medigap Insurance
Appendix III 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Group Policies (1991-93)

1992 1993

o Premiums Claims Loss ratio Premiums Claims Loss ratio

• • • • 174,745 83,080 47.5

2 x x x x x x

x • • • 220,376 157,634 71.5

x x x x 1,397,886 864,984 61.9

6 917,219 549,921 60.0 • • •

• 1,523,746 1,057,682 69.4 x x x

x 12,092,951 8,721,626 72.1 12,067,057 8,547,684 70.8

• 987,598 646,108 65.4 x x x

• 313,304 212,948 68.0 x x x

4 • • • • • •

• 1,488,029 1,000,306 67.2 1,277,282 706,656 55.3

• 313,478 195,686 62.4 x x x

6 x x x x x x

• • • • 298,790 223,575 74.8

5 • • • • • •

• x x x 309,813 207,883 67.1

• x x x 752,097 406,696 54.1

7 628,837 457,801 72.8 x x x

• 220,450 121,897 55.3 246,646 136,342 55.3

0 • • • • • •

• 204,586 142,588 69.7 184,571 90,548 49.1

x x x x x x

• x x x 213,264 135,792 63.7

x • • • 326,021 241,858 74.2

• • • • 236,944 175,739 74.2

• • • • 261,431 184,876 70.7

• 327,145 176,215 53.9 288,499 151,456 52.5

• x x x 303,267 177,549 58.5

• x x x 177,084 125,490 70.9

• 159,917 95,047 59.4 • • •

• 988,873 680,887 68.9 902,435 566,560 62.8

(continued)

Page 89 GAO/HEHS-95-151 Medigap Insurance
Appendix III 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Group Policies (1991-93)

1991

Company Policy number Premiums Claims Loss ratio

Provident Life & Accident Ins. Co. F-65872 x x x

USAA Life Ins. Co. AG7001 • • •

Maine

Assoc. Hospital Service of Maine 028073 • • •

Hartford Life Ins. Co. SRP-7318 x x x

SRP-1261 • • •

Maryland

Hartford Life Ins. Co. SRP-7318 x x x

SRP-1261 • • •

Provident Life & Accident Ins. Co. F-65872 • • •

Toyota Motor Life Ins Co MSP2000 281,468 187,160 66.5

Massachusetts

Blue Cross & Blue Shield of Massachusetts ME 2 50,933,901 29,022,187 57.0

ME 4 2,438,483 1,103,984 45.3

Hartford Life Ins. Co. SRP-1261 • • •

National Home Life Assurance Co. NH 910 • • •

Provident Life & Accident Ins. Co. F-65872 167,543 79,552 47.5

Toyota Motor Life Ins Co MSP2000 310,311 231,725 74.7

Michigan

National Home Life Assurance Co. NH 910 • • •

Minnesota

Blue Cross & Blue Shield of Minnesota 1 • • •

Hartford Life Ins. Co. SRP-7318 x x x

Life Investors Ins. Co. of America GMS 1,2,3b 377,045 192,892 51.2

Monumental Life Ins. Co. MS3000PGM • • •

Provident Life & Accident Ins. Co. F-65872 • • •

Prudential Insurance Co. of America 1 x x x

Mississippi

Hartford Life Ins. Co. SRP-1261 • • •

Monumental Life Ins. Co. MS3000PGM • • •

National Home Life Assurance Co. NH1380 • • •

NH 910 • • •

Missouri

Allianz Life Ins. Co. of North Americaa GSC1054 • • •

Blue Cross & Blue Shield of Missouri UC24 3,335,484 2,243,323 67.3

LMC-1 522,926 347,304 66.4

C-6D x x x

National Home Life Assurance Co. NH 910 • • •

Page 90 GAO/HEHS-95-151 Medigap Insurance
Appendix III 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Group Policies (1991-93)

