AmFirst Holdings Grp Market Analysis: Market Share and Coverage by State

Payer Overview

AmFirst Holdings Grp operates as a modest national accident & health insurer positioned outside the largest national franchises. The company ranks as the #201 in US A&H market position and writes $71.6M in the US, representing a 0.01% US market share across 29 states. The organization reports an Estimated Total Members base of 10.7K and operates through 2 affiliated subsidiaries, which supports a footprint concentrated in select Southern and Midwestern markets.

While AmFirst Holdings Grp does not hold a #1 position in any state, its premium footprint is focused regionally rather than coast-to-coast. That concentration shapes contracting leverage: provider systems in states where the payer writes larger premium volumes will encounter its most significant negotiating influence, while national multi-state groups should expect limited commercial exposure outside those core states.

Premium by Scope

AmFirst Holdings Grp's premium is exclusively within the US States & DC scope according to the available data, with $71.6M reported in that category and no recorded premium in US territories or foreign jurisdictions. This concentration means providers negotiating with AmFirst Holdings Grp are engaging with a payer whose financial exposure is limited to the domestic state markets listed, increasing the relative importance of state-level contracting performance where the payer has premium. For multi-state providers, the payer represents targeted regional opportunity rather than a broad national contract counterparty.

AmFirst Holdings Grp's premium is concentrated in a limited set of Southern and Midwestern states, with $13.4M in Mississippi and multi-million dollar position in Missouri, Virginia, Texas, Louisiana, and Ohio. The national premium total of $71.6M is driven by these concentrated state positions, which creates localized contracting leverage in those markets. For provider networks, meaningful commercial exposure to this payer will be state-specific rather than uniform across the country.

The Affordable Care Act (ACA) established federally-facilitated health insurance marketplaces ("exchanges") where individuals and small businesses can shop for and enroll in health plans, often with income-based subsidies. Issuers that participate in these marketplaces are required to report enrollment, claims, and denial data to CMS (Centers for Medicare & Medicaid Services) each year.

The sections below cover this payer's ACA marketplace-specific footprint — enrollment, plan portfolio, and claims/denial-rate data. This is a narrower, separate population from the NAIC-based commercial data shown earlier on this page (total premium, market share, and membership across all lines of business): ACA marketplace enrollment is typically a small fraction of a payer's total commercial book, and the two datasets should not be treated as equivalent. CMS claims-transparency reporting has also been inconsistent industry-wide since 2020 — many issuers have little or no data for 2021 onward, so a single reporting year is common and does not necessarily indicate anything about the payer's current ACA presence.

Nationally, the largest age band among AMFIRST HOLDINGS GRP members is 6-18 (1.64K), followed by 55-64 (1.54K), 35-44 (1.52K), and 45-54 (1.50K). The <6 and >75 bands are the smallest, with 619 and 637 members respectively. This points to a membership base that is primarily composed of families and working-age adults, with a significant pre-retirement population.

Some states, such as Mississippi (2.11K) and Alabama (1.67K), have a notably higher concentration of members across all age bands, while states like Alaska (3) and Montana (7) have very few. States with larger member counts tend to have a more balanced age distribution, whereas smaller states may skew toward certain age bands due to their limited sample size.