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Notes

Narrations written during the monthly analyst pass. The analyst-in-residence (Claude, in Claude Code) reads the DB, drafts the note, and persists it to fact_insight. Sorted by severity, then by recency.

Notes filed12
High severity8
CadenceMonthly
high2026-06-02

The 2025 → 2026 cycle: plans contracted, premium fell, MOOP rose, members rotated rather than expanded

Plan supply fell from 5,712 to 5,501 distinct identifiers (net -211, gross churn 21%). Among MA-PD/SNP with non-zero premium, the median monthly consolidated premium fell from $37 to $31 (-15%) while the average in-network MOOP rose from $6,803 to $7,111 (+5%) — a decisive cost-shift from monthly premium to year-end exposure. Aggregate MA enrollment grew 2.85% (Jan 2025 to Jan 2026) but the headline obscures redistribution: Humana's +870K net gain is roughly 80% sourced from a single new contract (H7617, ~8K → ~708K), Elevance lost -308K, and UnitedHealth recorded its first January contraction (-84K). UCare Minnesota's five contracts (184K Dec'25 members) were non-renewed with no successor crosswalk row; Aware Integrated (+80K) and Medica (+73K) in Minnesota absorbed via fresh AEP enrollment, which the official crosswalk file does not trace. The 2027 forecast projects UHG +2.87M as a reversion-to-trend recovery; treat as projection, not thesis. See the full narrative at /cycles/2025-26.

high2026-06-02

Three of the five biggest 2026 contract declines belong to UnitedHealth; Elevance and Humana each lose 100K+ on flagship contracts

Outside the UCare termination cluster, the largest contract-level losses at AEP 2026 are concentrated in incumbent flagships. UnitedHealth's H2001 lost -171K members (2.0M → 1.8M, -8.6%); its H8768 lost -132K (470K → 339K, -28.0%). Elevance's H3655 lost -130K (288K → 158K, -45.0%) — half its book. Humana's H5216, the parent's single largest contract, lost -111K (2.4M → 2.3M, -4.7%) despite the parent's overall growth, which means Humana's +870K headline figure is sourced almost entirely from H7617 (see analyst note on H7617). UHG's contraction is broad-based across multiple contracts; Elevance's is concentrated in a small number of high-impact losses. The pattern suggests fundamentally different go-to-market situations for the two parents.

high2026-06-02

H7617 (Humana) added 700K MA members at AEP 2026 — the single largest contract-level growth on record

Among contracts that crossed the ±2σ threshold on Jan 2026 vs Jan 2025 enrollment, H7617 (Humana Inc.) is the singular outlier: 8,621 → 708,436 members, a +699,815 / +8,118% gain that bins as a 'new entrant' classification because the prior-year base was effectively immaterial. This single contract accounts for roughly 80% of Humana's total 2026 net MA gain. Without it the parent-org's Jan-vs-Jan story compresses to +170K (+2.9%) and the 2026 AEP narrative no longer reads as a Humana-led market rotation. Strategically the contract is either an HMO migration vehicle for a major existing block or a regional consolidation under a fresh HPMS identifier — its scale is decisive enough that downstream competitive analyses need to dimension Humana with and without it.

high2026-06-02

2027 forecast: UnitedHealth projected to add 2.87M MA members, Elevance recovers, Humana plateaus

The CY 2027 enrollment forecast — Prophet on contracts with enough history, seasonal-naive baseline elsewhere — places UnitedHealth Group at 10.73M Jan 2027 MA members, a 2.87M / +36.6% reversal from its 2026 first-ever January contraction. Humana, which led 2026 with +870K, is projected to add only +101K (+1.7%) in 2027, consistent with diminishing returns after its outsized AEP gain. Elevance is modeled to rebuild +258K (+16.9%) toward 1.79M after its 2026 308K loss. Centene (+22.6%) and Health Care Service Corp (+22.2%) lead among scaled regional plans. Cross-published Prophet beats the seasonal-naive baseline on its own backtest in 37.6% of contracts; the rest publish the baseline. The forecast is gated, not narrated — treat the UHG figure as a reversion-to-trend projection, not a thesis.

high2026-06-02

Anthem and UHG win the 2026 Star uplift cycle; CVS Health loses stars on three contracts

The 2026 Star Ratings release moved 47 contracts by at least 0.5 stars in either direction. Top gainers include Elevance's H4004 (4.0 -> 5.0, 105,914 Jan-2026 members), UnitedHealth's H3256 (4.0 -> 5.0, 58,112 members), BCBS Massachusetts H2230 and H2261 (both 3.5 -> 4.5, ~77K combined), and Devoted's H9884 (3.5 -> 4.5). CVS Health appears three times on the loss list (H3928 dropped a full 1.5 stars from 4.5 to 3.0; H1692 and H5325 each fell 1.0 to 3.5), making it the only major parent with multiple notable downgrades. Aware Integrated's H2461 lost 1.0 star to 3.5 on 47K members, BCBS Michigan's H5900 lost 1.0 to 3.5 on 42K, and BCBS Tennessee's H3259 lost 1.0 to 3.5 on 29K. The national 4-star+ contract share held essentially flat (213 -> 207, both years averaging 3.65 overall), so the action is in the redistribution, not the level. For 2027 bid implications, the contracts crossing the 4-star threshold capture the QBP increase; Elevance's H4004 is the most material because of its enrollment scale and its parent's broader 2026 contraction story (Elevance lost 308K MA members at Jan AEP). The H4004 uplift is one of the few unambiguous bright spots in Elevance's CY 2026 portfolio.

high2026-06-02

1,013 contracts non-renewed for 2026 — but the crosswalk file traces only a sliver of the member moves