1992 1993

o Premiums Claims Loss ratio Premiums Claims Loss ratio

x 314,332 169,030 53.8 x x x

• • • • 247,356 151,256 61.1

• 7,708,190 1,690,483 21.9 7,598,127 1,322,953 17.4

x • • • 241,284 151,317 62.7

• • • • 152,260 91,672 60.2

x • • • 1,144,548 770,834 67.3

• • • • 774,263 424,693 54.9

• 232,788 167,750 72.1 x x x

5 • • • • • •

0 • • • • • •

3 • • • • • •

• • • • 466,549 286,170 61.3

• 357,782 132,683 37.1 322,416 150,488 46.7

5 272,550 136,473 50.1 x x x

7 • • • • • •

• 159,501 64,797 40.6 • • •

• 4,488,331 2,597,351 57.9 x x x

x • • • 215,525 157,140 72.9

2 • • • • • •

• • • • 186,200 97,036 52.1

• • • • 172,774 87,265 50.5

x x x x 8,699,198 6,446,194 74.1

• • • • 452,674 335,047 74.0

• • • • 255,512 145,173 56.8

• 600,609 415,575 69.2 525,528 301,774 57.4

• 196,547 84,558 43.0 162,516 89,138 54.8

• • • • 179,356 123,290 68.7

3 3,483,760 2,404,089 69.0 2,594,431 1,432,553 55.2

4 494,258 144,493 29.2 733,456 405,206 55.2

x x x x 2,179,694 1,508,121 69.2

• 348,302 179,791 51.6 296,415 152,312 51.4

(continued)

Page 91 GAO/HEHS-95-151 Medigap Insurance
Appendix III 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Group Policies (1991-93)

1991

Company Policy number Premiums Claims Loss ratio

NH1380 • • •

Principal Mutual Life Ins. Co. GC500(D-MSP)W/GC 757,668 515,643 68.1

Provident Life & Accident Ins. Co. F-65872 x x x

Montana

Hartford Life Ins. Co. SRP-7318 • • •

Prudential Insurance Co. of America 1 x x x

Nebraska

Blue Cross & Blue Shield of Nebraska 9704(I), 9710(G) 193,555 94,588 48.9

9721(I), 9733(G) • • •

Hartford Life Ins. Co. SRP-7318 • • •

Life Investors Ins. Co. of America GMS 1,2,3b 229,771 104,552 45.5

Principal Mutual Life Ins. Co. GC500(D) WITH GC 6,873,824 4,911,736 71.5

Nevada

Blue Cross & Blue Shield Plan of Nevada 82171 525,444 320,596 61.0

82172 301,027 183,670 61.0

National Home Life Assurance Co. NH1380 • • •

Prudential Insurance Co. of America 01 x x x

New Hampshire

Blue Cross & Blue Shield of New Hampshire 061.065 x x x

Hartford Life Ins. Co. SRP-7318 • • •

SRP-1261 • • •

New Jersey

Hartford Life Ins. Co. SRP-1261 • • •

Monumental Life Ins. Co. MS3000PGM • • •

National Home Life Assurance Co. NH 910 • • •

NH1380 • • •

Provident Life & Accident Ins. Co. F-65872 450,283 305,559 67.9

USAA Life Ins. Co. ag7001 • • •

New Mexico

Hartford Life Ins. Co. SRP-1261 • • •

SRP-7318 x x x

Monumental Life Ins. Co. MS3000PGM • • •

National Home Life Assurance Co. NH1380 • • •

New Mexico Blue Cross & Blue Shield, Inc. M296 502,168 169,290 33.7

M297 • • •

Prudential Insurance Co. of America 01 x x x

Page 92 GAO/HEHS-95-151 Medigap Insurance
Appendix III 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Group Policies (1991-93)

