Payer Overview

Carle Holding Co Grp Market Analysis: Market Share and Coverage by State

Carle Holding Co Grp is a regional health insurer focused on a concentrated set of states with localized contracting strength. Its footprint supports targeted negotiations with providers rather than broad national leverage.

Carle Holding Co GrpHealth InsuranceHealthcare MarketProvider ContractingReimbursementIllinoisWashingtonNorth CarolinaIowaIndiana

Payer Overview

Carle Holding Co Grp operates as a regional health insurer with a concentrated but meaningful national presence. The company ranks as the #74 largest US A&H payer and reports $1.98B in US premium, representing a 0.14% US market share across 5 states. The organization reports an Estimated Total Members figure of 289.4K and operates through 5 affiliated subsidiaries, shaping its underwriting and provider contracting approach.

The payer does not hold a #1 position in any US state. Carle Holding Co Grp's premium and membership are highly concentrated in the Midwest, with the largest single-state premium position in Illinois. This concentrated footprint and modest national ranking influence negotiation leverage with national provider groups while offering deeper local relationships in its core states.

Premium by Scope

Scope	Jurisdictions	Premium	Share of Payer Total
US States & DC	5	$1.98B	100.00%
Total	5	$1.98B	100.00%

Carle Holding Co Grp's premium footprint is exclusively within the US states and DC scope as reported. The payer writes $1.98B in US premium, representing the entirety of its reported premium across all scopes. For providers evaluating this payer, the absence of territory or foreign exposure means network negotiations and utilization patterns will be driven by US state dynamics only, with particular attention to the states where the insurer is active.

Subsidiary	Domicile
Firstcarolinacare Insurance Company Inc	NC
Health Alliance Connect Inc	IL
Health Alliance Medical Plans	IL
Health Alliance Midwest Inc	IL
Health Alliance Nw Health Plan	WA

Subsidiary

Domicile

Firstcarolinacare Insurance Company Inc

Health Alliance Connect Inc

Health Alliance Medical Plans

Health Alliance Midwest Inc

Health Alliance Nw Health Plan

State	Market Share	Premium Written	Estimated Members
IA	0.11%	$17.2M	2.59K
IL	2.72%	$1.72B	248.7K
IN	0.03%	$10.8M	1.73K
NC	0.2%	$97.1M	14.6K
WA	0.38%	$128M	21.7K

State

Market Share

Premium Written

Estimated Members

0.11%

$17.2M

2.59K

2.72%

$1.72B

248.7K

0.03%

$10.8M

1.73K

0.2%

$97.1M

14.6K

0.38%

$128M

21.7K

Age Band	Illinois	Washington	North Carolina	Iowa	Indiana	National Total
Under 6	14995	1308	828	159	107	17398
6–18	38970	3216	2125	425	289	45024
19–25	23269	1848	1382	269	177	26945

Age Band

Illinois

Washington

North Carolina

Iowa

Indiana

National Total

Under 6

14995

1308

828

159

107

17398

6–18

38970

3216

2125

425

289

45024

19–25

23269

1848

1382

269

177

26945

State-by-State Market Position

Carle Holding Co Grp's strongest presence is in the Midwest, anchored by Illinois where it writes $1.72B of premium. The payer's footprint outside the Midwest is modest, with Washington and North Carolina each representing secondary markets at $128M and $97.1M respectively. Iowa and Indiana are minor markets by comparison.

This geographic distribution means multi-state provider groups should prioritize Illinois for broader contracting impact and consider targeted arrangements in Washington and North Carolina to cover important regional networks. Smaller markets like Iowa and Indiana are likely to demand bespoke, localized contracting tactics rather than uniform national terms.

Estimated Members by State

CARLE HOLDING CO GRP's estimated member distribution is highly concentrated in Illinois, with 248,747 members—over 85% of the payer's national total. Washington follows with 21,683 members, North Carolina with 14,626, Iowa with 2,586, and Indiana with 1,734. This geographic concentration aligns with the payer's premium volume and market share, indicating Illinois as the primary market for both membership and revenue.

Despite presence in multiple states, the payer's member base outside Illinois is relatively modest. Washington and North Carolina contribute meaningful but much smaller populations, while Iowa and Indiana are minor markets. For providers, this means that contracting strategies and care delivery models should be tailored primarily to Illinois, with secondary focus on Washington and North Carolina. Multi-state provider groups will find the payer's footprint to be regionally concentrated rather than nationally dispersed, affecting negotiation leverage and care management approaches.

OpenPayer

Payer Overview

Carle Holding Co Grp Market Analysis: Market Share and Coverage by State

Payer Overview

Premium by Scope

National Market Presence

Estimated Member Demographics

State-by-State Market Position

Estimated Members by State