The CY 2026 plan crosswalk has 9,066 transitions: 5,064 Renewal Plan (55.9%), 1,013 Terminated/Non-renewed Contract, 868 New Plan, 746 Consolidated Renewal Plan, 733 Renewal Plan with SAR (service area reduction), 515 Renewal Plan with SAE (service area expansion), and 127 Initial Contract. UCare Minnesota's wind-down is a textbook example: contracts H2459, H8070, H2456, H5937, and H8783 — carrying 184K Dec 2025 members combined — were all flagged Terminated/Non-renewed, with no successor row in the crosswalk. The members didn't auto-roll; they had to re-enroll during AEP 2026, which is why the parent-org cross-flow analysis on the crosswalk file shows almost nothing while the January enrollment shifts show Aware Integrated +80K and Medica +73K in Minnesota. Practical implication: for absorption modeling, the crosswalk file misses the largest share of competitive-disenrollment volume; tie it to monthly CPSC deltas at the (parent_org, state) grain to recover the structural flow.

high2026-06-02

1,243 plans terminated for CY 2026, 1,032 added — net -211 plans (-3.7%)

Distinct MA / PDP / SNP plans contracted from 5,712 in CY 2025 to 5,501 in CY 2026 — a net loss of 211 plans (-3.7%). The gross movement is much larger: 1,243 plan IDs from the CY 2025 landscape did not return, and 1,032 new plan IDs appeared. That ~21% gross-churn rate is the structural backdrop for crosswalks: every terminated plan forces a member migration, and every new plan has to convert from scratch. For health plans modeling 2026 competitive dynamics, the share of contestable members is much higher than the net plan delta suggests, and the crosswalk file becomes essential for tracking where each terminated cohort actually lands.

high2026-06-02

Humana takes 870K MA members in 2026 AEP, Elevance gives up 308K, UnitedHealth slips first time

The 2026 Annual Enrollment Period reshuffled the top of the MA leaderboard: Humana added +869,949 MA members (+17.2%) to reach 5.94M and overtook the previous gap to UnitedHealth, which actually shed -84,227 to 7.86M — its first January contraction on record. Elevance Health (Anthem) lost -308,043 (-16.8%) and Highmark -54,477, while Devoted Health more than doubled (+114%) to 371K, the fastest growth among scaled players. UCare Minnesota exited entirely (-175,694 to zero); the Aware Integrated and Medica gains of +80K and +73K in the same state strongly suggest absorption of UCare's book. Strategic read: the largest carriers are no longer monolithic, share is becoming more contestable, and the value of disciplined benefit-design plus star-rating execution is rising for any plan with a defensible cost base.

medium2026-06-02

Median MA-PD premium falls $5.60 (-15%) but MOOP exposure rises $308 (+5%)

Among MA-PD and SNP plans with a non-zero consolidated premium, the median fell from $37.00 in CY 2025 to $31.40 in CY 2026 (-$5.60, -15%); the mean dropped less, from $46.72 to $43.65 (-6.6%), implying that the cheap end of the market compressed faster than the expensive end. In the same window, the average in-network MOOP rose from $6,803 to $7,111 (+$308, +4.5%). The pattern is consistent with carriers shifting cost-sharing from monthly premium to year-end exposure — a structurally rational response to the IRA-driven Part D OOP cap and the broader margin pressure on MA bids. For consumers the headline premium is friendlier; for plans, MOOP-driven utilization caps now sit closer to the median benefit design and are likely to become a more prominent comparison point in AEP 2027.

medium2026-06-02

MA penetration growth flattened to +25 bps in 2025 after +181 bps in 2024

National MA penetration closed 2025 at 51.30%, up from 51.05% in January — a +25 basis-point gain that is roughly an eighth of the +181 bps jump 2024 delivered (50.52% Dec 2024 vs 48.91% Dec 2023). With MA now structurally above 50% of a 69.4M eligible base, marginal growth has shifted from Original-Medicare conversion to inter-plan share-taking, and the AEP effect is compressing: the Dec-to-Jan jump halved from +137 bps a year ago to +53 bps this AEP. Strategy implication: 2026 contract enrollment will be driven by competitive disenrollment more than market expansion, raising the value of crosswalk analysis and benefit-diff signal.

low2026-06-02

Miami-Dade sits at 75% MA penetration — one of the deepest markets in the country

Miami-Dade (FIPS 12086) carries a 75.1% MA penetration rate on 520.9K eligibles and 390.7K MA members — about 24 points above the national 51.3%. The top three contracts in the county by May 2026 enrollment all sit between 30K and 36K members and span UnitedHealth (H5420), CarePlus / Humana (H1036), and Humana (S4802 PDP). With penetration already this deep, share growth comes from cross-contract switching rather than from Original Medicare conversion; AEP execution and benefit-richness on plans like the H5471 and H1045 series are what move the needle here. This is a market where benefit-diff monitoring at the contract level is materially more useful than the national rollup.

low2026-06-02

4★+ plan share inches up to 55.3% of rated plans for CY 2026

The Overall Star Rating distribution moved modestly in CY 2026: 4★+ plans rose from 54.4% to 55.3% of rated plans, and average star edged from 3.82 to 3.86. The rated plan count fell from 4,741 to 4,614 because plans that terminated or are too new for ratings drop out of the denominator. Given the contemporaneous parent-org enrollment shifts, Humana's gain is more notable since its rating-eligible plan footprint moved without a headline rating uplift, while UCare's exit and Elevance's contraction released a non-trivial chunk of 4★+ membership that competitors absorbed without raising the national average dramatically.