1992 1993

o Premiums Claims Loss ratio Premiums Claims Loss ratio

• 1,066,840 667,159 62.5 954,224 525,728 55.1

717,820 535,641 74.6 x x x

x 303,958 182,532 60.1 x x x

• • • • 150,450 99,850 66.4

x x x x 7,378,074 5,512,732 74.7

9 336,374 194,906 57.9 267,346 114,470 42.8

• 373,322 147,556 39.5 • • •

• • • • 196,201 142,582 72.7

5 • • • • • •

5 x x x x x x

0 • • • • • •

0 • • • • • •

• 202,005 99,227 49.1 185,880 112,242 60.4

x 10,391,223 7,381,006 71.0 x x x

x x x x 404,421 274,677 67.9

• • • • 186,784 134,521 72.0

• • • • 189,854 124,197 65.4

• • • • 539,640 404,109 74.9

• 729,774 537,852 73.7 859,033 492,542 57.3

• 447,807 209,762 46.8 404,660 140,941 34.8

• 1,036,969 622,714 60.1 957,286 527,931 55.1

9 754,472 505,114 66.9 x x x

• • • • 172,305 105,363 61.1

• • • • 345,176 226,613 65.7

x • • • 584,369 436,268 74.7

• • • • 180,195 105,592 58.6

• 213,615 122,881 57.5 189,186 71,525 37.8

7 643,015 236,114 36.7 411,391 163,252 39.7

• 166,365 56,241 33.8 • • •

x 7,987,047 5,940,435 74.4 x x x

(continued)

Page 93 GAO/HEHS-95-151 Medigap Insurance
Appendix III 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Group Policies (1991-93)

1991

Company Policy number Premiums Claims Loss ratio

New York

Blue Cross of Western New York, Inc. BCMS-4 W/BCMS69 x x x

Colonial Penn Franklin Ins. Co. 10-82-316 • • •

Empire Blue Cross & Blue Shield CARVE-OUTS x x x

MSB1992 • • •

MS-MMR x x x

ABC-MED.SUPP. x x x

Hartford Life Ins. Co. SRP-1261 • • •

Monumental Life Ins. Co. MS3000PGM • • •

Provident Life & Casualty Ins. Co. F-65872 x x x

Prudential Insurance Co. of America 1 x x x

North Carolina

Monumental Life Ins. Co. MS3000PGM • • •

National Home Life Assurance Co. NH 850 • • •

NH1380 • • •

NH 910 • • •

Provident Life & Accident Ins. Co. F-63150 572,311 316,990 55.4

F-65872 230,249 160,200 69.6

USAA Life Ins. Co. ag7001 • • •

North Dakota

Blue Cross & Blue Shield of North Dakota MEDICARE

EXTENDED

2,556,918 1,871,787 73.2

Principal Mutual Life Ins. Co. GC500(D) WITH GC 253,532 168,196 66.3

Prudential Insurance Co. of America 1 1,535,480 963,734 62.8

Ohio

Hartford Life Ins. Co. SRP-1261 • • •

SRP-7318 x x x

Monumental Life Ins. Co. MS3000PGM • • •

National Home Life Assurance Co. NH 910 • • •

NH 810 • • •

NH1380 • • •

Nationwide Life Ins. Co. GR-1100, Plan C • • •

GR-1100, Plan H • • •

Principal Mutual Life Ins. Co. GC500(D) W/GC552 583,313 328,192 56.3

Provident Life & Accident Ins. Co. F-63150 343,197 255,296 74.4

F-65872 x x x

Oklahoma

Allianz Life Ins. Co. of North Americaa GSC1054 • • •

Page 94 GAO/HEHS-95-151 Medigap Insurance
Appendix III 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Group Policies (1991-93)

1992 1993

o Premiums Claims Loss ratio Premiums Claims Loss ratio

x 9,996,589 6,902,029 69.0 • • •

• x x x 219,633 65,649 29.9

x • • • 31,479,047 21,823,389 69.3

• • • • 6,030,774 4,087,758 67.8

x • • • 5,144,361 3,502,995 68.1

x • • • 150,255 99,394 66.2

• • • • 731,421 458,631 62.7

• x x x 431,572 279,645 64.8

x 1,958,206 1,435,578 73.3 x x x

x x x x 117,161,120 85,418,760 72.9

• 159,857 104,721 65.5 291,871 192,918 66.1

• x x x 201,740 141,340 70.1

• 2,064,406 1,064,660 51.6 1,756,988 859,863 48.9

• 249,212 119,278 47.9 200,924 83,055 41.3

4 x x x • • •

6 344,064 230,479 67.0 438,032 282,351 64.5

• • • • 168,389 102,968 61.1

2 • • • • • •

3 x x x x x x

8 x x x 1,738,129 1,031,941 59.4

• • • • 524,462 339,671 64.8

x • • • 474,379 315,088 66.4

• x x x 1,502,615 969,198 64.5

• 439,305 231,836 52.8 409,527 173,814 42.4

• 157,549 92,228 58.5 • • •

• 1,671,797 1,001,273 59.9 1,515,811 893,932 59.0

• • • • 947,948 554,967 58.5

• • • • 4,327,097 3,181,951 73.5

3 611,958 454,376 74.2 x x x

4 x x x • • •

x 862,611 499,364 57.9 920,254 657,535 71.5

• • • • 168,449 99,223 58.9

(continued)

Page 95 GAO/HEHS-95-151 Medigap Insurance
Appendix III 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Group Policies (1991-93)

1991

Company Policy number Premiums Claims Loss ratio

Hartford Life Ins. Co. SRP-1261 • • •

National Home Life Assurance Co. NH1380 • • •

Principal Mutual Life Ins. Co. GC500(D-MSP)W/GC 156,354 116,823 74.7

USAA Life Ins. Co. ag7001 • • •

Oregon

Blue Cross & Blue Shield of Oregon 88-MEDSTD-20 1,082,485 706,358 65.3

Hartford Life Ins. Co. SRP-1261 • • •

Klamath Medical Service Bureau MS 65 208,230 141,900 68.1

Monumental Life Ins. Co. MS3000PGM • • •

Provident Life & Accident Ins. Co. F-65872 • • •

Pennsylvania

Allianz Life Ins. Co. of North Americaa GSC1054 • • •

GSC1169 • • •

Monumental Life Ins. Co. MS3000PGM • • •

National Home Life Assurance Co. NH 910 • • •

NH1190 • • •

NH1380 • • •

NH 810 • • •

Provident Life & Accident Ins. Co. F-65872 319,329 203,469 63.7

Puerto Rico

Prudential Insurance Co. of America 01 1,063,607 672,569 63.2

South Carolina

Monumental Life Ins. Co. MS3000PGM • • •

Provident Life & Accident Ins. Co. F-63150 294,975 187,249 63.5

USAA Life Ins. Co. AG7001 • • •

South Dakota

Life Investors Ins. Co. of America GMS 1,2,3b 155,553 57,593 37.0

Tennessee

Allianz Life Ins. Co. of North Americaa GSC1054 • • •

Blue Cross & Blue Shield of Tennessee 65 x x x

81 x x x

87 • • •

88 • • •

Memphis Hospital Service & Surgical

Association, Inc.

BCBS-65 CO-051 307,401 159,891 52.0

Monumental Life Ins. Co. MS3000PGM • • •

National Home Life Assurance Co. NH 910 • • •

NH1380 • • •

Page 96 GAO/HEHS-95-151 Medigap Insurance
Appendix III 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Group Policies (1991-93)

1992 1993

o Premiums Claims Loss ratio Premiums Claims Loss ratio

• • • • 477,797 344,990 72.2

• 560,550 283,597 50.6 484,717 244,503 50.4

7 164,370 119,739 72.8 x x x

• • • • 159,792 97,712 61.1

3 1,416,664 864,234 61.0 1,744,991 1,003,501 57.5

• • • • 388,117 272,099 70.1

• • • • • •

• • • • 187,439 124,276 66.3

• 184,655 95,614 51.8 230,988 143,371 62.1

• • • • 166,631 117,009 70.2

• 165,437 106,139 64.2 • • •

• x x x 2,171,219 1,465,270 67.5

• 377,381 251,610 66.7 311,550 165,594 53.2

• 233,480 136,842 58.6 232,804 144,756 62.2

• 1,743,349 1,058,212 60.7 1,568,103 927,835 59.2

• 152,262 82,979 54.5 • • •

7 523,526 301,628 57.6 512,022 343,497 67.1

2 x x x x x x

• • • • 183,434 106,358 58.0

5 x x x x x x

• • • • 163,783 100,152 61.1

0 • • • • • •

• 157,353 105,960 67.3 204,805 109,349 53.4

x x x x 1,425,901 906,981 63.6

x 275,579 180,953 65.7 x x x

• 275,285 197,160 71.6 x x x

• 327,879 207,811 63.4 x x x

0 258,349 138,377 53.6 • • •

• x x x 599,553 388,234 64.8

• 436,576 254,349 58.3 379,780 226,388 59.6

• 1,207,578 704,002 58.3 1,075,773 624,859 58.1

(continued)

Page 97 GAO/HEHS-95-151 Medigap Insurance
Appendix III 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Group Policies (1991-93)

1991

Company Policy number Premiums Claims Loss ratio

Provident Life & Accident Ins. Co. F-65872 x x x

F-63150 266,513 183,625 68.9

USAA Life Ins. Co. AG7001 • • •

Texas

Allianz Life Ins. Co. of North Americaa D603 • • •

Blue Cross & Blue Shield of Texas, Inc. B-STCS-6 • • •

STCS-MS-3 • • •

Business Mens Assurance Co. of America GR 838-1 x x x

Colonial Penn Franklin Ins. Co. 10-82-316 • • •

Monumental Life Ins. Co. MS3000PGM • • •

Principal Mutual Life Ins. Co. GC500(D)TX W/GC5 2,893,543 1,836,155 63.5

Provident Life & Accident Ins. Co. F-65872 x x x

USAA Life Ins. Co. AG7001 • • •

Utah

Blue Cross & Blue Shield of Utah 888365-001/3-005 • • •

888365-001/3-007 186,752 115,687 61.9

Educators Mutual Ins. Asso. grpmedsup • • •

Hartford Life Ins. Co. SRP-1261 • • •

SRP-7318 154,420 108,614 70.3

Virginia

Allianz Life Ins. Co. of North Americaa GSC1054 • • •

Hartford Life Ins. Co. SRP-7318 x x x

Monumental Life Ins. Co. MS3000PGM • • •

National Home Life Assurance Co. NH1380 • • •

NH 910 • • •

NH1190 • • •

Provident Life & Accident Ins. Co. F-65872 171,487 103,287 60.2

Toyota Motor Life Ins Co MSP2000 353,893 231,029 65.3

USAA Life Ins. Co. AG4001 616,221 430,468 69.9

AG7001 • • •

Virgin Islands

Prudential Insurance Co. of America 1 175,394 104,459 59.6

Washington

Hartford Life Ins. Co. SRP-1261 • • •

SRP-7318 x x x

King County Medical Blue Shield 33900 176,657 131,382 74.4

34200 163,003 121,226 74.4

34000 403,586 300,151 74.4

Page 98 GAO/HEHS-95-151 Medigap Insurance
Appendix III 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Group Policies (1991-93)

1992 1993

o Premiums Claims Loss ratio Premiums Claims Loss ratio

x 362,814 230,790 63.6 x x x

9 x x x • • •

• • • • 222,632 136,137 61.1

• x x x 151,758 85,056 56.0

• • • • 369,231 255,822 69.3

• • • • 32,083,729 23,623,871 73.6

x 169,282 102,489 60.5 177,302 117,539 66.3

• • • • 152,169 39,540 26.0

• 902,302 658,295 73.0 x x x

5 2,766,582 1,859,002 67.2 2,973,742 1,965,573 66.1

x 1,065,014 730,840 68.6 x x x

• • • • 1,815,308 1,167,540 64.3

• • • • 227,092 79,897 35.2

9 254,474 105,445 41.4 • • •

• • • • 851,214 494,933 58.1

• • • • 227,379 136,364 60.0

3 • • • 213,906 141,891 66.3

• • • • 155,119 87,007 56.1

x • • • 3,373,704 2,508,593 74.4

• 383,968 265,739 69.2 723,881 441,186 60.9

• 1,842,036 1,052,992 57.2 • • •

• 367,639 185,340 50.4 335,843 131,224 39.1

• 155,312 102,452 66.0 1,710,957 955,243 55.8

2 286,088 164,503 57.5 310,481 202,276 65.1

3 • • • • • •

9 • • • • • •

• • • • 556,266 383,448 68.9

6 171,783 77,349 45.0 211,584 154,816 73.2

• • • • 1,426,186 831,905 58.3

x • • • 1,281,402 890,870 69.5

4 • • • • • •

4 • • • • • •

4 • • • • • •

(continued)

Page 99 GAO/HEHS-95-151 Medigap Insurance
Appendix III 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Group Policies (1991-93)

1991

Company Policy number Premiums Claims Loss ratio

33800 253,384 188,444 74.4

30000 • • •

Monumental Life Ins. Co. MS3000PGM • • •

National Home Life Assurance Co. NH1380 • • •

Principal Mutual Life Ins. Co. GC500(D) W/GC552 165,908 95,308 57.4

Provident Life & Accident Ins. Co. F-65872 • • •

Toyota Motor Life Ins Co MSP2000 208,423 145,837 70.0

USAA Life Ins. Co. AG7001 • • •

West Virginia

Mountain State Blue Cross & Blue Shield ED 215 x x x

ED214 1,917,393 1,391,861 72.6

National Home Life Assurance Co. NH1380 • • •

Wisconsin

Hartford Life Ins. Co. SRP-1261 • • •

Life Investors Ins. Co. of America GMS 1,2,3b 202,748 100,727 49.7

Principal Mutual Life Ins. Co. GC500(D) WITH GC 5,867,409 4,148,788 70.7

Provident Life & Accident Ins. Co. F-65872 x x x

Total $124,003,963 $76,285,311 61.5

Page 100 GAO/HEHS-95-151 Medigap Insurance
Appendix III 

Medigap Insurers With Mature and Credible

Loss Ratio Experience Below the Minimum

Standard for Group Policies (1991-93)

1992 1993

o Premiums Claims Loss ratio Premiums Claims Loss ratio

4 • • • • • •

• 295,371 184,890 62.6 • • •

• • • • 412,942 252,967 61.3

• 382,224 178,032 46.6 350,784 192,762 55.0

4 201,382 135,659 67.4 247,522 173,812 70.2

• 255,325 145,843 57.1 253,880 147,473 58.1

0 • • • • • •

• • • • 370,343 226,461 61.1

x 1,060,026 628,015 59.2 x x x

6 x x x x x x

• 825,701 525,193 63.6 762,814 385,755 50.6

• • • • 211,005 138,460 65.6

7 • • • • • •

7 x x x x x x

x 432,297 273,635 63.3 x x x

5 $128,574,266 $80,243,654 62.4 $391,313,456 $263,476,478 67.3

Legend:

X = Policy loss ratio met the applicable minimum federal standard.

• = Insurer reported no loss ratio experience or experience reported was either not mature or not

credible.

aName changed from North American Life & Casualty in 1993.

bCompanies included data for similar policies on a single experience exhibit.

Page 101 GAO/HEHS-95-151 Medigap Insurance
Appendix IV 

Major Contributors to This Report

Thomas G. Dowdal, Assistant Director, (202) 512-6588

William A. Hamilton, Evaluator-in-Charge

Jerry G. Baugher

Roger T. Hultgren

Wayne J. Turowski

(106423) Page 102 GAO/HEHS-95-151 Medigap Insurance
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